The Sustainability of European Health Care Systems: Beyond Income and Ageing
AbstractDuring the last thirty years health care expenditure (HCE) has been growing much more rapidly than GDP in all OECD countries. Against this background, we look at the determinants of HCE growth in Europe, explicitly taking into account the role of income, ageing population, life habits, technological progress, as well as institutional and budgetary variables. Our results confirm that the current trend of increasing HCE is rooted in a set of differentiated factors. Income levels lead to higher HCE, and the magnitude of the estimated elasticity poses serious concerns about long-term sustainability of current trends. All in all, HCE growth appears to be driven by structural factors that cannot be easily compressed if not through rationing. The key challenge for many European Governments seems to be the design of pluralistic systems, where a well-balanced mix of public and private financing can realize a balance between sustainability and access.
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 University Library of Munich, Germany in its series MPRA Paper with number 16026.
Date of creation: 24 Oct 2008
Date of revision:
health care expenditure; sustainability; ageing population; income elasticity; welfare;
Other versions of this item:
- Fabio Pammolli & Massimo Riccaboni & Laura Magazzini, 2012. "The sustainability of European health care systems: beyond income and aging," The European Journal of Health Economics, Springer, vol. 13(5), pages 623-634, October.
- Fabio Pammolli & Massimo Riccaboni & Laura Magazzini, 2008. "The Sustainability of European Health Care Systems: Beyond Income and Ageing," Working Papers 52, University of Verona, Department of Economics.
- H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
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.:
- Daniela Del Boca & Daniela Vuri, 2006.
"The Mismatch between Employment and Child Care in Italy: the Impact of Rationing,"
CHILD Working Papers
wp08_06, CHILD - Centre for Household, Income, Labour and Demographic economics - ITALY.
- Daniela Del Boca & Daniela Vuri, 2007. "The mismatch between employment and child care in Italy: the impact of rationing," Journal of Population Economics, Springer, vol. 20(4), pages 805-832, October.
- Daniela Del Boca & Daniela Vuri, 2006. "The Mismatch between Employment and Child Care in Italy: the Impact of Rationing," Carlo Alberto Notebooks 31, Collegio Carlo Alberto.
- Blundell, R. & Bond, S., 1995.
"Initial Conditions and Moment Restrictions in Dynamic Panel Data Models,"
104, Economics Group, Nuffield College, University of Oxford.
- Blundell, Richard & Bond, Stephen, 1998. "Initial conditions and moment restrictions in dynamic panel data models," Journal of Econometrics, Elsevier, vol. 87(1), pages 115-143, August.
- Richard Blundell & Steve Bond, 1995. "Initial conditions and moment restrictions in dynamic panel data models," IFS Working Papers W95/17, Institute for Fiscal Studies.
- R Blundell & Steven Bond, . "Initial conditions and moment restrictions in dynamic panel data model," Economics Papers W14&104., Economics Group, Nuffield College, University of Oxford.
- Baumol, William J, 1993. " Health Care, Education and the Cost Disease: A Looming Crisis for Public Choice," Public Choice, Springer, vol. 77(1), pages 17-28, September.
- Robert E Hall & Charles I Jones, 2007.
"The Value of Life and the Rise in Health Spending,"
The Quarterly Journal of Economics,
MIT Press, vol. 122(1), pages 39-72, 02.
- Blomqvist, A. G. & Carter, R. A. L., 1997.
"Is health care really a luxury?,"
Journal of Health Economics,
Elsevier, vol. 16(2), pages 207-229, April.
- Gerdtham, Ulf-G. & Jonsson, Bengt, 2000. "International comparisons of health expenditure: Theory, data and econometric analysis," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 1, pages 11-53 Elsevier.
- 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.
- Elizabeth Docteur & Howard Oxley, 2003.
"Health-Care Systems: Lessons from the Reform Experience,"
OECD Health Working Papers
9, OECD Publishing.
- Elizabeth Docteur & Howard Oxley, 2003. "Health-Care Systems: Lessons from the Reform Experience," OECD Economics Department Working Papers 374, OECD Publishing.
- N.R. Murthy & Albert Okunade, 2000. "Managed care, deficit financing, and aggregate health care expenditure in the United States: A cointegration analysis," Health Care Management Science, Springer, vol. 3(4), pages 279-285, September.
- Hans-Peter Kohler & Francesco C. Billari & José Antonio Ortega, 2002. "The Emergence of Lowest-Low Fertility in Europe During the 1990s," Population and Development Review, The Population Council, Inc., vol. 28(4), pages 641-680.
- Pammolli, Fabio & Riccaboni, Massimo & Oglialoro, Claudia & Magazzini, Laura & Baio, Gianluca & Salerno, Nicola, 2005.
"Medical Devices Competitiveness and Impact on Public Health Expenditure,"
16021, University Library of Munich, Germany.
