Performance of long-term care systems in Europe. ENEPRI Policy Brief No. 13, December 2012

The evaluation of long-term care (LTC) systems carried out in Work Package 7 of the ANCIEN project shows which performance criteria are important and – based on the available information – how European countries score on those criteria. This paper summarises the results and discusses the policy implications. An overall evaluation was carried out for four representative countries: Germany, the Netherlands, Spain and Poland. Of the four countries, the Dutch system has the highest scores on quality of life of LTC users, quality of care and equity of the LTC system, and it performs the secondbest after Poland in terms of the total burden of care (consisting of the financial burden and the burden of informal caregiving). The German system has somewhat lower scores than the Dutch on all four dimensions. The Polish system excels in having a low total burden of care, but it scores the lowest on quality of care and equity. The Spanish system has few extreme scores. Some important lessons are the following. The performance of a LTC system is a complex concept where many dimensions have to be included. Specifically, the impact of informal caregiving on the caregivers and on society should not be forgotten. The role of the state in funding and organising LTC versus individual responsibilities is one of the most important differences among countries. Choices concerning private funding and the role of informal care have a large effect not only on the public expenditures but also on the fairness of the system. International research into the relative preferences for the different performance criteria could produce a sound basis for the weights used in the overall evaluation.

Growth, migration and unemployment across Swedish municipalities

Fundamental questions in economics are why some regions are richer than others, why their economic growth rates vary, whether their growth tends to converge and the key factors that contribute to the variations. These questions have not yet been fully addressed, but changes in the local tax base are clearly influenced by the average income growth rate, net migration rate, and changes in unemployment rates. Thus, the main aim of this paper is to explore in depth the interactive effects of these factors (and local policy variables) in Swedish municipalities, by estimating a proposed three-equation system. Our main finding is that increases in local public expenditures and income taxes have negative effects on subsequent local income growth. In addition, our results support the conditional convergence hypothesis, i.e. that average income tends to grow more rapidly in relatively poor local jurisdictions than in initially “richer” jurisdictions, conditional on the other explanatory variables.

Sustained growth, government expenditure and inflation

We construct and simulate a theoretical model in order to explain particular historical experiences in which inflation acceleration apparently helped to spur a period of economic growth. Government financed expenditures affect positively the produtivity growth in this model so that the distortionary effect of inflation tax is compensated by the productive effect of public expenditures. We show that for some interval of money creation rates there is an equilibrium where money is valued and where steady state physica1 capital grows with inflation. It is a1so shown that zero inflation and growth maximization are never the optimal policies.

A note on growth and inflation

A simple exercise on growth and inflationary financing of public expenditures is presented in this note. In a parameterized overlapping generations mode1 where government expenses positivc1y affects the growth rate of human capital, steady state capital and output increase with inflation, reproducing the so called Tobin effect. For large inflation rates, however, government authorities cannot affect real variables and there are only nominal effects. It is also shown that the optimal policy implies some inflation but not growth maximization.

Transparência, a resposta institucional à pressão social: o caso do Tribunal de Contas do Estado do Rio de Janeiro

The present work aims to identify emerging organizational changes in the Court of Accounts of the State of Rio de Janeiro - TCE/RJ that are happening in the contemporary scenery known as the Age of Information. The search for the comprehension of the institutional dynamics is oriented by concepts originated from the theory of complexity, which believe that the public services external control system can be understood in a political, technical and legal environment with growing levels of learning and innovation. While chasing the possible causes of these changes, we try to prove the hypothesis that the TCE/RJ is turning into a more transparent organization. For this purpose, we define the outlines and reaches of the principle of transparency, based in bibliographical and documental researches, and analyze the phenomenon perceived in a explanation research through semi-structured interviews performed with two groups: a sample representing the universe under jurisdiction entities top level directors and the other obtained in the universe of formal and informal leaderships existing in the educational body of the institution. The conclusion of the present work confirms the initial questions, indicating that the organization is really becoming more and more transparent. The social-technical changes that are happening today at the TCE/RJ are caused by the growing social pressure for more effective results in the control of public expenditures. Under the systemic point of view, we observe cracks in the protective bell-glass that evolves the institution - previously hermetic to the external contingencies and that works today as a SAC - Adaptive Complex System. Aspects such as organization structural changes, the introduction of strategic planning and the growing democratization of the decision process are producing a new organizational culture. The seniority of the Technical Headcount contributes to establish the pre-conditions for the development of a administration where the participation of the TCE/RJ technical employees adds importance to its development as an institution that generates republican effects in the society from its less hermetic decision process.

