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APOCALYPSE NO: Population Aging and the Future of Health Care Systems


  • R.G. Evans
  • K.M. McGrail
  • S.G. Morgan
  • M.L. Barer
  • C. Hertzman


Illness increases with age. All else equal, an older population has greater needs for health care. This logic has led to dire predictions of skyrocketing costs-- "apocalyptic demography". Yet numerous studies have shown that aging effects are relatively small, and all else is not equal. Cost projections rest on specific assumptions about trends in age- specific morbidity and health care use that are far from self-evident. Sharply contrasting assumptions, for example, are made by Fries, who foresees a "compression of morbidity" and falling needs. Long term trends in health care use in British Columbia show minimal effects of population aging, but major effects, up and down, from changes in age- specific use patterns. Why then is the demographic apocalypse story so persistent, despite numerous contrary studies? It serves identifiable economic interests.

Suggested Citation

  • R.G. Evans & K.M. McGrail & S.G. Morgan & M.L. Barer & C. Hertzman, 2001. "APOCALYPSE NO: Population Aging and the Future of Health Care Systems," Social and Economic Dimensions of an Aging Population Research Papers 59, McMaster University.
  • Handle: RePEc:mcm:sedapp:59

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    Cited by:

    1. Frank T. Denton & Byron G. Spencer, 2003. "Population Change and Economic Growth: The Long-Term Outlook," Social and Economic Dimensions of an Aging Population Research Papers 102, McMaster University.
    2. Peine, Alexander & Rollwagen, Ingo & Neven, Louis, 2014. "The rise of the “innosumer”—Rethinking older technology users," Technological Forecasting and Social Change, Elsevier, vol. 82(C), pages 199-214.
    3. repec:clh:techni:y:2010 is not listed on IDEAS
    4. Brigitte Dormont & Michel Grignon & Hélène Huber, 2006. "Health expenditure growth: reassessing the threat of ageing," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 947-963.
    5. Peine & Ingo Rollwagen & Louis Neven, 2012. "Exploring new patterns of user involvement – baby boomers and the future of consumption," Innovation Studies Utrecht (ISU) working paper series 12-09, Utrecht University, Department of Innovation Studies, revised Sep 2012.
    6. William Robson & Colin Busby & Aaron Jacobs, 2014. "Healthcare and an Aging Population: Managing Slow-Growing Revenues and Rising Health Spending in British Columbia," e-briefs 195, C.D. Howe Institute.
    7. Constantina Safiliou-Rothschild, 2009. "Are Older People Responsible for High Healthcare Costs?," CESifo Forum, Ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 10(1), pages 57-64, April.
    8. Di Matteo, Livio & Cantarero-Prieto, David, 2018. "The Determinants of Public Health Expenditures: Comparing Canada and Spain," MPRA Paper 87800, University Library of Munich, Germany.
    9. William Robson & Colin Busby & Aaron Jacobs, 2014. "Managing Healthcare for an Aging Population: Ontario’s Troubling Collision Course," e-briefs 192, C.D. Howe Institute.
    10. Morgan, Steven G. & Agnew, Jonathan D. & Barer, Morris L., 2004. "Seniors' prescription drug cost inflation and cost containment: evidence from British Columbia," Health Policy, Elsevier, vol. 68(3), pages 299-307, June.
    11. repec:clh:briefi:v:3:y:2010:i:2 is not listed on IDEAS
    12. Di Matteo, Livio, 2005. "The macro determinants of health expenditure in the United States and Canada: assessing the impact of income, age distribution and time," Health Policy, Elsevier, vol. 71(1), pages 23-42, January.
    13. Berta, Whitney & Laporte, Audrey & Zarnett, Dara & Valdmanis, Vivian & Anderson, Geoffrey, 2006. "A pan-Canadian perspective on institutional long-term care," Health Policy, Elsevier, vol. 79(2-3), pages 175-194, December.
    14. William Robson & Colin Busby & Aaron Jacobs, 2015. "Managing Healthcare for an Aging Population: Are Demographics a Fiscal Iceberg for Newfoundland and Labrador?," e-briefs 200, C.D. Howe Institute.
    15. Michel Grignon, 2005. "Aging, Health and Aggregate Medical Care Spending in France," Department of Economics Working Papers 2005-05, McMaster University.

    More about this item


    aging; health care utilization; demography; health care financing;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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