2008年-世界发展银行全球_FYR_Macedonia_Public_Expenditure_Review_102页_6mb

FYR Macedonia Public Expenditure Review Summary

Core Content Overview

This document provides an analysis of public expenditure developments and challenges in FYR Macedonia, focusing on key sectors such as education, health, pensions, and transport. It highlights the country's progress in political and economic reforms, fiscal stability, and macroeconomic performance, while identifying areas where efficiency and effectiveness of public spending can be improved. The report also outlines recommendations for enhancing fiscal sustainability, public service delivery, and long-term growth.

Key Sectors and Findings

A. Public Expenditure Developments and Challenges

• Fiscal Adjustment: Since the 2001 conflict, FYR Macedonia has made significant fiscal adjustments, reducing the budget deficit and public spending as a share of GDP from 44% in 2001 to 34% in 2006.
• Macroeconomic Stability: The country has achieved macroeconomic stability, with public debt at 30% of GDP by 2006, and the smallest current account deficit in the region (0.4% of GDP).
• Spending Priorities: The government faces challenges in improving the efficiency and effectiveness of public spending. While spending is relatively low compared to Europe and Central Asia (ECA), it remains higher than in some emerging markets.
• Spending Pressures: Future pressures include EU integration costs, road maintenance backlog, and potential increases in pension reform spending.

B. Education

• Government Spending: Education spending as a share of officially-estimated GDP is modestly higher than in neighboring countries but still lower than in the EU.
• Performance Issues: Learning outcomes are poor compared to EU and other ECA countries, with low enrollment in secondary education and skills not aligned with market needs.
• Equity Gaps: Enrollment disparities exist based on wealth, residence, and ethnicity. Spending on schools with different ethnic compositions also varies.
• Recommendations:
  • Shift to per-pupil financing to improve efficiency.
  • Slow the increase in teacher salaries.
  • Increase instructional time and access to learning materials.
  • Enhance teacher training.
  • Reduce the cost burden for poorer households through capitation financing.

C. Health

• High Spending, Poor Outcomes: Health spending is among the highest in the ECA region and close to OECD levels, but health outcomes are poor.
• Funding Issues: High out-of-pocket payments and informal payments threaten financial protection for vulnerable groups. Spending is skewed towards inpatient and specialized care rather than preventive and primary care.
• Inefficiencies: Low productivity in health centers and mal-distribution of resources (personnel, beds) are noted.
• Recommendations:
  • Review and reform the health benefit package.
  • Shift part of healthcare financing from payroll taxes to general revenues.
  • Introduce generic and external referencing for outpatient drugs.
  • Revise pharmaceutical co-payments.
  • Develop a plan to rightsize the health sector, especially hospitals and specialist services.

D. Pensions

• Financial Challenges: The pension system faced a severe financial crisis in the 1990s due to reduced formal employment and high implicit pension obligations.
• Reforms Implemented: A mandatory fully-funded second pension pillar was introduced in 2006, and parametric reforms have been initiated.
• Replacement Rates: Under the baseline scenario, the replacement rate is expected to decrease from 55% to 50% of average wages, which is still higher than the New Member States (NMS) average of 68%.
• Recommendations:
  • Unify the retirement age for men and women at 64, with consideration of increasing it to 65.
  • Reduce fees on fully-funded pension accounts, including those charged by MAPAS.
  • Consider consolidating supervision of both the PAYG and funded pillars.

E. Transport

• Infrastructure Deterioration: Years of under-spending on maintenance have led to significant deterioration of transport infrastructure, particularly roads.
• Fiscal Risk: Poor road conditions represent a serious fiscal risk, especially for economic growth and export competitiveness.
• Reforms in Railways: The MZ (Macedonian Railways) has been restructured into two separate entities: one for infrastructure and one for transport operations.
• Recommendations:
  • Increase maintenance outlays within the fiscal envelope.
  • Introduce competitive bidding for maintenance activities.
  • Strengthen the technical capacity of the Ministry of Transport and Communication (MoTC) and Fund for National and Regional Roads (FNRR).
  • Enhance the implementation of the MZ-I National Program and MZ-T business plans.

Key Information and Main Points

• Economic Reforms: The government has implemented significant fiscal adjustments, leading to improved macroeconomic stability and a declining public debt ratio.
• EU Integration: The country has made progress in EU integration, and the SAA has played a key role in this.
• Fiscal Sustainability: The pension system is expected to be sustainable under the baseline scenario, but reforms must continue to ensure long-term viability.
• Public Sector Efficiency: Improving the efficiency of public spending in education and health is critical for better outcomes and supporting growth.
• Social Security Reforms: Reducing social security contribution rates is recommended, but must be balanced with expenditure cuts or tax increases.

Conclusions

• A 2% reduction in public spending as a share of GDP over the next few years is necessary to address fiscal pressures.
• The focus should be on improving the efficiency and equity of spending in education and health to enhance outcomes and support growth.
• The government should consider structural reforms in transport and pension systems to improve long-term sustainability and performance.
• Strengthening public sector governance and formalizing economic activity are essential for achieving stronger growth and fiscal stability.