Can we afford to live longer in better health?
AbstractThis document analyses the effects of ageing populations upon public finances. More specifically, it focuses on the implications of ageing for acute health care, long-term care, and public pension expenditure. It does so for 15 EU countries. �It pays particular attention to three novel insights: (i) a large part of health care spending relates to time to death rather than to age: (ii) life expectancy may increase much faster than current demographic projections suggest, and (iii) the average health status may continue to improve in the future. It adopts a generational accounting model that incorporates health care costs during the last years of life, decomposed into an acute health care component and a long-term care component. The projections show that gains in life expectancy increase age-related expenditure; better health has the opposite effect. Combined, these trends reduce health care expenditure and increase pension expenditure. Their joint effect upon public finance is rather modest, however. Hence, the assessment of public finances in most EU15 countries does not change: even if a faster increase in life expectancy should combine with an improvement in health, current fiscal and social security institutions are unsustainable.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by CPB Netherlands Bureau for Economic Policy Analysis in its series CPB Document with number 85.
Date of creation: Jun 2005
Date of revision:
Find related papers by JEL classification:
- H62 - Public Economics - - National Budget, Deficit, and Debt - - - Deficit; Surplus
- I10 - Health, Education, and Welfare - - Health - - - General
- J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
This paper has been announced in the following NEP Reports:
- NEP-ALL-2006-02-12 (All new papers)
- NEP-EEC-2006-02-12 (European Economics)
- NEP-HEA-2006-02-12 (Health Economics)
- NEP-PBE-2006-02-12 (Public Economics)
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Seshamani, Meena & Gray, Alastair M., 2004. "A longitudinal study of the effects of age and time to death on hospital costs," Journal of Health Economics, Elsevier, vol. 23(2), pages 217-235, March.
- Sally C. Stearns & Edward C. Norton, 2004. "Time to include time to death? The future of health care expenditure predictions," Health Economics, John Wiley & Sons, Ltd., vol. 13(4), pages 315-327.
- David M. Cutler & Louise Sheiner, 1998.
"Demographics and Medical Care Spending: Standard and Non-Standard Effects,"
NBER Working Papers
6866, National Bureau of Economic Research, Inc.
- David M. Cutler & Louise Sheiner, 1999. "Demographics and medical care spending: standard and non-standard effects," Finance and Economics Discussion Series 1999-20, Board of Governors of the Federal Reserve System (U.S.).
- Darius Lakdawalla & Tomas Philipson, 1999.
"Aging and the Growth of Long-Term Care,"
9909, Harris School of Public Policy Studies, University of Chicago.
- David M. Cutler & Ellen Meara, 2001.
"The Concentration of Medical Spending: An Update,"
in: Themes in the Economics of Aging, pages 217-240
National Bureau of Economic Research, Inc.
- Fogel, Robert W., 1993.
"Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy,"
Nobel Prize in Economics documents
1993-1, Nobel Prize Committee.
- Fogel, Robert W, 1994. "Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy," American Economic Review, American Economic Association, vol. 84(3), pages 369-95, June.
- Robert W. Fogel, 1994. "Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy," NBER Working Papers 4638, National Bureau of Economic Research, Inc.
- Borsch-Supan, Axel, 2000. "Incentive effects of social security on labor force participation: evidence in Germany and across Europe," Journal of Public Economics, Elsevier, vol. 78(1-2), pages 25-49, October.
- Thai-Thanh Dang & Pablo Antolín & Howard Oxley, 2001. "Fiscal Implications of Ageing: Projections of Age-Related Spending," OECD Economics Department Working Papers 305, OECD Publishing.
- Jonathan Gruber & David A. Wise, 2002.
"Social Security Programs and Retirement Around the World: Micro Estimation,"
NBER Working Papers
9407, National Bureau of Economic Research, Inc.
- Jonathan Gruber & David A. Wise, 2004. "Social Security Programs and Retirement around the World: Micro-Estimation," NBER Books, National Bureau of Economic Research, Inc, number grub04-1, December.
- Kathleen McGarry, 2004. "Health and Retirement: Do Changes in Health Affect Retirement Expectations?," Journal of Human Resources, University of Wisconsin Press, vol. 39(3).
- Vaupel, James W, 1998. "Demographic Analysis of Aging and Longevity," American Economic Review, American Economic Association, vol. 88(2), pages 242-47, May.
- Ivonne Honekamp & Daniel Possenriede, 2008. "Redistributive effects in public health care financing," The European Journal of Health Economics, Springer, vol. 9(4), pages 405-416, November.
- Casper van Ewijk & Nick Draper & Harry ter Rele & Ed Westerhout, 2006. "Ageing and the sustainability of Dutch public finances," CPB Special Publication 61, CPB Netherlands Bureau for Economic Policy Analysis.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ().
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.