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Indicators for Measuring Intergenerational Fairness of Social Security Systems—The Case of the German Social Health Insurance

Author

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  • Stefan Fetzer

    (Faculty of Business, Aalen University of Applied Sciences, D-73430 Aalen, Germany)

  • Stefan Moog

    (Prognos AG, D-79100 Freiburg im Breisgau, Germany)

Abstract

The issue of fiscal sustainability is often labelled as a synonym for intergenerational fairness; however, pay-as-you-go schemes such as the German Social Health Insurance (SHI) involve a “natural” amount of intergenerational redistribution from younger net payers to older net beneficiaries. We calculate intertemporal balance sheets of SHI and compare two generational accounting approaches (GAC and GAIB) with an alternative measure of intergenerational fairness, SM, which we derive from Settergren and Mikula (2005). Our results indicate that the SM concept leads to similar implications concerning the amount of intergenerational redistribution as classical measures of fiscal sustainability. For the SM approach, the balance sheet of SHI shows a rate of unfunded benefits of 25 percent. Closing this gap requires an increase of the contribution rate by 30 to 40 percent. This total effect can be separated into an effect due to the current population structure (10 p.p.), the increase in life expectancy (10 p.p.), and medical technical progress (about 10 to 20 p.p.).

Suggested Citation

  • Stefan Fetzer & Stefan Moog, 2021. "Indicators for Measuring Intergenerational Fairness of Social Security Systems—The Case of the German Social Health Insurance," Sustainability, MDPI, vol. 13(10), pages 1-18, May.
    • Handle: RePEc:gam:jsusta:v:13:y:2021:i:10:p:5743-:d:558666
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    1. Reibling, Nadine & Ariaans, Mareike & Wendt, Claus, 2019. "Worlds of Healthcare: A Healthcare System Typology of OECD Countries," Health Policy, Elsevier, vol. 123(7), pages 611-620.
    2. Olivier Blanchard, 2019. "Public Debt and Low Interest Rates," American Economic Review, American Economic Association, vol. 109(4), pages 1197-1229, April.
    3. Robert M. Solow, 1956. "A Contribution to the Theory of Economic Growth," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 70(1), pages 65-94.
    4. Laurence J. Kotlikoff, 2005. "Who’s Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," Working Papers id:286, eSocialSciences.
    5. Breyer Friedrich & Ulrich Volker, 2000. "Gesundheitsausgaben, Alter und medizinischer Fortschritt: Eine Regressionsanalyse / Ageing, Medical Progress and Health Care Expenditures: A Regression Analysis," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 220(1), pages 1-17, February.
    6. Friedrich Breyer & Normann Lorenz & Gerald Pruckner & Thomas Schober, 2021. "Looking into the Black Box of “Medical Progress”: Rising Health Expenditures by Illness Type and Age," CDL Aging, Health, Labor working papers 2021-01, The Christian Doppler (CD) Laboratory Aging, Health, and the Labor Market, Johannes Kepler University Linz, Austria.
    7. Carlos Vidal-Meliá & Mar𨁤el Carmen Boado-Penas, 2013. "Compiling the actuarial balance for pay-as-you-go pension systems. Is it better to use the hidden asset or the contribution asset?," Applied Economics, Taylor & Francis Journals, vol. 45(10), pages 1303-1320, April.
    8. Chernew, Michael E. & Newhouse, Joseph P., 2011. "Health Care Spending Growth," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 1-43, Elsevier.
    9. Christoph Metzger, 2018. "An actuarial balance sheet of the Swiss old‐age pension scheme," International Social Security Review, John Wiley & Sons, vol. 71(1), pages 25-49, January.
    10. Mihajlo Jakovljevic & Elena Potapchik & Larisa Popovich & Debasis Barik & Thomas E. Getzen, 2017. "Evolving Health Expenditure Landscape of the BRICS Nations and Projections to 2025," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 844-852, July.
    11. Felder, Stefan & Werblow, Andreas & Zweifel, Peter, 2010. "Do red herrings swim in circles? Controlling for the endogeneity of time to death," Journal of Health Economics, Elsevier, vol. 29(2), pages 205-212, March.
    12. Carlos Vidal-Meliá & María del Carmen Boado-Penas & Ole Settergren, 2009. "Automatic Balance Mechanisms in Pay-As-You-Go Pension Systems," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 34(2), pages 287-317, April.
    13. repec:ces:ifodic:v:7:y:2009:i:4:p:14567035 is not listed on IDEAS
    14. Ulrich Benz & Stefan Fetzer, 2006. "Indicators for Measuring Fiscal Sustainability: A Comparison of the OECD Method and Generational Accounting," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 62(3), pages 367-391, September.
