Demographic change, healthcare, and long-term care

The world has gone from centuries of negligible population growth to an unprecedented acceleration in the 20th century. Increasing longevity and declining fertility have introduced an era of population aging and, in some regions, population decline is on the rise, often reinforced by outmigration of the young and the skilled. These demographic changes have substantial consequences for social infrastructure (SI), particularly healthcare (HC) and long-term care (LTC). Expenditure for HC and LTC is increasing, and the declining workforce widens the gap between demand and supply. At the same time, changing family structures and women’s labor market participation further reduce the supply of informal care. While in-migration is often seen as a remedy, its effectiveness and negative externalities are debated. The future impact of demographic change on HC and LTC hinges on policy responses, and whether we spend our additional life years in good or in bad health.