The global financial crisis brought to the fore the question of sustainability of public finances. But it merely exacerbated a situation that was bound to attract attention sooner or later—governments all over the world have been spending more and more in recent decades. Here at the IMF, we’ve been looking into the factors behind this increase in public spending, particularly social spending, and our latest Fiscal Monitor report discusses some of the options for spending reform.
As the world economy continues to struggle, people are taking to the streets by the thousands to protest painful cuts in public spending designed to reduce government debt and deficits. This fiscal fury is understandable. People want to regain the confidence they once had about the future when the economy was booming and more of us had jobs. But after a protracted economic crisis, this will take planning, fair burden-sharing, and time itself.
Health care reform is tricky. On the one hand, providing access to affordable health care is of paramount importance. But spending on health care is putting enormous pressure on public purses all over the world, and it’s only getting worse. How can we fix this? How can governments keep their health care promises to citizens without busting the budget? Despite the obvious differences, advanced and emerging markets share something very basic in common—they all need to get “more bang for their buck” when it comes to public health care spending.