Public Expenditure on Human Development in Argentina

WORKING PAPER N.03/04 Report no 29005 Produced by the World Bank Office for Argentina, Chile, Paraguay and Uruguay Public Expenditure on Human Development in Argentina Damián Bonari* Marcelo Becerra Ariel Fiszbein April 2004 This publication was prepared and produced by the World Bank Office for Argentina, Chile, Paraguay and Uruguay The series “Working Papers” does not constitute a formal document of the World Bank It is informally published and distributed to promote discussion and comments from the community that works on the topics presented The findings, interpretations, judgements and conclusions expressed in this paper are those of the author or authors and should not be attributed to the World Bank, its affiliate organizations, the members of the Executive Board or the governments they represent (*) Head of the Directorate of Consolidated Social Expenditure The statements made in this document are exclusively those of the authors and not necessarily reflect the opinions of the Ministry of Economy and Production Working Papers are available at www.bancomundial.org.ar For comments and/or suggestions, please write to mbecerra@worldbank.org World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table of Contents INTRODUCTION I ANALYSIS OF PUBLIC EXPENDITURE ON HUMAN DEVELOPMENT 2000-2001 I.1 DEFINITION I.2 RESPONSIBILITY OF THE DIFFERENT GOVERNMENT LEVELS 11 I.3 FINANCING OF PUBLIC EXPENDITURE ON HUMAN DEVELOPMENT 20 II PUBLIC EXPENDITURE ON HUMAN DEVELOPMENT IN THE POSTCONVERTIBILITY PERIOD 24 THE POST-CONVERTIBILITY PERIOD GENERATED CHANGES IN GPDH COMPOSITION AND LEVEL ON THE ONE HAND, THE MAGNITUDE OF THE SOCIAL CRISIS REQUIRED EMERGENCY RESPONSES ON THE PART OF THE STATE WHICH GENERATED INCREASES IN CERTAIN ITEMS ON THE OTHER, THE RISE IN THE LEVEL OF PRICES IMPLIED A FALL IN SALARIES AND RETIREMENT PAYMENTS IN REAL TERMS, WHICH, TO A GREAT EXTENT, REMAINED CONSTANT IN NOMINAL TERMS 24 II.1 CHANGES AT NATIONAL LEVEL 24 II.2 CHANGES AT PROVINCIAL LEVEL 31 III CONCLUSIONS 35 ANNEX 38 BIBLIOGRAPHY 59 Index of Boxes Box 1: Consolidated Social Public Expenditure…… …………………………………………5 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Box 2: Considerations on Mutual Funds Expenditure ……………………………………… Box 3: Fiscal Relation between the National Government and the Provinces………… ……21 Box 4: Social Assistance in Times of Crisis……………………………………………… ….27 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 INTRODUCTIONI This paper develops the sectoral, structural and financing composition of public expenditure on human development The objective of this paper is to provide a first contribution to the multiples aspects that are treated, laying analytical foundations for further developments In particular, the report analyses the distribution by government level and expenditure composition during and after convertibility For that purpose, the period 2000-2001 is compared with years 2002-2003 The document provides information to identify and quantify social expenditure, simultaneously considering the sectors included and the agents involved The purpose of this document is eminently descriptive, and therefore, the analyses and conclusions to be inferred from it will be the result of future research The report is organized in the following way: the first part of the document focuses on public expenditure on human development in the 2000-2001 period and the responsibility of each government level for its execution and financing The second part refers to public expenditure on human development during the 2002-2003 period The main changes in the sectoral and pragmatic composition of expenditure are described for the national government, and financing for social plans is analysed With respect to provincial governments, the paper studies a group of provinces which were selected on the basis of the data available “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 I I.1 ANALYSIS OF PUBLIC EXPENDITURE ON HUMAN DEVELOPMENT 2000-2001 II Definition This section will analyse the structure of public expenditure on human development (GPDH) in Argentina in the period 2000-2001, that is to say, in the last two years of the convertibility regime Although as from 2002 there are a series of important changes –which are reviewed in detail in the second part of the document–, many of the structural aspects identified are still valid The availability of detailed information on the provincial level is limited for years 2002 and 2003 However, the structural analysis performed for 2000-2001 is valid for the following years without major accuracy losses.iii The frame of reference of analyses performed in Argentina has traditionally been Consolidated Social Public Expenditure (GPSC), that is expenditure that is meant to provide health, education, housing and fresh water services; to enforce compensatory nutrition, labor and social assistance policies aimed at mitigating situations of uncertainty in relation to income, health, employment and other contingencies GPSC comprises budget and extra-budget expenditure from the non-financial public sector of the three government levels The usual consolidation process follows the criterion of recording expenditure in the jurisdiction that executes it and not in the one that finances it Therefore, to avoid duplications, fund transfers from the National government to the provinces and municipalities, and from the provinces to municipalities are deducted from the financing jurisdiction and are included in the executing jurisdiction.iv In this document, we will use a narrower definition, in an effort to reflect the activities that are