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Who’s going broke? Comparing growth in Public healthcare expenditure in Ten OECD Countries

Author

Listed:
  • Christian Hagist

    (Freiburg University)

  • Laurence J. Kotlikoff

    (Boston University)

Abstract

Government healthcare expenditures have been growing much more rapidly than GDP in OECD countries. How much of this growth is due to demographic change versus increases in benefit levels (expenditures per person at a given age)? This paper answers this question for ten OECD countries –Australia, Austria, Canada, Germany, Japan, Norway, Spain, Sweden, the UK, and the U.S. using data from 1970-2002. Growth in benefit levels explains 89 of overall healthcare spending growth in the ten countries over the period, with Norway, Spain, and the U.S. recording the highest annual benefit growth rates. As we show, allowing government healthcare benefit levels to grow at historic rates is fraught with danger given the impending retirement of the baby boom generation.

Suggested Citation

  • Christian Hagist & Laurence J. Kotlikoff, 2009. "Who’s going broke? Comparing growth in Public healthcare expenditure in Ten OECD Countries," Hacienda Pública Española / Review of Public Economics, IEF, vol. 188(1), pages 55-72, March.
    • Handle: RePEc:hpe:journl:y:2009:v:188:1:p:55-72
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    References listed on IDEAS

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    3. Sheng-Ti Hung & Kevin X.D. Huang & Hui He, 2013. "Substituting Leisure for Health Expenditure: A General Equilibrium-Based Empirical Investigation," 2013 Meeting Papers 1310, Society for Economic Dynamics.
    4. Hui He & Kevin x.d. Huang, 2013. "Why Do Americans Spend So Much More on Health Care than Europeans?--A General Equilibrium Macroeconomic Analysis," Vanderbilt University Department of Economics Working Papers 13-00005, Vanderbilt University Department of Economics.
    5. Y. Natalia Alfonso & Guiru Ding & David Bishai, 2016. "Income Elasticity of Vaccines Spending versus General Healthcare Spending," Health Economics, John Wiley & Sons, Ltd., vol. 25(7), pages 860-872, July.
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    7. Bettin, Giulia & Sacchi, Agnese, 2020. "Health spending in Italy: The impact of immigrants," European Journal of Political Economy, Elsevier, vol. 65(C).
    8. Hui He & Kevin X.D. Huang & Lei Ning, 2021. "Why Do Americans Spend So Much More On Health Care Than Europeans?," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 62(4), pages 1363-1399, November.
    9. Rossana Merola & Douglas Sutherland, 2013. "Fiscal Consolidation and the Implications of Social Spending for Long-Term Fiscal Sustainability," Review of Economics and Institutions, Università di Perugia, vol. 4(3).
    10. Seth G. Benzell & Laurence J. Kotlikoff & Guillermo LaGarda & Victor Yifan Ye, 2017. "Simulating Business Cash Flow Taxation," NBER Working Papers 23675, National Bureau of Economic Research, Inc.
    11. Goryunov, Evgeny & Kotlikoff, Lawrence & Sinelnikov-Murylev, Sergey, 2015. "The fiscal gap: An estimate for Russia," Russian Journal of Economics, Elsevier, vol. 1(3), pages 240-256.
    12. Oliver Fritz & Peter Mayerhofer & Reinhard Haller & Gerhard Streicher & Florian Bachner & Herwig Ostermann, 2013. "Die regionalwirtschaftlichen Effekte der österreichischen Krankenanstalten," WIFO Studies, WIFO, number 46672.
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    More about this item

    Keywords

    Healthcare expenditure growth; long-term fiscal imbalance;

    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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