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Submitted by Andrea Planter-Otter, MD, MPH on

Thank you for the clear distinctions among rationales for government spending (and taxation). You say that governments adopt goals like "free health care" and "free water", which are mainly private goods, for essentially populist reasons and then too often the benefits are captured mainly by the rich. Am I correct in my understanding?

If so, what role should World Bank and international technocrats play? In particular, just last month the World Bank has adopted universal health coverage as its one and only goal for all its aid programmes in all developing countries. Would better health of the poor be a more appropriate goal, as I believe? For example through sanitation, reducing pollution and other externalities? Or do you think it makes no difference what the World Bank-endorsed goal for health of the poor is?

If it has influence and funds government spending (taxpayers have to repay the loans), then it should perhaps avoid exacerbating the perverse redistributive impacts you have highlighted.