typically related to human development more closely v In particular, the analysis focuses on public expenditure that finances activities linked to social services traditionally aimed at individuals The first difference with the definition of GPSC is that expenditure on housing and fresh water is excluded From the point of view of public policy making, expenditure on these items is strongly linked to infrastructure services The definition of GPDH used includes, in the first place, the provision of education services in the different levels; but it excludes culture and science and technology, -as we understand that to a great extent, these areas not involve the provision of basic services for the development of individuals–, and expenditure on education for the armed and security forces, as from the point of view of public policy making, these services belong to the defence and/or security areas and not to the field of social policies, which are part of GPSC Thus, the Education sector comprises the items “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 that are directly linked to the provision of education services to the population –public sector teachers’ salaries and transfers to the private sector, the purchase of goods and services, expenditure on infrastructure and equipment, and transfers to national universities– and the policy, coordination, regulation and system management actions that enable the provision of such services Likewise, expenditure on compensatory programs –for e.g scholarships– executed by the ministries of Education is included in the Social Assistance sector and not in Education, as it is considered to provide support to vulnerable groups and not a part of the cost of providing education services In the second place, GPDH encompasses the provision of public health services and expenditure on public providers of health services –for e.g hospitals and health centers– and the drugs and inputs that the national government provides for the fight against AIDS and for maternal and child health care for the needy “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Box Consolidated Social Public Expenditure It GPSC for 2000 reached $59,341.62 million of 2001 –in other words, 21.23% of GDP In 2001, there was a slight decrease of 0.25%; however, due to the fall in the level of economic activity, it increased in terms of GDP Concerning consolidated total public expenditure (GPT), GPSC represented 62.82% in 2000 and 61.62% in 2001 At National level, as a percentage of GPT, GPS is approximately of 62% and in the provinces, of 66% Instead, municipalities show a lower ratio, closer to 51% For 2000, disaggregation by government level reflected that $30,467.90 million of 2001 correspond to the national government, $24,858.63 million of 2001 to provincial governments and $4,015.08 million of 2001 to municipal governments In other terms, 51.34% of GPSC correspond to the national government, 41.89% to the provinces and 6.77% to municipalities Consolidated Social Public Expenditure, 2000-2001 In millions of pesos of 2001 and in percentages Source: analysis based on data from the Directorate of Consolidated Expenditure According to the classification used by the Directorate of Consolidated Social Expenditure (DGSC), GPSC can be broken down into the following functions: Education, Culture, and Science and Technology; Health; Fresh Water and Sewerage; Housing and Urbanism; Social Development and Assistance; Social Security; Labor and Other Urban Services The most relevant functions in budgetary terms are Social Security, Health and Education, which concentrate more than 80% of GPSC Consolidated Social Public Expenditure by Function, 2000-2001 In millions of pesos of 2001 and in percentages Source: analysis based on data from to Directorate of Consolidated Social Expenditure also includes the Federal Health Program (PROFE) – that is to say, expenditure allocated to medical assistance for non-Contributive pension beneficiaries (PNC)?? – and expenditure on health service providers’ infrastructure and equipment As in the case of education services, it includes policy, “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 coordination and regulation actions to ensure that services will be adequately provided, for e.g prevention of AIDS and specific diseases and risks The main difference with the health expenditure included in GPSC is that expenditure executed by social security agents is excluded, and in this document, it is considered expenditure on Social Insurance The other two sectors of GPDH correspond to Social Assistance and Social Insurance The former comprises programs that grant monetary and non-monetary benefits, as well as the administrative expenditure of the social development and labour ministries, which are the main executors of these programs On the other hand, Social Insurance includes expenditure from money transfers – retirement payments, pensions, family benefits and unemployment insurance - and health insurance for the beneficiaries of different social security regimes in force in the country, including PAMI and provincial programs.vi It is worth noting that the traditional distinction between “contributive” and “non-contributive” programs represents the difference between Social Assistance and Social Insurance only partially, as part of the Social Insurance expenditure is financed by the same general treasury resources as is Social Assistance expenditure The distinction is mainly institutional: social insurance benefits are derived from a legal right that is generally granted as a result of a labor relationship, whereas social assistance benefits are derived from a decision