Health Earmarks and Health Taxes

Earmarking means taking all or a portion of total revenue from a tax or group of taxes and setting it aside or ‘protecting’ it for a designated expenditure purpose. Earmarking practices vary from ‘hard’ to ‘soft,’ and are associated with different levels of fiscal risk. At least 80, and likely more, countries earmark for health. However, earmarking is unlikely to bring a sustained net increase in revenue due to offsetting and can create rigidities and inefficiencies. If allocations fail to match priorities or if a tax can make the priority more politically acceptable, soft earmarks that are closer to standard budget processes may be useful in the short term. The primary intent of “health taxes” is to curb unhealthy behaviors that affect population health and can strain health systems. Health taxes can generate revenue without compromising equity, and their revenues can be earmarked, but they do not by design net more money for health. In the context of fiscal constraints (e.g., with COVID-19), heath taxes may provide an overall source of revenue for governments and help manage disease burden and fiscal pressure on the health system by reducing risk factors for COVID-19. Soft earmarks on health taxes may also help inject short-term funding into the health sector, if the appropriate public financial management safeguards are in place.

Bibliographic Details

Main Authors:	Ozer, Ceren, Bloom, Danielle, Martinez Valle, Adolfo, Banzon, Eduardo, Mandeville, Kate, Paul, Jeremias, Blecher, Evan, Sparkes, Susan, Chhabra, Sheena
Format:	Brief biblioteca
Language:	English
Published:	World Bank, Washington, DC 2020-12
Subjects:	HEALTH TAX EARMARKS, TAX REVENUE, PUBLIC HEALTH SERVICE, FISCAL TRENDS, TOBACCO TAX,
Online Access:	http://documents.worldbank.org/curated/en/415911607500858658/Health-Earmarks-and-Health-Taxes-What-Do-We-Know https://hdl.handle.net/10986/34947
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