The Fiscal Crisis of National Health Insurance in the Republic of Korea: In Search of a New Paradigm

In 2001, National Health Insurance (NHI) in Korea, the social insurance system for health care with universal population coverage, experienced a serious fiscal crisis as its accumulated surplus was depleted. This fiscal crisis is attributed to its chronic imbalance: health care expenditure has increased more rapidly than have insurance contributions. The recent failure in implementing pharmaceutical reform was a further blow to the deteriorating fiscal status of the NHI. Although the NHI has since recovered from the immediate fiscal crisis, this has mainly been because of a temporary increase in government subsidy into the NHI. The strong influence of the medical profession in health policy‐making remains a major barrier to the introduction of policy changes, such as a reform of the payment system to strengthen the fiscal foundations of the NHI. Korea also has to restructure its national health insurance in an era of very rapid population ageing. A new paradigm is called for in the governance of the NHI: to empower groups of consumers and payers in the policy and major decision‐making process of the NHI. The fiscal crisis in Korean national health insurance sheds light on the vulnerability of the social health insurance system to financial instability, the crucial role of provider payment schemes in health cost containment, the importance of governance in health policy, and the unintended burdens of health care reform on health care financing systems.     

On evaluating and extending the target zone proposal

This article examines the target zone proposal for exchange-rate management by presenting the results of simulations performed on both a large macroeconometric model and a small analytical model. The main conclusions derived from the large model are: (1) that exchange-rate-oriented monetary policy could have curbed misalignments without undermining counterinflation policy, but (2) a major impact on current balances would have required compensatory fiscal policy as well. The small model suggests the value of assigning world interest rates to the pursuit of a (flexible) world nominal income target and fiscal policy to national nominal income targets, if interest rate differentials are assigned to exchange-rate management.     

Monetary policy in the New-Keynesian model: An application to the Euro Area

This paper analyzes monetary policy in a stylized New-Keynesian model. A number of issues are focused upon: (i) optimal monetary policy under commitment or discretion versus ad-hoc monetary policy based on simple rules, (ii) the effects of fiscal policies and foreign variables on monetary policy, (iii) the effects of fiscal deficit and interest rate smoothing objectives and the role of forward-backward linkages in the model. The model is estimated for the Euro Area. Using simulations of the estimated model, it is analyzed how these aspects might affect monetary policy of the ECB and macroeconomic fluctuations in the Euro Area.     

Revisiting History: The Creation of Provinces and the Politics of Social Policy in a Democratic South Africa

The pre‐democracy negotiations between the African National Congress (ANC) and the National Party (NP) established nine provincial forms of government to replace the four provinces of the apartheid era. The nine provinces contrasted with the historical goal of the ANC to create a ‘democratic, non‐racial and unitary South Africa’. The NP wanted nine new provinces to prevent centralized state power under an ANC government and saw possibilities for winning electoral power in the Western Cape. The ANC conceded following political pressure from the Inkatha Freedom Party, which threatened civil war, and a policy shift after examining the German federal governance system. The article analyzes the history, politics, process and outcomes of the establishment of the nine provinces for social policy delivery in South Africa. It explores the contention that the nine provinces re‐fragmented service delivery (although not on a statutory racial basis) and created a system of fiscal decentralization with serious implications for social policy: weakening bureaucratic capacity, institutional capability and political accountability. The provincial governance mechanisms and fiscal institutions created a particular ‘path dependency’ which, 18 years after democratic, rule still impacts negatively on service delivery and more equitable policy outcomes. This is in part due to the undermining of provincial governance mechanisms and fiscal institutions by a significant minority of corrupt and incompetent provincial civil servants. The corruption of these provincial governance mechanisms and fiscal institutions erodes the egalitarian values aimed at creating a non‐racial, non‐sexist, democratic and unitary South Africa which historically underpinned the policy agenda of the ANC. It also has weakened social citizenship on a geographical and ultimately racial basis given the continuing co‐incidence of race and place in a democratic South Africa.     