of the State based on wider eligibility criteria Main differences in the classification of GPSC and GPDH Program GPSC GPDH Education and training provide by Ministry of Interior and Ministry of Defence Include as expenditure in education Exclude Science and technology Include Exclude Culture Include Exclude Include as expenditure in education Include as expenditure in Social Assistance Include as health Include as social insurance Scholarships Housing and Potable Water Health Insurance “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table summarizes the main figures of the GPDH classification adopted The sectoral composition reflects that over 60% of expenditure corresponds to Social Insurance and almost 25% to Education, while percentages for Health and Social Assistance are much lower This composition remained relatively stable during the 2000-2001 period, but, as it will be analysed later on, important changes are observed in the post-convertibility period Table Public Expenditure on Human Development by Sector, 2000-2001 In millions of pesos of 2001, as a percentage of GDP and in percentage structure 2000 Sector Education Health Social Assistance Social Insurances Total In of $ of 2001 millions 12,000.54 4,325.64 3,187.20 32,298.17 51,811.55 As a % of GDP 4.29 1.55 1.14 11.56 18.54 2001 % Structure 23.16 8.35 6.15 62.34 100.00 In millions of $ of 2001 12,185.42 4,371.50 3,252.54 31,916.33 51,725.79 As a % of GDP 4.54 1.63 1.21 11.88 19.25 % Structure 23.56 8.45 6.29 61.70 100.00 Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 10 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Box Considerations on Social Security Health Insurers Expenditure Considering Social Security Health Insurers (including PAMI) as public expenditure on human development deserves a methodological clarification since it is not executed by a state entity and it is not included in the budget, as the rest of the social programs included in public expenditure This category, which could be called “quasi” public expenditure, presents characteristics by which it should be included as public expenditure In the case of social security health insurers, there are three important aspects: (i) compulsory provision: all formal workers have the right to be provided services by social security health insurers (health) and by law, both employers and employees are obliged to contribute a percentage of their gross salaries Therefore, it is an insurance that is regulated by the State, who delegates its execution to a private entity and lets employees choose among the providers in this system; (ii) collection: the collection of personal and employers’ contributions is performed by an official collection agency, the AFIP; (iii) insurance is based on a solidarity criterion: although each employee can choose among the health insurers of the system, there is not a relation between the contributions made and the services provided, as the former are distributed among contributors of different salary level and therefore, of different contribution level, following a solidarity criterion – all of them receive the same service package Recording this social insurance as public expenditure is also validated by international methodology, typically the methodology of the International Monetary Fund In the case of Argentina, there are two other types of insurance that would also belong to this “quasi” public expenditure category: expenditure on retirement annuities and pensions from the fully funded system (expenditure of AFJPs) and expenditure on the insurances of labor risk insurance companies (expenditure of ART companies) These two insurances are not officially recorded as social expenditure in Argentina yet, although they will be soon included in social expenditure, as this is the standard established by internationally accepted methodology Until now, the incidence on expenditure has been low, fundamentally because the private retirement regime still has few beneficiaries However, and beyond conventions, it is considered that expenditure on health insurers has a characteristic that further justifies its inclusion as public expenditure: the solidarity nature of health insurance makes it different -in particular from private retirement, where benefits are directly related to contributions In other words, risk pooling is an essential aspect of the program I.2 Responsibility of the Different Government Levels Responsibility for executing and financing GPDH, once municipalities are excluded, is shared by the National government and the provinces.vii The national government is in charge of defining and coordinating health, education and social assistance public policies, and of financing national universities It designs and finances health care and prevention, education, poverty reduction and social vulnerability programs As a result of pacts signed between the National government and the provinces, among other reasons, expenditure on retirement funds and pensions is mainly centralized at national level The “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 11 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.8.2 Public Expenditure on Social Assistance, 2000-2001 As a % of GDP Item 2000 National Provincial Targeted Social Programs/ Monetary Personal Transfers Employment Programs Jefes/as de Hogar Trabajar Labor Emergency Plan Financial Assistance (PEL) 0.04 For Provincial Social Expenditure Provincial Programs Scholarships National Education Scholarships Polimodal Scholarships, Buenos Aires Province Non-Contributive Pensions Other Programs Human Development Income 0.00 Solidaridad (IDH) Other National Programs 0.00 Provincial Programs 