Public Expenditure Allocation and Incidence under Health Care Market Liberalization: a Tanzanian Case Study

Abstract

The arguments for health care commercialization in the international policy literature have been strongly reliant on the premise that promotion of the private sector ‘frees’ public sector resources for the poor (World Bank 1993). Concurrently, policies to address poverty, including those of the Tanzanian government, actively seek to shift public expenditure on health in a more ‘pro-poor’ direction (URT 2000, 2003b). Potential conflicts between health care commercialization (promoted through health sector reform policies) and poverty-focused public expenditure policies are widely remarked upon by African policy analysts (Mackintosh 2001), yet are insufficiently researched.

Our thanks to participants in the Helsinki Conference and to Marc Wuyts for helpful comments; the views expressed are solely the responsibility of the authors.