Earmarked Health Taxes as a Tool for Expanding the Fiscal Space for Health Care
Keywords:
earmarked health taxes, health financing, budget revenues, fiscal space, fiscal policy, sugar-sweetened beverages taxes.
Abstract
The article explores the prospects of introducing earmarked health taxes as a mechanism for expanding of the fiscal space for health care financing. It was determined that in the conditions of martial law in Ukraine and the increase in the debt burden on the budget, there is a need to use new fiscal mechanisms that will increase budget revenue. One new fiscal mechanism could be the use of earmarked health taxes.
An analysis of the global best practice of earmarked health taxes was carried out. Earmarked health taxes items typically are goods that have a negative public health impact, such as alcohol, tobacco, sugar-sweetened beverages, salt, fat content, fast food, etc. The peculiarities and foreign experience of applying sugar-sweetened beverages taxes, as well as their rates, tax base and instrument, are considered in detail. It was determined that earmarked health taxes were implemented not only in countries with a high level of economic development, but also in conflict-affected countries.
Attention is focused on the need to apply the principles earmarking for reservation of tax revenues for health care financing in order to ensure transparency and establish a clear relationship between the amount of tax revenues from earmarked health taxes and budget expenditures for health care financing. The potential challenges of the implementation of earmarked health taxes for the fiscal sustainability are identified. Measures to improve the development, substantiation and forecasting of the principles of implementation of earmarked health taxes are proposed.
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References
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2. Witter, S., Bertone, M., Dale, E., & Jowett, M. (2020). Health financing in fragile and conflict-affected situations: a review of the evidence. Health Financing Working Paper, 13. Geneva: World Health Organization. Retrieved from https://iris.who.int/bitstream/handle/10665/331658/9789240003491-eng.pdf?sequence=1
3. Affun-Adegbulu C., Ricarte, B., Van Belle, S., Van Damme, W., Van De Pas, R., & Van De Put, W., (2017). Contexts and Crises. Evidence on Coordination and Health Systems Strengthening (HSS) in Countries under Stress: a literature review and some reflections on the findings. Final Report. www.uhc2030.org. Retrieved from https://www.uhc2030.org/fileadmin/uploads/uhc2030/1_Who_we_are/1.3_Governance/UHC2030_Working_Groups/2017_Fragility_working_groups_docs/ITM_-_Final_Report__v7_.pdf
4. Debarre, A. (2018). Hard to Reach: Providing Healthcare in Armed Conflict. www.ipinst.org. Retrieved from https://www.ipinst.org/wp-content/uploads/2018/12/1812_Hard-to-Reach.pdf
5. Фінансування державного бюджету України з початку повномасштабної війни (2023). www.mof.gov.ua. Retrieved November 27, 2023 from https://www.mof.gov.ua/uk/news/ukraines_state_budget_financing_since_the_beginning_of_the_full-scale_war-3435 [in Ukrainian]. (Дата звернення 27.11.2023).
6. Ozer, C., & Bloom, D., Martinez Valle, A., Banzon, E., Mandeville, K., Paul, J., & et al. (2020). Health earmarks and health taxes: what do we know? The Health, Nutrition and Population Global Practice. Knowledge Brief. documents1.worldbank.org. Retrieved from https://documents1.worldbank.org/curated/en/415911607500858658/pdf/Health-Earmarks-and-Health-Taxes-What-Do-We-Know.pdf
7. Allcott, H., Lockwood, B. & Taubinsky, D. (2023). Sin Taxes: Good, Better, Best. NBER Reporter, 1, 22–26. Retrieved from https://live-nber.pantheonsite.io/sites/default/files/2023-03/2023number1.pdf
8. Diet high in sugar-sweetened beverages – Level 3 risk. Global Health Metrics. (2020). The Lancet, 396, S286–S287. Retrieved from https://www.thelancet.com/pb-assets/Lancet/gbd/summaries/risks/diet-sweetened-beverages.pdf
