IDEAS home Printed from https://ideas.repec.org/p/ces/ceswps/_1574.html
   My bibliography  Save this paper

Social Health Insurance - the Major Driver of Unsustainable Fiscal Policy?

Author

Listed:
  • Christian Hagist
  • Norbert Klusen
  • Andreas Plate
  • Bernd Raffelhüschen

Abstract

During the next decades the populations of most developed countries will grow older as a result of the low level of birth rates since the 1970s and/or the continuously increasing life expectancy. We show within a Generational Accounting framework how unsustainable the public finances of France, Germany, Switzerland and the U.S. are, given their demographic developments. Thereby our focus lies on social health insurance systems that are in addition affected by medical-technical progress. Due to the cost-increasing effect of medical-technical progress one can justifiably say that social health insurance schemes are the major drivers behind unsustainable fiscal policies.

Suggested Citation

  • Christian Hagist & Norbert Klusen & Andreas Plate & Bernd Raffelhüschen, 2005. "Social Health Insurance - the Major Driver of Unsustainable Fiscal Policy?," CESifo Working Paper Series 1574, CESifo.
  • Handle: RePEc:ces:ceswps:_1574
    as

    Download full text from publisher

    File URL: https://www.cesifo.org/DocDL/cesifo1_wp1574.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Hans Fehr & Laurence J. Kotlikoff & Willi Leibfritz, 1999. "Generational Accounting in General Equilibrium," NBER Chapters, in: Generational Accounting around the World, pages 43-72, National Bureau of Economic Research, Inc.
    2. Jagadeesh Gokhale & Kent Smetters, 2003. "Fiscal and generational imbalances: new budget measures for new budget priorities," Policy Discussion Papers, Federal Reserve Bank of Cleveland, issue Dec.
    3. 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.
    4. 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.
    5. Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1992. "Social Security and Medicare Policy from the Perspective of Generational Accounting," NBER Chapters, in: Tax Policy and the Economy, Volume 6, pages 129-145, National Bureau of Economic Research, Inc.
    6. Rafflhuschen, B. & Risa, A.E., 1997. "Generational Accounting and intergenerational Welfare," Norway; Department of Economics, University of Bergen 164, Department of Economics, University of Bergen.
    7. Raffelhuschen, Bernd & Risa, Alf Erling, 1997. "Generational Accounting and Intergenerational Welfare," Public Choice, Springer, vol. 93(1-2), pages 149-163, October.
    8. 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.
    9. 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.
    10. Barro, Robert J., 1987. "Government spending, interest rates, prices, and budget deficits in the United Kingdom, 1701-1918," Journal of Monetary Economics, Elsevier, vol. 20(2), pages 221-247, September.
    11. Stefan Fetzer & Bernd Raffelhüschen, 2005. "Zur Wiederbelebung des Generationenvertrags in der gesetzlichen Krankenversicherung: Die Freiburger Agenda," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 6(2), pages 255-274, May.
    12. Jennifer Roberts, 1999. "Sensitivity of elasticity estimates for OECD health care spending: analysis of a dynamic heterogeneous data field," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 459-472, August.
    13. Carole Bonnet, 2002. "Comptabilité générationnelle appliquée à la France : quelques facteurs d'instabilité des résultats," Économie et Prévision, Programme National Persée, vol. 154(3), pages 59-78.
    14. Benz, Ulrich & Fetzer, Stefan, 2004. "Indicators for Measuring Fiscal Sustainability: A Comparative Application of the OECD-Method and Generational Accounting," Discussion Papers 118, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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.
    2. Robert Stelter, 2016. "Fertility and health insurance types in Germany," LIDAM Discussion Papers IRES 2016021, Université catholique de Louvain, Institut de Recherches Economiques et Sociales (IRES).
    3. Bernd Raffelhüschen, 2008. "Gesundheitsreformen: und kein Ende in Sicht!," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 77(1), pages 108-116.
    4. Stefan Moog & Bernd Raffelhüschen, 2010. "Herausforderungen der Legislaturperiode für die Tragfähigkeit der Renten- und Pflegeversicherung," Vierteljahrshefte zur Wirtschaftsforschung / Quarterly Journal of Economic Research, DIW Berlin, German Institute for Economic Research, vol. 79(1), pages 27-43.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hagist, Christian & Klusen, Norbert & Plate, Andreas & Raffelhüschen, Bernd, 2005. "Social health insurance: The major driver of unsustainable fiscal policy?," FZG Discussion Papers 1, University of Freiburg, Research Center for Generational Contracts (FZG).
