Fiscal Vaccine: Strategic Public Expenditure Allocation in Health Promotion and Disease Prevention for Thailand’s Long-term Sustainability
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Abstract
The COVID-19 pandemic and demographic transition toward aging societies have exposed healthcare system vulnerabilities and highlighted the urgent need to reshape public health expenditure allocation approaches. Thailand, entering an aged society with 20% elderly population and facing non-communicable disease burdens causing 1.6 trillion baht annual economic losses, requires innovative frameworks for health investment emphasizing prevention and fiscal sustainability. This study aims to develop a “Fiscal Vaccine” conceptual framework through integration of theories from public economics, public administration, and public policy for systematic and strategic allocation of public expenditure on health promotion and disease prevention. The study employed systematic literature review following PRISMA guidelines from 127 selected research articles, combined with conceptual framework development and feasibility analysis. The study developed the Fiscal Vaccine conceptual framework, analogizing public expenditure allocation to medical vaccine mechanisms to create “Economic Immunity” for nations. The framework comprises five core components: prevention-first approach, strategic long-term investment, intersectoral coordination, sustainability focus, and integrated monitoring and evaluation, operating through a five-stage interconnected mechanism. The Fiscal Vaccine represents a conceptual innovation with potential as a crucial tool for policymakers in building health and economic security, particularly for developing countries facing demographic transition and fiscal sustainability challenges.
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