IDEAS home Printed from https://ideas.repec.org/p/ces/ceswps/_1574.html
   My bibliography  Save this paper

Social Health Insurance - the Major Driver of Unsustainable Fiscal Policy?

Author

Listed:
  • Christian Hagist
  • Norbert Klusen
  • Andreas Plate
  • Bernd Raffelhüschen

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

Suggested Citation

  • Christian Hagist & Norbert Klusen & Andreas Plate & Bernd Raffelhüschen, 2005. "Social Health Insurance - the Major Driver of Unsustainable Fiscal Policy?," CESifo Working Paper Series 1574, CESifo.
  • Handle: RePEc:ces:ceswps:_1574
    as

    Download full text from publisher

    File URL: https://www.cesifo.org/DocDL/cesifo1_wp1574.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. Alan J. Auerbach & Jagadeesh Gokhale & Laurence J. Kotlikoff, 1992. "Social Security and Medicare Policy from the Perspective of Generational Accounting," NBER Chapters, in: Tax Policy and the Economy, Volume 6, pages 129-145, National Bureau of Economic Research, Inc.
    7. Rafflhuschen, B. & Risa, A.E., 1997. "Generational Accounting and intergenerational Welfare," Norway; Department of Economics, University of Bergen 164, Department of Economics, University of Bergen.
    8. Raffelhuschen, Bernd & Risa, Alf Erling, 1997. "Generational Accounting and Intergenerational Welfare," Public Choice, Springer, vol. 93(1-2), pages 149-163, October.
    9. 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.
    10. Barro, Robert J., 1987. "Government spending, interest rates, prices, and budget deficits in the United Kingdom, 1701-1918," Journal of Monetary Economics, Elsevier, vol. 20(2), pages 221-247, September.
    11. Stefan Fetzer & Bernd Raffelhüschen, 2005. "Zur Wiederbelebung des Generationenvertrags in der gesetzlichen Krankenversicherung: Die Freiburger Agenda," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 6(2), pages 255-274, May.
    12. 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, August.
    13. 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.
    14. Benz, Ulrich & Fetzer, Stefan, 2004. "Indicators for Measuring Fiscal Sustainability: A Comparative Application of the OECD-Method and Generational Accounting," Discussion Papers 118, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    15. Kent Smetters & Jagadeesh Gokhale, 2003. "Fiscal and Generational Imbalances: New Budget Measures for New Budget Priorities," Books, American Enterprise Institute, number 52628, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Robert Stelter, 2016. "Fertility and health insurance types in Germany," LIDAM Discussion Papers IRES 2016021, Université catholique de Louvain, Institut de Recherches Economiques et Sociales (IRES).
    2. Häcker, Jasmin & Raffelhüschen, Bernd, 2005. "Internal rates of return of the German statutory long-term care insurance," FZG Discussion Papers 5, University of Freiburg, Research Center for Generational Contracts (FZG).
    3. Kai Konrad & Stergios Skaperdas, 2012. "The market for protection and the origin of the state," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 50(2), pages 417-443, June.
    4. 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.
    5. 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.
    6. 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.
    7. André Decoster & Xavier Flawinne & Pieter Vanleenhove, 2014. "Generational accounts for Belgium: fiscal sustainability at a glance," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 41(4), pages 663-686, November.
    8. Viktor von Wyl & Konstantin Beck, 2014. "Risk adjustment in aging societies," Health Economics Review, Springer, vol. 4(1), pages 1-14, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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).
    2. Damla Hacýibrahimoðlu & Pýnar Derin-Güre, 2015. "Generational Accounting in Turkey," Bogazici Journal, Review of Social, Economic and Administrative Studies, Bogazici University, Department of Economics, vol. 29(1), pages 1-26.
    3. Martin Larch & João Nogueira Martins, 2007. "Fiscal indicators - Proceedings of the the Directorate-General for Economic and Financial Affairs Workshop held on 22 September 2006 in Brussels," European Economy - Economic Papers 2008 - 2015 297, Directorate General Economic and Financial Affairs (DG ECFIN), European Commission.