Government policy and private investment in Brazil (1955/82)

The questlon of the crowding-out of private !nvestment by public expenditure, public investment in particular , ln the Brazilian economy has been discussed more in ideological terrns than on empirical grounds. The present paper tries to avoid the limitation of previous studies by estlmatlng an equation for private investment whlch makes it possible to evaluate the effect of economic policies on prlvate investment. The private lnvestment equation was deduced modifylng the optimal flexible accelerator medel (OFAM) incorporating some channels through which public expendlture influences privateinvestment. The OFAM consists in adding adjustment costs to the neoclassical theory of investrnent. The investment fuction deduced is quite general and has the following explanatory variables: relative prices (user cost of capitaljimput prices ratios), real interest rates, real product, public expenditures and lagged private stock of capital. The model was estimated for private manufacturing industry data. The procedure adopted in estimating the model was to begin with a model as general as possible and apply restrictions to the model ' s parameters and test their statistical significance. A complete diagnostic testing was also made in order to test the stability of estirnated equations. This procedure avoids ' the shortcomings of estimating a model with a apriori restrictions on its parameters , which may lead to model misspecification. The main findings of the present study were: the increase in public expenditure, at least in the long run, has in general a positive expectation effect on private investment greater than its crowding-out effect on priva te investment owing to the simultaneous rise in interst rates; a change in economlc policy, such as that one of Geisel administration, may have an important effect on private lnvestment; and reI ative prices are relevant in determining the leveI of desired stock of capital and private investrnent.

Três ensaios sobre o gasto local no Brasil: descentralização, eficiência e voto

Partindo de uma avaliação sobre o contexto mundial de descentralização fiscal e de democratização em que o Brasil se encontrava no final do século XX, essa tese apresenta na primeira parte uma análise empírica para países em desenvolvimento evidenciando o condicionamento do tipo de regime de governo na relação entre descentralização fiscal e tamanho de governo. Estimações por system-GMM para países em desenvolvimento mostram que existe um nível de descentralização fiscal, entre 20% e 30%, que uma vez superado, resulta em democracias com tamanhos de governos menores do que as ditaduras. Esses resultado, que chama a atenção tanto para os governos locais, como para a influência da democracia no gasto público, estimulou a continuação da pesquisa na avaliação da eficiência dos gastos municipais no Brasil e sua relação com o voto. Assim, no segundo ensaio, são calculados indicadores de evolução da eficiência e da produtividade do gasto municipal (fatores de Malmquist) entre 2004 e 2008, para as áreas da saúde e educação. Os resultados da análise por fronteira estocástica mostram que tanto na educação, como na saúde, houve avanços na fronteira de produção (TFPC, em média, de 18.7%, na educação e de 14.2% na saúde) por avanços de mudança técnica (Technical Change - TC), ao invés de elevação da eficiência (Technical Efficiency Change – TEC). No último ensaio, os indicadores de eficiência e de produtividade são usados para testar a hipótese de que o eleitor municipal premia com o voto os prefeitos que melhoraram a eficiência do gasto da educação e/ou saúde em sua gestão. Os resultados não rejeitam a hipótese para a educação, mas rejeitam para a saúde. A fim de tratar prováveis erros de medida das variáveis de produtividade, as estimações são instrumentalizadas em regressões por dois estágios.