- Gianluca Baio & Laura Magazzini & Claudia Oglialoro & Fabio Pammolli & Massimo Riccaboni, 2005. "Medical Devices: Competitiveness and Impact on Public Health Expenditure," Working Papers 05-2005, Competitività Regole Mecati (CERM).
- Jochen Hartwig, 2006.
"What Drives Health Care Expenditure? Baumol’s Model of ‘Unbalanced Growth’ Revisited,"
KOF Working papers
06-133, KOF Swiss Economic Institute, ETH Zurich.
- Hartwig, Jochen, 2008. "What drives health care expenditure?--Baumol's model of 'unbalanced growth' revisited," Journal of Health Economics, Elsevier, vol. 27(3), pages 603-623, May.
- Jochen Hartwig, 2011. "Testing The Baumol–Nordhaus Model With Eu Klems Data," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 57(3), pages 471-489, 09.
- Nickell, Stephen J, 1981. "Biases in Dynamic Models with Fixed Effects," Econometrica, Econometric Society, vol. 49(6), pages 1417-26, November.
- John Nixon, . "Convergence Analysis of Health Care Expenditure in the EU Countries Using Two Approaches," Discussion Papers 99/3, Department of Economics, University of York.
- Richard Rogerson, 2008.
"Structural Transformation and the Deterioration of European Labor Market Outcomes,"
Journal of Political Economy,
University of Chicago Press, vol. 116(2), pages 235-259, 04.
- Richard Rogerson, 2007. "Structural Transformation and the Deterioration of European Labor Market Outcomes," NBER Working Papers 12889, National Bureau of Economic Research, Inc.
- Jewell, Todd & Lee, Junsoo & Tieslau, Margie & Strazicich, Mark C., 2003. "Stationarity of health expenditures and GDP: evidence from panel unit root tests with heterogeneous structural breaks," Journal of Health Economics, Elsevier, vol. 22(2), pages 313-323, March.
- Richard B. Freeman & Ronald Schettkat, 2005. "Marketization of household production and the EU-US gap in work," Economic Policy, CEPR & CES & MSH, vol. 20(41), pages 6-50, 01.
- Anderson, T. W. & Hsiao, Cheng, 1982. "Formulation and estimation of dynamic models using panel data," Journal of Econometrics, Elsevier, vol. 18(1), pages 47-82, January.
- Han, Yoo-Jin, 2007. "Measuring industrial knowledge stocks with patents and papers," Journal of Informetrics, Elsevier, vol. 1(4), pages 269-276.
- Richard Rogerson, 2006. "Understanding Differences in Hours Worked," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 9(3), pages 365-409, July.
- 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.
- Arellano, Manuel & Bond, Stephen, 1991.
"Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations,"
Review of Economic Studies,
Wiley Blackwell, vol. 58(2), pages 277-97, April.
- Tom Doan, . "RATS program to replicate Arellano-Bond 1991 dynamic panel," Statistical Software Components RTZ00169, Boston College Department of Economics.
- Okunade, Albert A. & Murthy, Vasudeva N. R., 2002. "Technology as a 'major driver' of health care costs: a cointegration analysis of the Newhouse conjecture," Journal of Health Economics, Elsevier, vol. 21(1), pages 147-159, January.
- Mary O'Mahony & Marcel P. Timmer, 2009. "Output, Input and Productivity Measures at the Industry Level: The EU KLEMS Database," Economic Journal, Royal Economic Society, vol. 119(538), pages F374-F403, 06.
- Carrion-i-Silvestre, Josep Lluis, 2005. "Health care expenditure and GDP: Are they broken stationary?," Journal of Health Economics, Elsevier, vol. 24(5), pages 839-854, September.
- Fabio Pammolli & Nicola Carmine Salerno, 2011. "Le differenze regionali nella governance della spesa sanitaria - SaniRegio-2011," Working Papers 02-2011, Competitività Regole Mecati (CERM).
- Allen, Nicola & Pichler, Franz & Wang, Tina & Patel, Sundip & Salek, Sam, 2013. "Development of archetypes for non-ranking classification and comparison of European National Health Technology Assessment systems," Health Policy, Elsevier, vol. 113(3), pages 305-312.
- Renuga Nagarajan & Aurora A.C. Teixeira & Sandra T. Silva, 2013. "The impact of population ageing on economic growth: an in-depth bibliometric analysis," FEP Working Papers 505, Universidade do Porto, Faculdade de Economia do Porto.
- Pammolli, Fabio & Salerno, Nicola, 2011.
"Le differenze regionali nella governance della spesa sanitaria. La sanità alla sfide del federalismo: il modello SaniRegio di CeRM
[Regional differences in the governance of health care expenditur," MPRA Paper 36934, University Library of Munich, Germany.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Ekkehart Schlicht).
If references are entirely missing, you can add them using this form.