0.32 0.29 0.07 - 0.08 0.03 - 0.04 0.02 0.08 0.02 0.06 0.24 0.06 - 0.10 - 2001 National Provincial Total 0.61 0.15 - 0.06 0.03 0.01 0.02 0.05 0.06 0.29 0.02 0.02 0.01 0.27 0.01 - 0.01 - 0.40 0.10 0.45 Food Programs School Kitchens Food Emergency Program Community Kitchens (FOPAR) (PEA) Provincial Food Programs Prohuerta Others Central Administration Ministry of Social Development Ministry of Labor Total 0.02 0.02 0.10 0.03 0.03 0.02 0.25 0.26 0.04 - - 0.05 0.10 0.40 0.05 - 0.01 Non-Monetary Targeted Social Programs 0.01 - - 0.08 - 0.08 - 0.10 - 0.00 0.35 0.04 - 0.01 - 0.10 0.15 0.15 0.06 0.18 0.02 - 0.01 0.15 - 0.02 0.06 0.74 0.03 0.08 0.00 1.140.01 - Total 0.27 0.12 - 0.18 - 0.01 0.62 0.05 - - 0.12 0.12 0.03 0.02 0.05 0.01 0.09 - 0.10 - 0.01 0.09 0.32 0.40 0.44 0.24 0.09 - 0.01 0.25 0.09 0.09 - 0.14 0.03 0.02 0.16 0.02 - 0.14 0.00 0.06 0.19 0.08 0.04 0.42 0.02 0.06 0.03 0.73 1.14 Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 46 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.9.1 National Government Conditional Transfers to Social Assistance, 2000-2001 In millions of pesos Item 2000 2001 Targeted Social Programs/ 0.72 87.17 Monetary Personal Transfers Employment Programs 0.72 87.17 Jefes/as de Hogar Trabajar 0.72 1.37 Labor Emergency Plan Financial Assistance for Social Expenditure (PEL) Provincial Programs 85.80 Scholarships National Education Scholarships Polimodal Scholarships, Buenos Aires Province Non-Contributive Pensions Other Programs Human Development Income Solidaridad (IDH) Provincial Programs Non-Monetary Targeted Social Programs 106.94 58.50 Food Programs 4.19 School Kitchens 1.58 Unidos/ Food Emergency Program 4.19 (PEA) 1.58 Community Kitchens (FOPAR) Provincial Food Programs Prohuerta Others 105.37 54.31 Central Administration 0.80 Ministry of Social Development Ministry of Labor Total 107.67 0.80146.48 Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 47 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.9.2 National Government Conditional Transfers to Social Assistance, 2000-2001 As a % of GDP Item 2000 2001 Targeted Social Programs/ 0.00 0.03 Monetary Personal Transfers Employment Programs 0.03 Jefes/as de Hogar 0.00 Trabajar Labor Emergency Plan - 0.00 0.00 Financial Assistance (PEL) 0.03 For Provincial Social Expenditure Provincial Programs Scholarships National Education Scholarships Polimodal Scholarships, Buenos Aires Province Non-Contributive Pensions Other Programs Human Development Income Solidaridad (IDH) Other National Programs Provincial Programs Non-Monetary Targeted Social Programs Food Programs School Kitchens Food Emergency Program Community Kitchens (FOPAR) (PEA) Provincial Food Programs Prohuerta Others Central Administration Ministry of Social Development Ministry of Labor Total 0.04 0.02 0.00 - 0.00 - 0.00 - 0.00 - 0.04 0.04 0.00 0.02 0.00 0.05 Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 48 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.10.1 Public Expenditure on Social Insurance, 2000-2001 In millions of pesos Item Administration of ANSeS, SSS, etc Retirement and Pensions National (including ex-provincial Provincial funds) Subsidies Family Benefits Unemployment Insurance PAMI Health Insurers National Provincial Total 2000 2001 National Provincial Total National Provincial Total 292.99 88.49 381.48 249.11 89.09 338.20 16,379.92 4,331.56 20,711.47 15,690.20 4,520.36 20,210.56 16,379.92 16,379.92 15,690.20 15,690.20 4,331.56 4,331.56 4,520.36 4,520.36 633.71 633.71 609.00 609.00 1.865,02 1.865,02 1.807,95 1.807,95 302.17 302.17 353.70 353.70 2,563.79 2,563.79 2,389.23 2,389.23 4,151.23 2,234.86 6,386.09 3,973.84 2,233.85 6,207.69 4,151.23 4,151.23 3,973.84 3,973.84 2,234.86 2,234.86 2,233.85 2,233.85 26,188.84 6,654.91 32,843.74 25,073.04 6,843.30 31,916.33 Source: analysis based on data from the Directorate of Consolidated Social Expenditure Table A.10.2 Public Expenditure on Social Insurance, 2000-2001 As a % of GDP Item Administration of ANSeS, SSS, etc Retirement and Pensions National (including ex-provincial funds) Subsidies Provincial Family Benefits Unemployment Insurance PAMI Health Insurers National Provincial Total 2000 National Provincial 0.10 0.03 5.76 1.52 5.76 1.52 0.22 0.66 0.11 0.90 1.46 0.79 1.46 0.79 9.21 2.34 Total 0.13 7.29 5.76 1.52 0.22 0.66 0.11 0.90 2.25 1.46 0.79 11.56 2001 National Provincial 0.09 0.03 5.84 1.68 5.84 1.68 0.23 0.67 0.13 0.89 1.48 0.83 1.48 0.83 9.33 2.55 Total 0.13 7.52 5.84 1.68 0.23 0.67 0.13 0.89 2.31 1.48 0.83 11.88 Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 49 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.11.1 National Government Conditional Transfers to Social Insurance, 2000-2001 In millions of pesos Item Administration of ANSeS, SSS, etc Retirement and Pensions National (including ex-provincial Provincial funds) Subsidies Family Benefits Unemployment Insurance PAMI Health Insurers National Provincial Total 2000 168.05 168.05 5.10 5.10 173.16 2001 142.27 142.27 4.09 4.09 146.35 Source: analysis based on data from the Directorate of Consolidated Social Expenditure Table A.11.2 National Government Conditional Transfers to Social Insurance, 2000-2001 As a % of GDP Item Administration of ANSeS, SSS, etc Retirement and Pensions National (including ex-provincial Provincial funds) Subsidies Family Benefits Unemployment Insurance PAMI Health Insurers National Provincial Total 2000 0.06 0.06 0.00 0.00 0.06 2001 0.05 0.05 0.00 0.00 0.05 Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 50 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.12.1 Composition of Public Expenditure on Human Development Financing, 2000-2001 In millions of pesos Sector 2000 Education