The Long-Term Sustainability Of European Health Care Systems

Vincenzo Rebba ()

No 191, "Marco Fanno" Working Papers from Dipartimento di Scienze Economiche "Marco Fanno"

Abstract: Over the past thirty years, health expenditure has grown at a faster rate than the economy in almost every OECD country. The main drivers of public health spending are income growth, insurance coverage, demographics, and, above all, technological change. According to the projections of the major international institutions (European Commission, OECD, International Monetary Fund), public health spending for the of EU-15 countries could significantly increase by 2050. These projections vary in an extremely wide range, between +27% and +84%, depending on the assumptions made. However, the big challenge will be the growth of public spending on long-term care which could more than double over the 2010-2050 period, owing to the sharp rise of frailty and disability at older ages, especially amongst the very old (aged 80+) which will be the fastest growing segment of the EU population in the decades to come. The European countries are facing a common challenge: the need to secure the economic and financial sustainability of their health care systems without undermining the values of universal coverage and solidarity in financing. Command and control policies aimed at expenditure restraints and largely operating through regulatory controls (controls over inputs and wages, budget caps, etc.) are widely used during periods of recession. They can hold expenditures down in the short term. However, they do little or nothing to moderate the underlying pressures which push health spending up over the long-run. Other policies to guarantee both economic and financial sustainability in the long-run should be explored: 1) the adoption of new regulation tools on supply and demand side; 2) a new balanced mix of public and private financing, strengthening the role of supplementary private health insurance, to allow investment and innovation, without imposing unsustainable burdens on public budgets and without denying care to the disadvantaged. The former policies focus on economic sustainability, improving the way health systems address the rise in chronic disease and seek to incentive and reward patients, providers and buyers for healthy behaviour, quality and efficiency of care. The latter policies could ensure long-term financial stability of the health care systems but may determine negative effects in terms of equity and, therefore, they must be carefully designed.

Keywords: health care expenditure; health care systems; projection models; sustainability; health care policy. (search for similar items in EconPapers)
Pages: 50 pages
Date: 2014-12
New Economics Papers: this item is included in nep-age and nep-eur
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

Downloads: (external link)
https://economia.unipd.it/sites/economia.unipd.it/files/20140191.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:pad:wpaper:0191

Access Statistics for this paper

More papers in "Marco Fanno" Working Papers from Dipartimento di Scienze Economiche "Marco Fanno" Contact information at EDIRC.
Bibliographic data for series maintained by Raffaele Dei Campielisi ().