In light of the many discussions advocating the use of pay-for-performance and performance budgeting, this paper argues that discouraging experience with both approaches should temper expectations that performance measurement can be a reform that will make health care systems more "sustainable"...

Our paper reviews Marxist, pluralist and conservative theories of the state under capitalism from the standpoint of evidence on United States federal taxing and spending during the 1980s. The deficit panic is a product of the political stratum that defines the public interest as actions opposed...

The OECD has created a Joint Network on Fiscal Sustainability of Health Systems. This article, developed as input to that project, seeks to summarise both why budgeting for healthcare is particularly challenging and why the challenge is often misunderstood. I argue that sustainability is a...

Health programs are shaped by the decisions made in budget processes, so how budget-makers view health programs is an important part of making health policy. Budgeting in any country involves its own policy community, with key players including budgeting professionals and political authorities....

Probabilistic risk assessment has been promoted within the Nuclear Regulatory Com mission as both a means of judging the extent of risk to the public and a direct means of determining what specific regulations should be strengthened, better enforced, or possibly abandoned. These uses have met...

In this paper we challenge the traditional distinction between public goods and private goods. Economists use a definition of public goods that rests on the inherent properties of the good itself. Referring to criteria such as non-rivalness and non-excludability, they assert that the distinction...