Health Social Assistance Social Insurance Administration Retirement/ Pensions Subsidies Family Unemployment Ins PAMI Health Insurers Total 2001 Education Health Social Assistance Social Insurance Administration Retirement/ Pensions Subsidies Family Benefits Unemployment Ins PAMI Health Insurers Total National Fiscal Payments Total Expend And Contrib Provincial Fiscal Payments Total Expend And Contrib 1,746.65 1,746.65 10,456.60 516.83 516.83 3,881.87 1,127.96 1,127.96 2,113.08 10,447.06 15,741.78 26,188.84 567.83 292.99 292.99 88.49 9,082.74 7,297.18 16,379.92 474.24 633.71 633.71 1,865.02 1,865.02 302.17 302.17 437.62 2,126.17 2,563.79 4,151.23 4,151.23 5.10 13,838.50 15,741.78 29,580.28 17,019.38 6,087.08 1,635.10 462.05 1,180.57 10,902.04 249.11 9,575.38 609.00 49.60 418.94 14,179.77 6,244.04 14,171.00 6,114.82 1,807.95 304.10 1,970.29 3,973.84 14,171.00 1,635.10 462.05 1,180.57 25,073.04 249.11 15,690.20 609.00 1,807.95 353.70 2,389.23 3,973.84 28,350.77 10,550.32 3,909.44 2,071.97 599.26 89.09 506.08 4.09 17,130.99 Total Fiscal Payments Total Expend And Contrib 10,456.60 12,203.25 12,203.25 3,881.87 4,398.71 4,398.71 2,113.08 3,241.04 3,241.04 6,654.91 11,014.89 21,828.86 32,843.74 88.49 381.48 381.48 3,857.32 4,331.56 9,556.97 11,154.50 20,711.47 633.71 633.71 1,865.02 1,865.02 302.17 302.17 437.62 2,126.17 2,563.79 2,229.76 2,234.86 5.10 6,380.99 6,386.09 6,087.08 23,106.46 30,857.88 21,828.86 52,686.74 4,014.28 2,229.76 6,244.0 10,550.32 3,909.44 2,071.97 6,843.30 89.09 4,520.36 2,233.85 23,375.03 12,185.42 4,371.50 3,252.54 11,501.29 338.20 10,081.46 609.00 49.60 418.94 4.09 31,310.75 20,415.04 10,129.10 1,807.95 304.10 1,970.29 6,203.6 20,415.04 12,185.42 4,371.50 3,252.54 31,916.33 338.20 20,210.56 609.00 1,807.95 353.70 2,389.23 6,207.69 51,725.79 Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 51 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.12.2 Composition of Public Expenditure on Human Development Financing, 2000-2001 As a % of GDP National Fiscal Payments Total Expend And Contrib Sector Provincial Fiscal Payments Total Expend And Contrib Total Fiscal Payments Total Expend And Contrib 2000 Education Health Social Assistance Social Insurance Administration Retirement and Pensions Subsidies Family Unemployment Insurance PAMI Health Insurance Total 0.61 0.18 0.40 3.68 0.10 3.20 0.22 0.15 4.87 5.54 2.57 0.66 0.11 0.75 1.46 5.54 0.61 0.18 0.40 9.21 0.10 5.76 0.22 0.66 0.11 0.90 1.46 10.41 3.68 1.37 0.74 0.20 0.03 0.17 0.00 5.99 2.14 1.36 0.78 2.14 3.68 1.37 0.74 2.34 0.03 1.52 0.79 8.13 4.29 1.55 1.14 3.88 0.13 3.36 0.22 0.15 0.00 10.86 7.68 3.92 0.66 0.11 0.75 2.25 7.68 4.29 1.55 1.14 11.56 0.13 7.29 0.22 0.66 0.11 0.90 2.25 18.54 2001 Education Health Social Assistance Social Insurance Administration Retirement and Pensions Subsidies Family Unemployment Insurance PAMI Health Insurers Total 0.61 0.17 0.44 4.06 0.09 3.56 0.23 0.02 0.16 5.28 5.27 2.28 0.67 0.11 0.73 1.48 5.27 0.61 0.17 0.44 9.33 0.09 5.84 0.23 0.67 0.13 0.89 1.48 10.55 3.93 1.45 0.77 0.22 0.03 0.19 0.00 6.38 2.32 1.49 0.83 2.32 3.93 1.45 0.77 2.55 0.03 1.68 0.83 8.70 4.54 1.63 1.21 4.28 0.13 3.75 0.23 0.02 0.16 0.00 11.65 7.60 3.77 0.67 0.11 0.73 2.31 7.60 4.54 1.63 1.21 11.88 0.13 7.52 0.23 0.67 0.13 0.89 2.31 19.25 Source: analysis based on data from the Directorate of Consolidated Social Expenditure Table A.13.1 National Government Public Expenditure on Education, 2001-2003 In millions of pesos Item Provision of Education Services Teachers’ Salaries Public Schools Transfers to Tertiary Institutes Transfers to Private Sector Goods and Services / Maintenance Infrastructure and Equipment Transfers to Universities Higher Education Development Policy, Coordination and Regulation Central Administration Quality Information and Curriculum Management and Training Assessment Strengthening of Provincial Administration Educational (PREGASE, PRISE Y PRODYMES) Decentralized Entities (INAP, CONEAU, etc.) Other Programs Total 2001 2002* 2003** Total Net Total Net Total Net Expend Expend Expend Expend Expend Expend 2,338.21 1,563.54 1,612.01 1,547.49 2,259.65 1,860.44 725.31 10.97 23.05 9.33 374.09 16.68 660.00 330.00 65.31 10.97 23.05 9.33 44.09 16.68 89.06 28.74 78.00 27.19 54.48 12.68 1,523.84 1,523.84 1,510.97 1,510.97 1,831.08 1,831.08 1,523.84 1,523.84 1,510.97 1,510.97 1,831.08 1,831.08 81.44 49.81 83.55 67.73 85.31 59.36 29.72 29.72 23.84 23.84 30.39 30.39 6.13 3.73 4.03 2.91 5.99 4.39 31.32 6.47 13.76 3.94 8.27 3.90 34.15 29.28 39.80 15.46 5.99 27.04 2,446.69 5.99 21.75 1,635.10 7.76 17.79 1,713.35 7.76 12.53 1,627.75 9.13 25.82 2,370.78 9.13 24.02 1,943.83 “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 52 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.13.2 National Government Public Expenditure on Education, 2001-2003 As a % of GDP Item 2001 2002* 2003** Total Net Total Net Total Net Expend Expend Expend Expend Expend Expend 0.87 0.58 0.51 0.49 0.62 0.51 0.27 0.00 0.01 0.00 0.10 0.00 0.25 0.09 0.02 0.00 0.01 0.00 0.01 0.00 0.03 0.01 0.02 0.01 0.01 0.00 0.57 0.57 0.48 0.48 0.50 0.50 0.57 0.57 0.48 0.48 0.50 0.50 0.03 0.02 0.03 0.02 0.02 0.02 0.01 0.01 0.01 0.01 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.01 0.00 0.00 0.00 - Provision of Education Services Teachers’ Salaries Public Schools Transfers to Tertiary Institutes Transfers to Private Sector Goods and Services / Maintenance Infrastructure and Equipment Transfers to Universities Higher Education Development Policy, Coordination and Central Administration Regulation Quality Information and Curriculum Management and Training Assessment Strengthening of Provincial Educational Administration (PREGASE, PRISE Y PRODYMES) Decentralized