This paper presents a new set of institutional indicators that assess how sub-central governments harness market mechanisms such as tendering, outsourcing, user choice and competition, user fees and output-related funding when providing public services. Services put under scrutiny comprise...

Over the past several decades, public debt has increased substantially in many OECD countries, particularly in the aftermath of recessions. The extent of this increase and the resulting debt levels varied across countries, partly reflecting differences in average budget balances. Despite rising...

Health outcomes and the quality of health care in Iceland are very good by international comparison, while income-related health inequality appears to be smaller than in most other countries. However, the health-care system is costly and, according to OECD estimates, public expenditure on health...

The aim of the recent healthcare reform was to increase the sustainability of healthcare finances, by reducing its negative impact on employment and increasing cost-effectiveness via enhanced competition. Higher budget contributions will help decouple healthcare finances from labour income a...

This paper reviews the strengths and weaknesses of the Swedish healthcare system and the challenges that it will face in the future. It discusses ways to improve access to primary care, including different methods for paying GPs, whether access is less equitable than in other countries and the...

The paper discusses the current state of fiscal relations across levels of government in Belgium and how it has developed over time. As the current system of fiscal federalism is creating imbalances between the federal and the sub-federal governments (vertical imbalance), and between sub-federal...

OECD indicators of structural policy show that policy changes in Italy since 1998 should have improved the environment for entrepreneurship significantly, but in the same period its economic performance has deteriorated noticeably. This may be partly because there is a difference between policy...

The EU Single Market remains fragmented by complex and heterogeneous rules at the EU and national levels affecting trade, capital, including foreign direct investment, and labour mobility. Further development of the Single Market and removing barriers to external trade would bring substantial...

Ce document de travail porte sur l’état actuel des relations budgétaires entre les différents niveaux d’administration en Belgique ainsi que sur la manière dont celles-ci ont évolué au fil du temps. Partant du constat que le système qui donne corps au fédéralisme budgétaire est...