The impact of fiscal shocks on real GDP and income inequality: What do Australian data say?

This paper examines the impact of three fiscal policy shocks on per capita real GDP and income inequality in Australia during the period 1965–2014. A small structural vector autoregressive (SVAR) model is constructed for an open economy for contemporaneous identification and estimation purposes. Based on the evidence of one cointegrating vector among the variables, a structural vector error correction (SVEC) model is specified for the long run. Direct taxation, indirect taxation receipts and government spending are identified as permanent fiscal policy shocks. The convergent use of two different models (SVAR & SVEC) strengthens the credibility of the results. The results have three key policy implications. First, a reduction in direct taxation receipts increases per capita real GDP without increasing income inequality. Second, a reduction in government expenditure significantly increases income inequality. Third, the adverse effect of indirect taxation receipts on income inequality is greater than the redistributive effect of government expenditure, which questions the widely held fiscal policy strategy of using indirect taxation to finance redistributive expenditure.     

Breaking the Stability Pact: Was it predictable?

We show analytically that the credibility problem which has affected the European Stability Pact originates from the insufficient distinction between two reasons for having binding fiscal constraints. The first reason deals with the governments’ tendency to neglect the effects of their fiscal policy on foreign governments (fiscal free-riding). The second reason follows from the governments’ tendency to raise debt by lowering taxes or increasing expenditures, and then to leave it to their successors (fiscal short-termism). An enforcement mechanism relying on governments’ collusion works if the fiscal constraints are not calibrated for curing fiscal short-termism but only for preventing fiscal free-riding.     

Fiscal Policy and Urban and Rural Residents＇ Marginal Propensity to Consume

基于代表性家庭最优消费决策及其与财政政策的关系,估计中国财政政策对城乡居民边际消费倾向的影响,结果表明,自1998年至今,城乡居民边际消费倾向的下降幅度超过20％。城乡居民边际消费倾向下降,．除源于收入分配、经济发展程度、预期、消费结构等因素的影响外,与财政政策运用也有很大关系。其中,未预期到的财政政策冲击对居民边际消费倾向产生的综合效应显著为负。以未预期到的税收增加为融资工具的策略选择,大大抑制了结构调整的正面效应。因此,扩大居民消费,不仅要通过财政增收,提高居民消费能力,而且要通过调整财政收支策略,稳定居民消费预期,提升居民边际消费倾向。     

Fiscal deficits under financial pressure and insolvency: Evidence for Italy,Greece and Spain

This article attempts to re-evaluate the sustainability of the fiscal deficit as well as the long-run macroeconomic relationship between government spending and revenues for three South-European economies under financial market pressure and insolvency; Italy, Greece and Spain. The empirical analysis uses annual data from 1970 to 2010 and employs various cointegration techniques to account for possible linear and nonlinear effects in fiscal policy actions. The evidence for all three countries suggests that, allowing for structural break, (i) the fiscal deficits are weakly sustainable in the long-run, (ii) the spend-and-tax hypothesis is supported and (iii) the budgetary adjustment process is asymmetric in Italy and Spain.     

Are government wages interlinked with private sector wages?

The ongoing fiscal and financial crisis with significant macroeconomic imbalances in the euro area raises the question in how far public–private wage interaction and even wage spirals contribute to fiscal and competitiveness problems. In this vain we analyse empirically whether the evolution of public sector wages is decoupled from that of the private sector. Using data for number of OECD countries, we find: (i) a strong and extremely robust positive annual contemporaneous correlation of public and private sector wages over the business cycle; (ii) evidence of co-movement of these variables over the medium and long run. From a policy perspective, the findings of this study suggest public wage restraint and private wage flexibility coupled—where needed—with institutional reform to prevent or break public–private wage spirals.     

Financial Crisis and Sustainability of US Fiscal Deficit: Indicators or Tests?