Entities (INAP, CONEAU, etc.) Other Programs Total 0.00 0.00 0.01 0.01 0.01 0.00 0.00 0.01 0.91 0.00 0.01 0.61 0.00 0.01 0.55 0.00 0.00 0.52 0.00 0.01 0.65 0.00 0.01 0.53 (*) Provisional accrual, (**) Initial credit Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 53 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.14.1 National Government Public Expenditure on Health, 2001-2003 In millions of pesos Item Provision of Health Care Providers (hospitals and health care centers) Salaries, Inputs and Assistance to PNC Beneficiaries Maintenance Goods and Inputs contributed by National Gov Fight against AIDS and Sexually Transmitted Diseases Health Emergency (Insumos Proaps/Remediar) Infrastructure and Equipment Policy, Coordination and Regulation Central Administration (mainly salaries) Training for Health and Assistance Human Resources Health Policy Planning, Control, Regulation And Enforcement/ Support for Public Health Studies and Fiscalización?? Health Sector Reform Research Public Health Programs Fight against AIDS and Sexually Transmitted Diseases Prevention and Control of Specific Diseases And Risks (including Immunizations, VIGI-A, etc.) Maternal and Child Health Care Emergency Coverage Other Programs Total 2001 2002* 2003** Total Net Total Net Total Net Expend Expend Expend Expend Expend Expend 349.62 304.49 388.84 332.67 771.38 699.75 299.80 254.75 296.15 250.94 373.58 302.94 198.24 198.24 219.96 219.96 260.42 260.42 101.56 56.51 76.19 30.98 113.17 42.53 49.82 49.74 92.69 81.73 397.80 396.81 49.82 49.74 75.37 74.42 185.74 184.75 - - 17.32 7.32 212.06 212.06 92.41 52.01 91.10 50.70 79.58 50.01 75.38 45.90 95.82 56.61 94.53 55.35 20.60 20.60 19.84 19.75 22.82 22.79 6.43 6.43 6.58 6.58 7.85 7.85 5.29 8.07 89.19 5.29 8.07 66.47 2.56 0.60 229.26 2.56 0.60 207.41 3.51 5.03 258.95 3.51 5.03 217.03 3.41 3.41 1.56 1.56 0.52 0.52 42.46 38.81 152.77 152.11 139.89 136.36 29.46 1.26 12.61 531.22 10.46 1.26 12.61 462.05 61.29 1.01 12.63 697.68 40.11 1.01 12.62 615.47 88.86 1.87 27.81 1,126.15 50.75 1.87 27.53 1,011.31 (*) Provisional accrual, (**) Initial credit Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 54 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.14.2 National Government Public Expenditure on Health, 2001-2003 As a % of GDP Item Provision of Health Care Providers (hospitals and health care centers) Salaries, Inputs and Assistance to PNC Beneficiaries Maintenance Goods and Inputs contributed by National Gov Fight against AIDS and Sexually Transmitted Diseases Health Emergency (Insumos Proaps/Remediar) Policy, Coordination and Regulation Central Administration (mainly salaries) Training for Health and Assistance Human Resources Health Policy Planning, Control, Regulation And Enforcement/ Support for ??Public Health Studies and Fiscalización Health Sector Reform Research Public Health Programs Fight against AIDS and Sexually Transmitted Diseases Prevention and Control of Specific Diseases And Risks (including Immunizations, VIGI-A, etc.) Maternal and Child Health Care Emergency Coverage Other Programs Total 2001 2002* 2003** Total Net Total Net Total Net Expend Expend Expend Expend Expend Expend 0.13 0.11 0.12 0.11 0.21 0.19 0.11 0.09 0.09 0.08 0.10 0.08 0.07 0.07 0.07 0.07 0.07 0.07 0.04 0.02 0.02 0.01 0.03 0.01 0.02 0.02 0.03 0.03 0.11 0.11 0.02 0.02 0.02 0.02 0.05 0.05 - - 0.01 0.00 0.06 0.06 0.03 0.02 0.03 0.02 0.03 0.02 0.02 0.01 0.03 0.02 0.03 0.02 0.01 0.01 0.01 0.01 0.01 0.01 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.03 0.00 0.00 0.02 0.00 0.00 0.07 0.00 0.00 0.07 0.00 0.00 0.07 0.00 0.00 0.06 0.00 0.00 0.00 0.00 0.00 0.00 0.02 0.01 0.05 0.05 0.04 0.04 0.01 0.00 0.00 0.20 0.00 0.00 0.00 0.17 0.02 0.00 0.00 0.22 0.01 0.00 0.00 0.20 0.02 0.00 0.01 0.31 0.01 0.00 0.01 0.28 (*) Provisional accrual, (**) Initial credit Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 55 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.15.1 National Government Public Expenditure on Social Assistance, 2001-2003 In millions of pesos Item Targeted Social Programs / Monetary Personal Transfers Employment Programs Jefes/as de Hogar Trabajar Labor Training Actions Labor Emergency Plan (PEL) Financial Assistance for Provincial Expenditure Social Scholarships National Education Non-Contributive Scholarships Pensions Other Programs Human Development Income (IDH) Solidaridad Non-Monetary Targeted Social Programs Food Programs School Kitchens Food Emergency Program (PEA) Community Kitchens (FOPAR) Prohuerta Other Central Administration Ministry of Social Presidency Development Ministry of Labor Total 2001 2002* 2003** Total Net Total Net Total Net Expend Expend Expend Expend Expend Expend 1,085.54 998.36 3,258.21 3,257.57 4,818.30 4,768.32 264.70 43.35 177.53 41.98 135.55 135.55 2,335.37 2,248.20 27.22 1.76 58.19 2,335.33 2,248.20 27.18 1.76 58.19 3,754.94 3,722.45 32.49 - 3,754.94 3,722.45 32.49 - 85.80 45.16 45.16 755.75 19.92 19.92 1,268.12 34.28 27.38 6.90 1,233.83 67.93 51.79 16.14 2,421.59 45.16 45.16 755.75 19.92 19.92 115.08 30.09 23.19 6.90 84.99 67.13 51.79 15.34 1,180.57 200.82 200.82 642.70 79.31 79.31 1,621.00 424.85 74.54 300.19 42.99 7.13 1,196.15 91.54 58.45 15.53 17.56 4,970.74 200.82 200.82 642.70 78.71 78.71 199.20 129.51 50.00 29.38 42.99 7.13 69.70 86.41 58.45 10.40 17.56 3,543.18 158.41 158.41 677.43 227.52 227.52 2,108.55 555.09 98.98 392.80 53.32 9.99 1,553.46 117.26 65.93 33.78 17.55 7,044.11 158.41 158.41 677.43 177.54 177.54 263.16 162.10 64.64 34.85 52.61 9.99 101.07 105.12 65.93 21.65 17.55 5,136.61 (*) Provisional accrual, (**) Initial credit Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 56 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.15.2 