The impacts of choice in public services are controversial. This paper exploits a reform in the English National Health Service to assess the impact of relaxing constraints on patient choice. The results suggest that greater choice can enhance quality.
Benedict Clements, David Coady, Sanjeev Gupta24 June 2012
It is a daunting reality for many advanced economies that even if they manage to cut public spending today, they will continue to have huge liabilities as their populations age. This column argues that healthcare reform, no matter how politically unpalatable, will have to be a part of countries’ financial adjustment plans.
With public debt ratios soaring to levels unprecedented since the Second World War, fiscal adjustments are already underway and more will need to be done in many advanced economies (Buti and Pench 2012, Cottarelli 2012). In these economies, for example, an adjustment of an astonishing eight percentage points of GDP will be required, on average, between 2011 and 2020, and then sustained for a decade beyond that, to bring debt ratios to 60% of GDP (IMF 2012).