9. Health Taxes to Save Lives. Employing Effective Excise Taxes on Tobacco, Alcohol, and Sugary Beverages. (2019). The Task Force on Fiscal Policy for Health. assets.bbhub.io. Retrieved from https://assets.bbhub.io/dotorg/sites/64/2020/12/Health-Taxes-to-Save-Lives.pdf
10. Bloom, D., Cafiero, E., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L. R., Fathima, S., & et al. (2011). The Global Economic Burden of Non-communicable Diseases. Retrieved from https://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf
11. WHO technical manual on tobacco tax policy and administration. (2021). World Health Organization. iris.who.int. Retrieved from https://iris.who.int/bitstream/handle/10665/340659/9789240019188-eng.pdf?sequence=1
12. Kiesel, K., Lang, H., & Sexton, R. A. (2023). New Wave of Sugar-Sweetened Beverage Taxes: Are They Meeting Policy Goals and Can We Do Better? Annual Review of Resource Economics, 15, 1, 407–432. Retrieved from http://dx.doi.org/10.1146/annurev-resource-111522-111325
13. Ghebreyesus, T., & Clark, H. (2023). Health taxes for healthier lives: an opportunity for all governments. BMJ Global Health, 8:e013761. doi: 10.1136/bmjgh-2023-013761
14. Sin Tax: Definition, How It Works and Examples. (2023). www.freshbooks.com. Retrieved from https://www.freshbooks.com/glossary/tax/sin-tax
15. Annual Report on Taxation 2023. (2023). Review of Taxation Policies in EU Member States. Luxembourg: Publications Office of the European Union. Retrieved from https://taxation-customs.ec.europa.eu/system/files/2023-08/ART%20-%20Report%202023_Digital%20Version_1.pdf
16. Cashin, Ch., Sparkes, S., & Bloom, D. (2017). Earmarking for health: from theory to practice. Health Financing Working Paper, 5. Retrieved from https://iris.who.int/handle/10665/255004
17. Colin, C., Melo, G., & Brys, B. (2023). The place for health taxes in the wider fiscal system. Health taxes: Policy and Practice. Lauer J. A., Sassi, F., Soucat, A., Vigo, & A. (Eds.) (Chapter 2, pp. 23–55). Retrieved from https://doi.org/10.1142/9781800612396_0002
18. SSB Taxes at a glance. (2023). World Bank Group. Global SSB Tax Database. datacatalog.worldbank.org. Retrieved November 27, 2023 from https://datacatalog.worldbank.org/search/dataset/0063310
19. Global report on the use of sugar-sweetened beverage taxes. (2023). Geneva: World Health Organization. iris.who.int. Retrieved from https://iris.who.int/bitstream/handle/10665/374530/9789240084995-eng.pdf?sequence=1
20. Rethink Your Drink. Centers for Disease Control and Prevention. Retrieved November 27, 2023 from https://www.cdc.gov/healthyweight/healthy_eating/drinks.html
21. Sugar-sweetened beverages (SSBs) taxation. (2012). World Health Organization. Global database on the Implementation of Nutrition Action. extranet.who.int. Retrieved from https://extranet.who.int/nutrition/gina/es/summary/SSB_taxes
22. Hattersley, L., & Mandeville, K. L. (2023). Global Coverage and Design of Sugar-Sweetened Beverage Taxes. JAMA Network Open, 6 (3):e231412. doi: 10.1001/jamanetworkopen.2023.1412
23. Sarda, B., & Debras, C., Eloi Chazelas, E., Péneau, S., Le Bodo, Ya., Hercberg, S., & et al. (2022). Public perception of the tax on sweetened beverages in France. Public Health Nutrition, 25 (11), 3240–3251. doi: 10.1017/S1368980022001665
24. BAREME – TCA – Barème des contributions sur les boissons non alcooliques. (2023). bofip.impots.gouv.fr. Retrieved from https://bofip.impots.gouv.fr/bofip/11575-PGP.html/identifiant%3DBOI-BAREME-000038-20221207 [in French].
25. TCA – Contribution sur les boissons non alcooliques – Contributions sur les boissons non alcooliques contenant des sucres ajoutés. (2019). Retrieved November 27, 2023 from https://bofip.impots.gouv.fr/bofip/11674-PGP.html/identifiant=BOI-TCA-BNA-10-20191230 [in French].