National Government Public Expenditure on Social Assistance, 2001-2003 As a % of GDP Item 2001 2002* 2003** Total Net Total Net Total Net Expend Expend Expend Expend Expend Expend Targeted Social Programs / Personal Monetary Transfers Employment Programs Jefes/as de Hogar 0.10 Trabajar Labor Training Actions Labor Emergency Plan Financial Assistance for Social Expenditure (PEL) Provincial Programs Scholarships National Education Scholarships Non-Contributive Pensions Other Programs 0.28 Human Development Income 0.01 Solidaridad (IDH) Non-Monetary Targeted Social Programs 0.01 Food Programs School Kitchens 0.01 Food Emergency Program Community Kitchens (FOPAR) (PEA) 0.01 Prohuerta Others 0.00 Central Administration 0.00 Ministry of Social Development Presidency Ministry of Labor Total 0.01 0.40 0.02 0.05 0.03 0.020.02 0.28 0.01 0.47 0.01 0.37 1.04 1.04 1.31 1.30 0.07 0.75 0.72 0.75 0.72 1.02 1.02 0.01 0.05 0.00 0.01 0.02 0.00 1.01 0.02 0.01 - 0.020.02 0.06 0.06 - - 0.06 0.21 0.06 0.03 0.03 0.04 0.21 0.04 0.03 0.18 0.03 0.06 0.06 0.06 - 0.02 0.04 - 0.52 - 0.02 1.01 0.01 0.04 0.04 0.18 0.57 0.15 0.03 0.04 0.11 0.05 0.05 0.07 0.01 0.01 0.00 0.03 0.02 0.14 0.02 0.04 0.02 0.10 0.01 0.03 0.00 0.02 0.38 0.02 0.01 0.01 0.00 0.03 0.02 0.01 0.02 0.00 0.03 0.02 0.01 0.01 0.42 0.00 0.03 0.02 0.03 0.03 0.02 0.900.01 0.00 0.440.01 0.00 1.590.01 0.01 1.130.00 0.01 1.920.00 1.40 (*) Provisional accrual, (**) Initial credit Source: analysis based on data from the Directorate of Consolidated Social Expenditure “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 57 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Table A.16.1 National Government Public Expenditure on Social Insurance, 2001-2003 In millions of pesos 2001 2002* 2003** Total Net Total Net Total Net Expend Expend Expend Expend Expend Expend 249.11 249.11 308.93 308.93 321.11 321.11 15,832.46 15,690.20 16,088.16 15,852.49 17,720.49 17,270.09 15.832,46 15.690,20 16.088,16 15.852,49 17.720,49 17.270,09 609.00 609.00 545.03 545.03 878.57 878.57 1,807.95 1,807.95 1,649.53 1,649.53 1,770.00 1,770.00 353.70 353.70 472.33 472.33 502.08 502.08 2,389.23 2,389.23 2,623.97 2,623.97 3,148.77 3,148.77 3,973.84 3,973.84 3,893.89 3,893.89 4,175.01 4,175.01 Item Administration of ANSES, SSS, etc Retirement and Pensions National (including ex-provincial funds) Provincial Subsidies Family Benefits Unemployment Insurance PAMI Health Insurers Total 25,215.30 25,073.04 25,581.84 25,346.17 28,516.03 28,065.63 (*) Provisional accrual, (**) Initial credit Source: analysis based on data from the Directorate of Consolidated Social Expenditure Table A.16.2 National Government Public Expenditure on Social Insurance, 2001-2003 As a % of GDP Item Administration of ANSES, SSS, etc Retirement and Pensions National (including ex-provincial funds) Provincial Subsidies Family Benefits Unemployment Insurance PAMI Health Insurers Total 2001 2002* 2003** Total Net Total Net Total Net Expend Expend Expend Expend Expend Expend 0.09 0.09 0.10 0.10 0.09 0.09 5.89 5.84 5.14 5.06 4.83 4.71 5.89 5.84 5.14 5.06 4.83 4.71 0.23 0.23 0.17 0.17 0.24 0.24 0.67 0.67 0.53 0.53 0.48 0.48 0.13 0.13 0.15 0.15 0.14 0.14 0.89 0.89 0.84 0.84 0.86 0.86 1.48 1.48 1.24 1.24 1.14 1.14 9.38 9.33 8.17 8.10 7.77 7.65 (*) Provisional accrual, (**) Initial credit Source: analysis based on data from the Directorate of Consolidated Social Expenditure Table A.17 Price Index and GDP, 2000-2003 2000 Wholesale Price Index Consumer Price Index Combined Price Index GDP in millions of pesos 2001 2002 2003 1.02 1.01 1.02 1.00 1.00 1.00 1.77 1.27 1.52 2.13 1.45 1.79 284,204 268,697 313,039 366,884 Data for 2003 is estimated “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 58 World Bank Office for Argentina, Chile, Paraguay and Uruguay –Working Paper N.03/04 Source: analysis based on data from the Directorate of Consolidated Social Expenditure Bibliography BECERRA, M., ESPAÑA, S and FISZBEIN, A (2003) Expenditure on Basic Education in Argentina and Aspects of Allocation Efficiency World Bank Washington D.C DGSC (2001a) Characterization and Evolution of Social Public Expenditure 2000 Secretariat of Economic Policy Ministry of Economy Buenos Aires DGSC (2001b) Report on Provincial Employment Programs Secretariat of Economy Ministry of Economy Buenos Aires DGSC (2003) Report on Employment Programs of Provincial Execution Secretariat of Economic Policy Ministry of Economy Buenos Aires DNPGS (1999a) Characterization and Evolution of Social Public Expenditure 1980-1997 Secretariat of Economic and Regional Programming Ministry of Economy Buenos Aires DNPGS (1999b) Characterization and Evolution of Social Public Expenditure 1999 Secretariat of Economic and Regional Programming Ministry of Economy Buenos Aires NATIONAL BUDGET OFFICE (2002) National Budget 2002 – Law N° 25.565 Secretariat of Economy Ministry of Economy Buenos Aires PORTO, A and SANGUINETTI, P (1997) “Fiscal Decentralization, Inter.-Governmental Transfers and Regional and Personal Income Distribution: Situation in Latin America.” In Fiscal Decentralization in Latin America CEPAL Santiago de Chile WORLD BANK (2003) Argentina: Reforming Policies and Institutions for Efficiency and Equity of Public Expenditures Argentina, Chile, Paraguay & Uruguay Country Management Unit Buenos Aires wb164040 /storage1/vhost/convert.123doc.vn/data_temp/document/twn1666072308-1276199-16660723087738/twn1666072308.doc “Public Expenditure on Human Development in Argentina.” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 59 i The authors would like to acknowledge the valuable contribution of Evelina Bertranou and Caterina Colombo in the preparation of this document, and of Sabrina Reichler in the preparation of figures with the aid of Julia Frenkel, Ariela Goldschmit and Ighal Low All of them are part of the Directorate of Consolidated Social Expenditure The authors also acknowledge the valuable comments and contributions of Oscar Cetrangolo, Rafael Rofman, Marcelo Harriague and Juan Pablo Jiménez ii The preparation of the data used in this document was finalized in April 2003 National government figures for 2002 are provisional, and those of 2003 correspond to the initial credit budget stage; for provinces as a whole, figures are provisional for the period 2000- 2001 and they are estimated for 2002 iii To get the value of data in real terms, a combined price index is used It is formed by the general wholesale price index and the consumer price index in equal parts For more details see table A.17 in the annex iv For more details on consolidation methodology see DNPGS (1999a and 1999b) and DGSC (2001a) v GPDH is executed by the National Government, the provinces and municipalities Although in GPSC municipal government expenditure is taken into account, it is not included in GPDH as from this point due to lack of information with the necessary disaggregation for our analysis vi Social Insurance is a wider area than Social Security as it is used in DGSC classifications, because it comprises items that not belong to social security and are executed through ANSeS, and that DGSC includes in the Labor function –Unemployment Insurance and Family Benefits– as well as expenditure that DGSC classifies under the Health function vii Buenos Aires City is considered as a province viii To analyze the 2000/2001 period, the average of both years is presented, as the structure of expenditure in terms of government level and programs is very similar, as it is observed in the tables and in the Statistical Annex ix Article of the Argentine Constitution establishes that each province will have its own Constitution that is to ensure the administration of justice and the provision of primary education x The program Fight Against AIDS and Sexually Transmitted Diseases is divided into two parts: expenditure on drugs is included in Provision of Health Care, while expenditure on prevention campaigns is allocated to Public Health Programs Due to the lack of accurate information, in the Assistance to PNC Beneficiaries program –PROFE– transfers to private providers are considered as national expenditure (Buenos Aires City and Buenos Aires Province, and a small percentage of the rest of the provinces), and transfers to the different entities in provincial governments are considered as provincial expenditure Transfers to PAMI are included in the Social Insurance sector xi Expenditure on provincial employment offices cannot be disaggregated and it is therefore included in provincial expenditure on employment programs Expenditure on the Food Emergency Program corresponds to the Unidos food program, which in 2000 included ProHuerta xii According to Law Nº 23.966, 11% of VAT is allocated to social security: 93.7% is allocated to the National Social Security Regime (SIJP) and 6.3% to provincial and municipal social security funds Besides, 6.3% of the tax on personal assets is also allocated to social security, after millions are deducted an allocated to INCUCAI annually xiii Other aspects of financing, such as the distinction between internal and external financing, are not analyzed in this document xiv For different classifications of GPSC, see (1999a and 1999b) and DGSC (2001a) xv It includes: tariffs subsidy, complementary subsidy and internments for retirees and pensioners xvi It is worth noting that 15% of co-participation taxes is pre-distributed (“pre-coparticipados”) to finance the social security deficit xvii In this section national government expenditure refers to total expenditures and therefore includes transfers to provinces xviii However, Law N° 25.733 of March 2003 establishes that FONID is to distribute $726 millions from 2002 and $750 millions from the 2003 budget, although these funds will be distributed if the corresponding revenue is available xix This program was created in 2002, but its percentage of accrual was low In 2003, its budget increased significantly Its characteristics are explained in detail in the following section xx In 2003, Health Care to PNC Beneficiaries becomes activity of the Health Care Development Support program, executed by the Ministry of Health Previously, it belonged to the Ministry of Social Development xxi In 2002 this program was called Care for Vulnerable Groups and was activity of the Elders and Social Action/ Social Action for the Elderly Program These changes are described in section II.1.1 xxii This increase is due to the fact that in 2003 Decrees N° 896 and N° 926, which established a 13% reduction on social security payments were abolished xxiii For further details see DGSC (2001b and 2003) xxiv In May 2002 the unemployment rate reached 21.5% and the incidence rate rose to 53.0% of the population, while in May 2001 those rates were 16.4% and 35.9% respectively ... not only a substitution effect but an increase in provincial nominal expenditure ? ?Public Expenditure on Human Development in Argentina. ” By Damián Bonari, Marcelo Becerra and Ariel Fiszbein 33... terms.xx Expenditure allocated to coordinating and regulating the sector remains the same in real terms, on account of the freeze on expenditure on personnel, its main component ? ?Public Expenditure on. .. Uruguay –Working Paper N.03/04 Box Considerations on Social Security Health Insurers Expenditure Considering Social Security Health Insurers (including PAMI) as public expenditure on human development