2021-06-10-世界卫生组织-Hypothecation_of_tax_revenue_for_health_7页_1mb

Hypothecation of tax revenue for health involves designating specific tax revenues for particular programs like healthcare, with roots in historical tax practices where funds were pledged for specific uses. The 2010 World Health Report by Ole Doetinchem explores its arguments, supported and opposed, and examines real-world examples.

Supporters argue that hypothecation enhances accountability and trust, promotes transparency by educating citizens on service costs, generates public support for tax increases, and protects health resources from competing budgetary interests. Opponents counter that it exempts revenues from review, undermines fiscal solidarity and flexibility, ties government hands in economic decisions, and may link funding to unrelated factors like macroeconomic conditions rather than health needs.

A key example is Australia's 1987 Victorian sin-tax on tobacco, which funded health promotion but later weakened. Other countries like Finland and Egypt have implemented similar measures. Studies suggest such taxes can reduce harmful behaviors and save healthcare costs, though support often depends on strict enforcement to prevent leakage or budget offsets from general taxation.

The conclusion highlights hypothecation as a sacrifice of fiscal flexibility for greater accountability and public trust, but its effects are likely temporary due to potential budget reallocations over time, with debates intensifying during elections and economic downturns.