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Social health insurance: The major driver of unsustainable fiscal policy?

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  • Hagist, Christian
  • Klusen, Norbert
  • Plate, Andreas
  • Raffelhüschen, Bernd

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 which are in addition affected by the medical-technical progress. Due to the cost-increasing effect of the medical-technical progress one can justifiably say that social health insurance schemes are the major drivers behind unsustainable fiscal policies.

Suggested Citation

  • 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).
  • Handle: RePEc:zbw:fzgdps:1
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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. Hagist, Christian & Fetzer, Stefan, 2004. "GMG, Kopfpauschalen und Bürgerversicherungen: Der aktuelle Reformstand und seine intergenerativen Verteilungswirkungen," Discussion Papers 114, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    7. 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.
    8. 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.
    9. 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.
    10. Stefan Fetzer & Christian Hagist, 2004. "GMG, Kopfpauschalen und Bürgerversicherungen: Der aktuelle Reformstand und seine intergenerativen Verteilungswirkungen," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 124(3), pages 387-420.
    11. 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.
    12. Kamke, Kerstin, 1998. "The German health care system and health care reform," Health Policy, Elsevier, vol. 43(2), pages 171-194, February.
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    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," Discussion Papers (IRES - Institut de Recherches Economiques et Sociales) 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.

    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

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