Whether or not budgetary policies are sustainable and can be conducted without creating the potential for government bankruptcy is a central question for macroeconomic analysis. In this paper, we show that indicators and tests to assess government solvency should not be used alternatively. We lay out a simple and intuitive procedure to integrate simultaneously the results from the two approaches to fiscal sustainability. Indicators are forward looking, for they are based on published forecasts, thus reacting to a set of current and expected future conditions in fiscal-policy making. Tests, by contrast, are backward looking, for they are based on a sample of past data. In the event of conflicting results, indicators may signal the occurrence of a structural change in policy, which may reverse the predictions of tests. Whether the results from indicators or from tests should be given priority in the assessment of the sustainability of public debt will thus depend on the structural stability of the historical data generating process of the primary surplus. Only in the absence of a structural break in the stance of fiscal policy, the potential warning predictions of fiscal indicators should be interpreted as merely reflecting transitory factors to be eventually reversed. An application to U.S. post-World War II historical data, from 1948 to 2016, and forecasts, from 2017 to 2027, demonstrates the empirical relevance of the proposed comprehensive approach and helps add new insights to the evaluation of the U.S. fiscal position. In particular, our results suggest that the potentially unsustainable course of U.S. fiscal policy from 2008 onwards, advocated by the use of fiscal indicators, reflects systematic—not cyclical—factors. The main policy implication is that deficit increases in the U.S. from 2008 onwards cannot be regarded as a transitory phenomenon and hence do entail an urgent need for a structural change in the future stance of budgetary policy.     

Fiscal harmonization in view of the Euro adoption: Economic implications for Poland

In this paper, we investigate the ex ante effects of fiscal policy harmonization that might be necessary for the adoption of the common currency on economic growth in Poland using a neoclassical dynamic two-sector general equilibrium model. We study two fiscal policy scenarios. In the first one, we adjust all taxes to German and EU-27 levels, respectively, while in the second one, we change only consumption taxes to German and EU-27 levels. We find that in the first scenario, the current Polish taxes yield the highest rate of growth due to lower capital taxation. However, in the second scenario, German and EU-27 taxes yield the highest rate of growth due to the lower consumption tax on capital-intensive good. From a policy perspective, our results suggest that fiscal policy with lower taxes on capital and capital-intensive goods can generate a higher rate of growth in the long-run. In the case of fiscal harmonization, our findings propose adopting only German or EU-27 consumption tax structure into the Polish tax system.     

The Ageing of Australia: Fiscal Sustainability,Intergenerational Equity and Inter‐temporal Fiscal Balance

Australian public policy makers are presently confronted with significant demographic changes that will profoundly affect the formulation of rational economic and social policy over the long term. This paper seeks to outline the potential impact of this demographic change and place it in historical perspective. The challenges posed by an ageing population for fiscal policy are explored and it is stressed that policy inertia will invite severe costs in future. It is argued that an appropriate policy stance should be developed in the context of a framework for inter‐temporal fiscal balance not only to focus on long‐run fiscal sustainability, but also to include considerations of intergenerational equity.     

Output-volatility reducing effects of automatic stabilizers: Policy implications for EMU member states

In this paper, we empirically explore the output-volatility reducing impact of automatic stabilizers and look in detail at their policy implications for selected EMU member states comprising Austria, Finland, France, Germany, Ireland, Italy, the Netherlands, Portugal, and Spain for the period 1995–2017. Overall, the results suggest that automatic stabilizers deliver a statistically significant, but fairly weak, counter-effect on output volatility in the short run. More specifically, output-volatility responses to automatic stabilizers by a reduction between −0.012 and −0.097 percentage points depending on the proxy measure used for automatic stabilizers. However, the automatic stabilizing impact from taxes and government spending is statistically insignificant in the long run. The results point to two main policy implications: i) automatic stabilizers are an important fiscal mechanism just for the short-run output stabilization, but their output-volatility offsetting role and power are largely subject to proxy measures used for automatic stabilizers; ii) no matter what proxy measures are used, automatic stabilizers largely produce a weak stabilizing performance in dampening short-term output volatility. So, from a macroeconomic policy standpoint, it can be safely claimed that automatic stabilizers can just be an integral part of discretionary fiscal policy rather than being an alternative to it.     

