This document discusses expenditure reform options for Portugal. It begins by framing the debate around rethinking the appropriate size and functions of the state. While larger governments have traditionally been linked to lower growth, they do not necessarily lead to worse outcomes if spending is efficient and equitable. The report then focuses on reform options in key spending areas for Portugal that could improve both efficiency and equity, including government wages and employment, pensions, non-pension social benefits, education, and health care. Reforms in these areas aim to enhance service delivery, focus policies on equitable outcomes, stimulate economic activity, and achieve significant permanent annual expenditure savings by 2014.