    4. Timothy C. Irwin, 2015. "Defining The Government'S Debt And Deficit," Journal of Economic Surveys, Wiley Blackwell, vol. 29(4), pages 711-732, September.
    5. Stefan Fetzer & Christian Hagist & Bernd Raffelhüschen, 2004. "Was bringen Bürgerversicherung und Gesundheitsprämie wirklich?," ifo Schnelldienst, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 57(15), pages 03-07, August.
    6. Veronika Deeg & Christian Hagist & Stefan Moog, 2009. "The fiscal outlook in Austria: an evaluation with Generational Accounts," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 36(4), pages 475-499, November.
    7. Mevis, Dirk & Weddige, Olaf, 2006. "Gefahr erkannt, Gefahr gebannt? Nachhaltigkeitsbilanz der 15. Legislaturperiode des deutschen Bundestages 2002-2005," Discussion Papers 140, Albert-Ludwigs-Universität Freiburg, Institut für Finanzwissenschaft.
    8. Róbert I. Gál & András Simonovits & Géza Tarcali, 2001. "Generational Accounting and Hungarian Pension Reform," World Bank Publications - Reports 20233, The World Bank Group.
    9. Raffelhüschen, Bernd & Hagist, Christian & Moog, Stefan & Vatter, Johannes, 2009. "Ehrbare Staaten? Die deutsche Generationenbilanz im internationalen Vergleich," Argumente zur Marktwirtschaft und Politik 107, Stiftung Marktwirtschaft / The Market Economy Foundation, Berlin.
    10. Kazakova, Maria & Nesterova, Kristina, 2015. "Long-Term Forecast of the Main Parameters of the Budgetary System of Russia," Published Papers 2309, Russian Presidential Academy of National Economy and Public Administration.
    11. Fullerton, Don & Metcalf, Gilbert E., 2002. "Tax incidence," Handbook of Public Economics, in: A. J. Auerbach & M. Feldstein (ed.), Handbook of Public Economics, edition 1, volume 4, chapter 26, pages 1787-1872, Elsevier.
    12. Alan J. Auerbach & Young Jun Chun & Ilho Yoo, 2005. "The Fiscal Burden of Korean Reunification: A Generational Accounting Approach," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 61(1), pages 62-97, March.
    13. 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.
    14. Abderrahim Chibi & Sidi Mohamed Chekouri & Mohamed Benbouziane, 2019. "Debt sustainability, structural breaks and nonlinear fiscal adjustment: empirical evidence from Algeria," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 66(4), pages 369-397, December.
    15. Raffelhüschen, Bernd & Moog, Stefan & Müller, Christoph, 2010. "Ehrbare Staaten? Die deutsche Generationenbilanz im internationalen Vergleich: Wie gut ist Deutschland auf die demografische Herausforderung vorbereitet?," Argumente zur Marktwirtschaft und Politik 110, Stiftung Marktwirtschaft / The Market Economy Foundation, Berlin.
    16. David Rosnick & Dean Baker, 2012. "Pension Liabilities: Fear Tactics and Serious Policy," World Economic Review, World Economics Association, vol. 2012(1), pages 1-57, September.
    17. Hagist, Christian & Moog, Stefan & Raffelhüschen, Bernd & Vatter, Johannes, 2009. "Ehrbare Staaten? Die Ergebnisse der Generationenbilanzierung im internationalen Vergleich," FZG Discussion Papers 34, University of Freiburg, Research Center for Generational Contracts (FZG).
    18. Heidler, Matthias & Müller, Christoph & Weddige, Olaf, 2009. "Measuring accrued-to-date liabilities of public pension systems: Method, data and limitations," FZG Discussion Papers 37, University of Freiburg, Research Center for Generational Contracts (FZG).
    19. Laurence J. Kotlikoff, 2005. "Who’s Going Broke? Comparing Growth in Healthcare Costs in Ten OECD Countries," Working Papers id:286, eSocialSciences.
    20. Raffelhüschen, Bernd & Hagist, Christian & Moog, Stefan, 2008. "Ehrbarer Staat? Die Generationenbilanz. Update 2008: Migration und Nachhaltigkeit," Argumente zur Marktwirtschaft und Politik 103, Stiftung Marktwirtschaft / The Market Economy Foundation, Berlin.

    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

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ces:ceswps:_1574. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Klaus Wohlrabe (email available below). General contact details of provider: https://edirc.repec.org/data/cesifde.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.