Xu and colleagues in their examination of data from household surveys in 59 countries, argue that middle and low income countries in particular ought to address gaps in their health policy in terms of available health services, health insurance, out-of-pocket payments and financial risk protection to minimise catastrophic health expenditures and potential consequences of impoverishment [ 37].
The great unexplored area of public expenditure is the annual revenue consequences of servicing the long-term PFI debts, all a consequence of investment in new hospitals, courts, schools, roads, IT and water and waste infrastructure.
The consequences of cutting expenditure further could be devastating.
While increases to RRT-related expenditure are troubling, the physiological consequences of CKD are most worrisome.
Research on the biochemistry of energy expenditure reveals the specific metabolic consequences of eating different food types, including sugars.
This finding leads to the hypothesis that changes in central nervous system disruption due to sleep loss, such as the alterations in appetitive brain signaling discovered in the current study, may trigger decisions that lead to increased calorie consumption in excess of energy expenditure changes, one consequence of which is weight gain.
What have been the practical consequences of these expenditures?
A large proportion of the population is impoverished because of high out-of-pocket health-care expenditures and suffers the adverse consequences of poor quality of care.
"Spending embedded in the tax code is effectively funded before discretionary spending is considered," said the Government Accountability Office in one of several reports warning of the consequences of tax expenditures.
Also in line with the literature [ 47] (systematic review), the strong association between BMI and walking impairments can simply be explained by low energy expenditure as a consequence of difficulties in moving around, contributing to a higher BMI.
Moreover it can be argued that high-burden countries could realize a significant return on investment from neglected disease R&D through savings to public expenditure as a consequence of improved treatment regimens, diagnostics, vaccines and operations.