26. Soft Drinks Industry Levy statistics background and references. Knowledge, Analysis and Intelligence. (2023). www.gov.uk. https://www.gov.uk/government/statistics/soft-drinks-industry-levy-statistics/soft-drinks-industry-levy-statistics-background-and-references#:~:text=Following%20public%20consultation%20with%20industry,sizes%20for%20high%20sugar%20drinks
27. Sasse, T., & Metcalfe, S. (2022). Sugar tax. Institute for Government. Retrieved from https://www.instituteforgovernment.org.uk/article/explainer/sugar-tax#:~:text=The%20soft%20drinks%20industry%20levy,soft%20drinks%20containing%20added%20sugar
28. Soft Drinks Industry Levy statistics commentary 2023. Headline statistics. (2023). HM Revenue and Customs. www.gov.uk. Retrieved from https://www.gov.uk/government/statistics/soft-drinks-industry-levy-statistics/soft-drinks-industry-levy-statistics-commentary-2021
29. List of Fragile and Conflict-affected Situations. (2023). World Bank Group. Retrieved from https://thedocs.worldbank.org/en/doc/69b1d088e3c48ebe2cdf451e30284f04-0090082022/original/FCSList-FY23.pdf
30. Pro vnesennia zmin do Podatkovoho kodeksu Ukrainy shchodo zaprovadzhennia aktsyznoho podatku na vody, vkliuchaiuchy mineralni ta hazovani, z dodanniam tsukru chy inshykh pidsolodzhuvalnykh abo aromatychnykh rechovyn: Proiekt Zakonu vid 06.03.2023 r. № 9032-1 [On Amendments to the Tax Code of Ukraine on the introduction of an excise tax on waters, including mineral and carbonated waters, with the addition of sugar or other sweetening or flavoring substances. Draft Law of Ukraine of March 06, 2023 No. 9032-1]. w1.c1.rada.gov.ua. Retrieved from https://w1.c1.rada.gov.ua/pls/zweb2/webproc4_1?pf3511=75717 [in Ukrainian].
31. Pro vnesennia zmin do Biudzhetnoho kodeksu Ukrainy u zviazku iz zaprovadzhenniam aktsyznoho podatku na vody, vkliuchaiuchy mineralni ta hazovani, z dodanniam tsukru chy inshykh pidsolodzhuvalnykh abo aromatychnykh rechovyn: Proiekt Zakonu Ukrainy vid 06.03.2023 r. № 9033-1 [On amendments to the Budget Code of Ukraine in connection with the introduction of an excise tax on waters, including mineral and carbonated waters, with the addition of sugar or other sweetening or flavoring substances. Draft Law of Ukraine of March 06, 2023 No. 9033-1]. w1.c1.rada.gov.ua. Retrieved from https://w1.c1.rada.gov.ua/pls/zweb2/webproc4_1?id=&pf3511=75718 [in Ukrainian].
32. Ekspertnyi vysnovok Ministerstva finansiv Ukrainy do zakonoproiektu zhidno zi statteiu 27 Biudzhetnoho kodeksu Ukrainy [Expert opinion of the Ministry of Finance of Ukraine on the draft law in accordance with Article 27 of the Budget Code of Ukraine]. (2023). www.kmu.gov.ua. Retrieved from https://www.kmu.gov.ua/storage/app/bills_documents/document-3274767.pdf [in Ukrainian].
33. Pro vnesennia zmin do Podatkovoho kodeksu Ukrainy shchodo zaprovadzhennia stavok aktsyznoho zboru na enerhetychni napoi: Proiekt Zakonu Ukrainy vid 24.04.2015 p. № 2740 [On amendments to the Tax Code of Ukraine regarding the introduction of excise tax rates on energy products: Draft Law of Ukraine of April 24, 2015 No. 2740]. w1.c1.rada.gov.ua. Retrieved from https://w1.c1.rada.gov.ua/pls/zweb2/webproc4_1?pf3511=54945 [in Ukrainian].
34. CRP.21 Health Taxes Chapter 4. General Issues in Designing Health Taxes. (2023). Committee of Experts on International Cooperation in Tax Matters. Twenty-sixth session. financing.desa.un.org. Retrieved from https://financing.desa.un.org/document/crp21-health-taxes-chapter-4-general-issues-designing-health-taxes-0
35. Lyons, C. (2023). Sugar-sweetened beverage taxes: a health policy analysis. The American Journal of Healthcare Strategy. DOI: 10.61449/ajhcs.2023.11
36. Lane, C., Glassman, A., & Smitham, E. (2021). Using Health Taxes to Support Revenue: An Action Agenda for the IMF and World Bank. Center for Global Development. Policy Papers, 203. Retrieved from https://www.cgdev.org/sites/default/files/Lane-Health-Tax-COVID-19.pdf
37. Beebe, J. (2019). Should There Be a Soda Tax? Report. Rice University’s Baker Institute for Public Policy. Center for Public Finance. www.bakerinstitute.org. Retrieved from https://doi.org/10.25613/zhsg-4e56
Abstract views: 86 PDF Downloads: 58
Published
2023-12-30
How to Cite
STEPANOVA, O. (2023). Earmarked Health Taxes as a Tool for Expanding the Fiscal Space for Health Care. Scientific Bulletin of the National Academy of Statistics, Accounting and Audit, (3-4), 58-69. https://doi.org/10.31767/nasoa.3-4-2023.05
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