A participação do poder legislativo na definição das metas e prioridades do orçamento publico federal no periodo 1990/95

A elaboração do orçamento público é uma das mais importantes atribuições do Poder Legislativo nos países de regime democrático, não obstante a iniciativa das leis orçamentárias tenha se transferido para o Executivo. Atualmente, os papéis desempenhados pelos Poderes Executivo e Legislativo na elaboração do orçamento estão definidos nas constituições, onde se observa uma tendência ao equilíbrio entre os dois Poderes. A história do orçamento está intimamente associada ao poderio crescente dos parlamentos que passaram a reivindicar o direito de autorizar as receitas e dispor sobre as despesas públicas. O orçamento, introduzido primeiramente na Inglaterra, como um instrumento de controle político do Parlamento sobre a Coroa, e adotado pelos franceses e norte-americanos em suas lutas por liberdade, aos poucos, foi sendo utilizado pela maioria das nações. No Brasil, tomando-se por referência as constituições ao longo de sua história, a participação do Poder Legislativo na elaboração do orçamento caracterizou-se pela oscilação em termos do maior ou menor controle sobre as decisões orçamentárias. A Constituição Federal de 1 988 recuperou as prerrogativas do Congresso Nacional para dispor sobre matéria orçamentária que haviam sido retiradas na Constituição de 1 967. A Constituição trouxe importantes mudanças nesta área, entre elas a conclusão do processo de unificação orçamentária, a aprovação pelo Legislativo não só da lei orçamentária como dos novos instrumentos de planejamento (lei do plano plurianual e lei de diretrizes orçamentárias), a instituição de uma comissão mista permanente de Senadores e Deputados e a possibilidade de emendar os projetos de lei do Executivo. A lei de diretrizes orçamentárias, considerada uma das mais relevantes inovações introduzidas ao capítulo da Constituição que trata do orçamento público, foi concebida com o objetivo maior de permitir uma intervenção prévia do Poder Legislativo na elaboração do projeto de lei do orçamento, antecipando as decisões sobre as metas e prioridades a serem contempladas na elaboração orçamentária. Apesar dos novos instrumentos e do amplo poder de intervenção, no período de 1990 à 1995 a atuação do Legislativo no que diz respeito à definição de metas e prioridades ficou comprometida principalmente pela falta de vontade política para aprovar a Lei Complementar de Finanças Públicas e para implantar na comissão mista de orçamento uma estrutura e processos de funcionamento correspondentes ao novo papel que a Constituição reservou a esta comissão. A análise dos documentos e os depoimentos levantados mostraram que a atuação do Legislativo foi prejudicada também pela inexistência do planejamento governamental e pela deficiência dos projetos de lei do Executivo, que pouca atenção deram às metas e prioridades.

The Limits of political compromise: debt ceilings and political competition

We study the desirability of limits on the public debt and of political competition in an economy where political parties alternate in office. Due to rent-seeking motives, incumbents have an incentive to set public expenditures above the socially optimal level. Parties cannot commit to future policies, but they can forge a political compromise where each party curbs excessive spending when in office if it expects future governments to do the same. In contrast to the received literature, we find that strict limits on government borrowing can exacerbate political-economy distortions by rendering a political compromise unsustainable. This tends to happen when political competition is limited. Conversely, a tight limit on the public debt fosters a compromise that yields the efficient outcome when political competition is vigorous, saving the economy from immiseration. Our analysis thus suggests a legislative tradeoff between restricting political competition and constraining the ability of governments to issue debt.

Equidad, desarrollo y ciudadanía

Incluye Bibliografía

Decentralization and reform in Latin America: improving intergovernmental relations

Includes bibliography

Equity, development and citizenship: abridged edition

Includes bibliography

Equidad, desarrollo y ciudadanía: versión definitiva

Incluye Bibliografía

Eqüidade, desenvolvimento e cidadania

Incluye Bibliografía

Cohesión social: inclusión y sentido de pertenencia en América Latina y el Caribe

Incluye Bibliografía