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AbstractDespite having low government spending, Switzerland scores highly in various public policy outcomes, including health, education and transportation. But, as the population grows and ages, efficiency of public spending will have to rise to maintain low tax rates. Given its high returns, the provision of early childhood education and care should be boosted, especially for children from disadvantaged socio-economic backgrounds, including those from immigrant families. Cantons should avoid oversupplying baccalaureates, thereby lowering university dropout rates. Policies will also need to adapt to structural changes in the labour market, by boosting the supply and attractiveness of fields of study that are facing high demand on the labour market, and by further clarifying study streams across tertiary education. Health-care efficiency could be raised by further developing managed-care networks. Enforcing systematic data collection for the quality of care would also help patients and providers make better informed choices. Generic drugs’ prices are too high due to a poorly designed price-fixing mechanism. Transportation suffers from congestion that could be reduced by implementing peak-load pricing on roads and trains. But efficiency in public spending is also about allocating public funds optimally. Switzerland’s rapidly rising social security entitlements and its fiscal equalisation system constrain public spending and risk crowding out important expenditures. Fast-rising social security entitlements could be addressed via indexing the retirement age to life expectancy. Fiscal equalisation weakens tax-raising incentives for some cantons; this could be addressed by allowing them to keep a larger part of their increased revenues. Efficiency in allocating public expenditure could also be raised by increasing the share of public spending allocated by tender and harmonising procurement regulations across all levels of government. This Working Paper relates to the 2015 OECD Economic Review of Switzerland (http://www.oecd.org/eco/surveys/economic-survey-switzerland.htm) Accroître l'Efficience des Dépenses Publiques en Suisse Malgré un volume de dépenses publiques faible, la Suisse obtient de très bons résultats dans de nombreux domaines de la politique publique, dont la santé, l’éducation et le transport. Toutefois, compte tenu de la croissance démographique et du vieillissement de la population, l’efficience des dépenses publiques devra être renforcée pour conserver des taux d’imposition bas. Compte tenu de ses effets très positifs, l’offre de structures d’éducation et d’accueil des jeunes enfants devrait être accrue, notamment pour les enfants issus de milieux socio-économiques défavorisés, comme les enfants d’immigrés. Les cantons devraient éviter une situation d’excès de bacheliers, afin de réduire les taux de décrochage universitaire. Les politiques devront aussi s’adapter aux changements structurels sur le marché du travail en améliorant l’offre et l’attractivité des domaines d’études qui suscitent une forte demande sur le marché de l’emploi, et en simplifiant encore les filières dans l’enseignement supérieur. Dans la santé, le développement des réseaux de soins intégrés pourrait renforcer l’efficience. Le recueil systématique de données sur la qualité des soins aiderait aussi patients et prestataires à faire des choix mieux informés. Les prix des médicaments génériques sont trop élevés en raison d’un mécanisme de fixation des prix mal conçu. Dans les transports, la congestion pourrait être réduite en adoptant une tarification de période de pointe sur les routes et les rails. Mais l’efficience des dépenses publiques a aussi trait à la répartition optimale des deniers publics. Les droits à prestations de sécurité sociale qui augmentent rapidement en Suisse et le système de péréquation budgétaire contraignent les dépenses publiques et risquent de supplanter des catégories de dépenses importantes. L’indexation de l’âge de la retraite sur l’espérance de vie pourrait permettre de faire face à l’augmentation rapide des droits à prestations de sécurité sociale. La péréquation budgétaire incite moins certains cantons à collecter les impôts. Pour remédier à cette situation, ils pourraient être autorisés à conserver une part plus importante de leurs recettes supplémentaires. La répartition des dépenses publiques pourrait aussi devenir plus efficiente en augmentant le pourcentage des marchés publics alloués par appels d’offres et en harmonisant les procédures de passation de marché à tous les niveaux de l’administration. Ce Document de travail se rapporte à l’Étude économique de l’OCDE de la Suisse 2015 (http://www.oecd.org/fr/eco/etudes/etude-economique-suisse.htm).
Suggested Citation
Richard Dutu, 2016.
"Raising Public Spending Efficiency in Switzerland,"
OECD Economics Department Working Papers
1280, OECD Publishing.
Handle:
RePEc:oec:ecoaaa:1280-en
DOI: 10.1787/5jm3rxpwrgjf-en
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Cited by:
- Rachamin, Yael & Meier, Rahel & Valeri, Fabio & Rosemann, Thomas & Muheim, Leander, 2021.
"Physician-dispensing as a determinant of clinical and process measurements in patients at increased cardiovascular risk: A cross-sectional study in Swiss general practice,"
Health Policy, Elsevier, vol. 125(10), pages 1305-1310.
More about this item
Keywords
dépense publique;
education;
efficience;
efficiency;
fiscal equalisation;
health care;
public spending;
santé;
éducation;
All these keywords.
JEL classification:
- H11 - Public Economics - - Structure and Scope of Government - - - Structure and Scope of Government
- H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
- H52 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Education
- H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions
- H57 - Public Economics - - National Government Expenditures and Related Policies - - - Procurement
- H77 - Public Economics - - State and Local Government; Intergovernmental Relations - - - Intergovernmental Relations; Federalism
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