    15. Friedrich Breyer & Normann Lorenz & Thomas Niebel, 2015. "Health care expenditures and longevity: is there a Eubie Blake effect?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 95-112, January.
    16. Christian Hagist & Stefan Moog & Bernd Raffelhüschen & Johannes Vatter, 2009. "Public Debt and Demography - An International Comparison Using Generational Accounting," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 7(04), pages 29-36, January.
    17. Daniel Ehing & Stefan Moog, 2013. "Erwerbspersonen- und Arbeitsvolumenprojektionen bis ins Jahr 2060 [Labor force- and work volume-projections until 2060]," Journal for Labour Market Research, Springer;Institute for Employment Research/ Institut für Arbeitsmarkt- und Berufsforschung (IAB), vol. 46(2), pages 167-182, August.
    18. Christian Hagist & Stefan Moog & Bernd Raffelhüschen & Johannes Vatter, 2009. "Public Debt and Demography - An International Comparison Using Generational Accounting," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 7(4), pages 29-36, 01.
    19. Robert Barro, 2023. "r Minus g," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 48, pages 1-17, April.
    20. Felder Stefan & Fetzer Stefan, 2007. "Kapitaldeckung in der Gesetzlichen Krankenversicherung: Wer bezahlt den Übergang? / Funding Social Health Insurance: Who Pays for the Transition?," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 227(5-6), pages 603-620, October.
    21. Christian Hagist & Laurence Kotlikoff, 2005. "Who's Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," NBER Working Papers 11833, National Bureau of Economic Research, Inc.
    22. Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1991. "Generational Accounts: A Meaningful Alternative to Deficit Accounting," NBER Chapters, in: Tax Policy and the Economy, Volume 5, pages 55-110, National Bureau of Economic Research, Inc.
    23. Auerbach, Alan J & Gokhale, Jagadeesh & Kotlikoff, Laurence J, 1992. " Generational Accounting: A New Approach to Understanding the Effects of Fiscal Policy on Saving," Scandinavian Journal of Economics, Wiley Blackwell, vol. 94(2), pages 303-318.
    24. Boll, Stephan, 1996. "Intergenerational redistribution through the public sector: Methodology of generational accounting and its empirical application to Germany," Discussion Paper Series 1: Economic Studies 1996,06e, Deutsche Bundesbank.
    25. Settergren, Ole & Mikula, Boguslaw D., 2005. "The rate of return of pay-as-you-go pension systems: a more exact consumption-loan model of interest," Journal of Pension Economics and Finance, Cambridge University Press, vol. 4(2), pages 115-138, July.
    26. Christoph Metzger, 2019. "Accounting of the German Statutory Pension Scheme: Balance Sheet, Cross‐Sectional Internal Rate of Return and Implicit Tax Rate," Fiscal Studies, John Wiley & Sons, vol. 40(2), pages 239-270, June.
    27. Settergren, Ole & Mikula, Boguslaw D., 2005. "The Rate of Return of Pay-As-You-Go Pension Systems: A More Exact Consumption-Loan Model of Interest," Discussion Paper 249, Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University.
    28. Peter Zweifel & Stefan Felder & Markus Meiers, 1999. "Ageing of population and health care expenditure: a red herring?," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 485-496, September.
    29. Klaus Kaier & Christoph Müller, 2015. "New figures on unfunded public pension entitlements across Europe: concept, results and applications," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 42(4), pages 865-895, November.
    30. Ventura-Marco, Manuel & Vidal-Meliá, Carlos, 2014. "An Actuarial Balance Sheet Model For Defined Benefit Pay-As-You-Go Pension Systems With Disability And Retirement Contingencies," ASTIN Bulletin, Cambridge University Press, vol. 44(2), pages 367-415, May.
    31. repec:aei:rpaper:1008582820 is not listed on IDEAS
    32. Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1994. "Generational Accounting: A Meaningful Way to Evaluate Fiscal Policy," Journal of Economic Perspectives, American Economic Association, vol. 8(1), pages 73-94, Winter.
    33. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
    34. Kelly, Mark, 2017. "Health capital accumulation, health insurance, and aggregate outcomes: A neoclassical approach," Journal of Macroeconomics, Elsevier, vol. 52(C), pages 1-22.
    35. Bahnsen, Lewe & Fetzer, Stefan & Franke, Fabian & Hagist, Christian, 2020. "Gone with the windfall – Germany's Second LTC Strengthening Act and its intergenerational implications," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    36. Robert Holzmann & Robert Palacios & Asta Zviniene, 2001. "On the Economics and Scope of Implicit Pension Debt: An International Perspective," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 28(1), pages 97-129, March.
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