Spillover effects of taxes on government debt: a spatial panel approach

It is claimed that tax policy is neither time- nor space-independent due to cross-border tax base mobility, which induces spillovers. Specifically, fiscal shocks in one country are supposed to have an impact on fiscal policies in other countries. Different types of taxes influence economies differently. This paper addresses the question of their impact on government debt. Within a framework of spatial econometric modeling, we evaluate the impact of capital, labor and consumption taxes on public debt in 34 European countries in 2002–2011, and find strong spatial spillovers. We show that a consumption tax and, to a lesser degree, a capital tax significantly affect the sovereign debt, and that the global relations play a leading role (i.e. dominate the local ones) in shaping fiscal policy.     

The effect of the rescue plans and the need for policies to increase economic growth

This paper evaluates the economic impact of discretionary fiscal and monetary actions taken in the United States during 2020 and 2021. The fiscal actions are The Coronavirus Aid, Relief, and Economic Security Act, or the “CARES” Act, passed in March 2020; The Consolidated Appropriations Act, passed in December 2020; and The American Rescue Plan Act, passed in March 2021. The paper focuses on the impact of the “economic impact payments” that underlie these fiscal actions. The paper also examines discretionary monetary policy actions taken during the same period. The overall implication is that there is a need to return to policies that increase economic growth and stability, including rules-based fiscal and monetary policy, rather than to continue with these one-time discretionary actions.     

积极财政政策的理论来源及政策走向

凯恩斯的需求管理经济学理论是我国积极财政政策的理论来源,但不能把我国积极的财政政策简单等同于西方短期反周期调节的扩张性财政政策。继续实施积极财政政策要在政策的力度、作用方向、运作方式和政策手段上进行适当调整,为逐步退出做准备。     

关于实施结构性减税政策若干问题的分析

2011年中央经济工作会议提出,2012年我国要继续实施积极的财政政策。结构性减税政策在积极的财政政策中具有重要的地位和作用。近年来,我国实施的结构性减税政策具有多税种并用、多手段并举、多环节并促的特点,这一政策在减轻企业和居民税收负担、鼓励和扩大内需、引导经济结构战略性调整、保障和改善民生等方面产生了积极效应。从动态上看,减税政策对经济的刺激作用在一定程度上增强了经济活力,培育了新的税源,为国家继续实施积极的财政政策提供了可靠的财力保障。     

Policy simulations with a macroeconometric model of the Indian economy

In this paper, the results of various dynamic policy simulations are analyzed within the context of a macroeconometric model of the Indian economy. The model contains 35 equations and offers a consistent framework for policy analysis. It is considerably expanded on the side of the fiscal sector and usefully incorporates the interdependence between monetary and fiscal sectors and gives due attention to supply side considerations. Magnitudes of effects of sustained policy changes are analyzed for the period 1964–1965 to 1974–1975. Impact multipliers and elasticities are also analyzed. Government expenditures variables and deficit financing are shown to have substantial impact on the system whereas changes in tax-rates, discount-rates, and liquidity ratios for commercial banks are shown to have only a marginal impact. The model is used for exploring the growth potential of the economy in a forecast period of five years under alternative assumptions regarding policy options.     

Reserve financing and government infrastructure investment: An application to China

This paper proposes a novel financing scheme, reserve financing, for government infrastructure investment in China. A two-sector open economy model explores the consequences and policy implications of a surge in infrastructure investment financed by international reserves. The results show that reserve financing, coupled with a managed float exchange rate system, can maintain the country's fast growth rate while mitigating fiscal pressure on local governments. Productive infrastructure capital stimulates domestic demand, reducing the country's dependence on exports. To promote growth and maintain price stability, three factors are critical: return on infrastructure, swift fiscal adjustment, and rapid infrastructure financing.