    2. Laurence J. Kotlikoff & Christian Hagist, 2005. "Who’s Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," Working Papers id:286, eSocialSciences.
    3. 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.
    4. 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.
    5. Fullerton, Don & Metcalf, Gilbert E., 2002. "Tax incidence," Handbook of Public Economics, in: A. J. Auerbach & M. Feldstein (ed.), Handbook of Public Economics, edition 1, volume 4, chapter 26, pages 1787-1872, Elsevier.
    6. Alan J. Auerbach & Young Jun Chun & Ilho Yoo, 2005. "The Fiscal Burden of Korean Reunification: A Generational Accounting Approach," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 61(1), pages 62-97, March.
    7. Raffelhüschen, Bernd & Moog, Stefan & Müller, Christoph, 2010. "Ehrbare Staaten? Die deutsche Generationenbilanz im internationalen Vergleich: Wie gut ist Deutschland auf die demografische Herausforderung vorbereitet?," Argumente zur Marktwirtschaft und Politik 110, Stiftung Marktwirtschaft / The Market Economy Foundation, Berlin.
    8. Janusz Jablonowski & Christoph Mueller & Bernd Raffelhüschen, 2011. "A fiscal outlook for Poland using Generational Accounts," NBP Working Papers 85, Narodowy Bank Polski, Economic Research Department.
    9. Auerbach, Alan J. & Chun, Young Jun, 2006. "Generational accounting in Korea," Journal of the Japanese and International Economies, Elsevier, vol. 20(2), pages 234-268, June.
    10. Holger Bonin & Joan Gil & Concepció Patxot, 2001. "Beyond the Toledo agreement: the intergenerational impact of the Spanish Pension Reform," Spanish Economic Review, Springer;Spanish Economic Association, vol. 3(2), pages 111-130.
    11. 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.
    12. Gál, Róbert I. & Simonovits, András & Tarcali, Géza, 2001. "Generational accounting and Hungarian pension reform," Social Protection Discussion Papers and Notes 90343, The World Bank.
    13. Stefan Fetzer & Christian Hagist & Bernd Raffelhüschen, 2004. "Was bringen Bürgerversicherung und Gesundheitsprämie wirklich?," ifo Schnelldienst, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 57(15), pages 03-07, August.
    14. Veronika Deeg & Christian Hagist & Stefan Moog, 2009. "The fiscal outlook in Austria: an evaluation with Generational Accounts," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 36(4), pages 475-499, November.
    15. Karin Mayr, 2004. "The fiscal impact of immigrants in Austria--a generational accounting analysis," Economics working papers 2004-09, Department of Economics, Johannes Kepler University Linz, Austria.
    16. Damla Haciibrahimoglu & Pinar Derin-Gure, 2013. "Generational Accounting in Turkey," ERC Working Papers 1301, ERC - Economic Research Center, Middle East Technical University, revised Jan 2013.
    17. Concepció Patxot & Elisenda Rentería & Miguel Romero & Guadalupe Souto, 2012. "Measuring the balance of government intervention on forward and backward family transfers using NTA estimates: the modified Lee arrows," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 19(3), pages 442-461, June.
    18. Benz, Tobias & Hagist, Christian, 2010. "Der Rücklagenbedarf der Versorgungsausgaben in Baden-Württemberg: Projektion und Reformoptionen," FZG Discussion Papers 42, University of Freiburg, Research Center for Generational Contracts (FZG).
    19. Stefan Fetzer & Stefan Moog, 2021. "Indicators for Measuring Intergenerational Fairness of Social Security Systems—The Case of the German Social Health Insurance," Sustainability, MDPI, Open Access Journal, vol. 13(10), pages 1-18, May.
    20. Christian Hagist & Bernd Raffelhüschen & Alf Erling Risa & Erling Vårdal, 2013. "Long-Term Fiscal Effects of Public Pension Reform in Norway – A Generational Accounting Analysis," Nordic Journal of Political Economy, Nordic Journal of Political Economy, vol. 38, pages 1-2.

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ces:ceswps:_1574. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://edirc.repec.org/data/cesifde.html .

    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 CitEc recognized a bibliographic reference but did not link an item in RePEc 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 RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Klaus Wohlrabe (email available below). General contact details of provider: https://edirc.repec.org/data/cesifde.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.