世界银行-亚美尼亚卫生税的影响（英）-2023.9-55页_6mb

Armenia's Health Tax Analysis Summary

This report, prepared by the World Bank, examines the economic and health impacts of increasing excise taxes on alcohol, tobacco, and sugar-sweetened beverages (SSBs) in Armenia. The goal is to support universal health coverage (UHC) by expanding fiscal space and reducing out-of-pocket healthcare costs.

Key Findings:

1. Health Impacts:

   • Tobacco taxes prevent the most deaths (33,139 over 20 years), predominantly among the poorest quintile (25%).
   • Alcohol taxes avoid 402 deaths, mostly in the richest quintile.
   • SSB taxes prevent 395 deaths, with relatively balanced impacts across income groups.

2. Revenue Generation:

   • Total projected annual revenue is AMD 136 billion (≈2% of GDP).
   • Tobacco taxes contribute 81% (≈AMD 110 billion), SSBs 18% (≈AMD 24 billion), and alcohol <1% (≈AMD 1.3 billion).
   • Revenue distribution varies by product: highest-income groups bear most alcohol taxes, lowest-income groups shoulder most SSB taxes, and middle-income groups face tobacco tax burdens.

3. Income Subgroup Burden:

   • Alcohol tax burden is highest in the richest quintile (24% of tax revenue).
   • SSB tax burden is highest in the poorest quintile (26% of tax revenue).
   • Tobacco tax burden is greatest in the richest quintile (22%).

4. Govt. Savings and HH OOP Expenses:

   • Tobacco taxes generate the highest savings for government subsidies and reduce out-of-pocket (OOP) payments, particularly in the richest quintile.
   • Alcohol taxes significantly impact OOP expenses among the richest quintile.
   • SSB taxes primarily help poorest and second-poorest quintiles with OOP savings.

Policy Recommendations:

• Increase tobacco taxes at the expense of SSB taxes to leverage higher health benefits and revenue gains.
• Explore effective reforms for alcohol and SSB taxes given their lower impact.
• Prioritize balancing fiscal space across income groups to strengthen NCD services and address financial barriers to healthcare.

The study suggests that raising tobacco taxes, especially alongside reforms in alcohol and SSB taxes, can enhance UHC funding while improving population health and reducing premature mortality.