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Intergenerational Solidarity of the Public Health Care Systems in Europe


  • Katerina Pavlokova

    () (Ministry of Health of the Czech Republic)


Ageing of the population has become one of the important topics in developed countries in recent times. Health care and pension systems based on solidarity are especially vulnerable to demographic changes associated with falling fertility rates and increasing life expectancy. The main task of the paper is to answer and quantify the question who bears the costs and who benefits from the public health care systems and reveal possible future imbalances. We introduce a long-term projection technique enhanced by some elements of generational accounting approach with intent to express the ageing problem in the health care sector. We explore both the revenue side of the public health care systems as well as the health care expenditures from the perspective of separate generations. Following countries have been selected as the representatives of the European health care systems: the Czech Republic, Denmark, Estonia, France, Italy, the Netherlands, Switzerland and the United Kingdom. The model points to un-sustainability of the current public health care systems if the effective tax rates did not increase. If the demand for health care had to be satisfied, the health care systems financed through social contributions and income-based taxes would be faced with increasing burden on working population.

Suggested Citation

  • Katerina Pavlokova, 2010. "Intergenerational Solidarity of the Public Health Care Systems in Europe," ACTA VSFS, University of Finance and Administration, vol. 4(1), pages 12-46.
  • Handle: RePEc:prf:journl:v:4:y:2010:i:1:p:12-46

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    References listed on IDEAS

    1. J. Ignacio Conde-Ruiz & Paola Profeta, 2007. "The Redistributive Design of Social Security Systems," Economic Journal, Royal Economic Society, vol. 117(520), pages 686-712, April.
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    More about this item


    health care financing; sustainability; generational accounts; population ageing;

    JEL classification:

    • E62 - Macroeconomics and Monetary Economics - - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook - - - Fiscal Policy
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health


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