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

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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
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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. 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.
    3. Raffelhuschen, Bernd & Risa, Alf Erling, 1997. "Generational Accounting and Intergenerational Welfare," Public Choice, Springer, vol. 93(1-2), pages 149-163, October.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    10. 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.
    11. 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.
    12. 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.
    13. 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.
    14. 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.
    15. 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.
    16. Kent Smetters & Jagadeesh Gokhale, 2003. "Fiscal and Generational Imbalances: New Budget Measures for New Budget Priorities," Books, American Enterprise Institute, number 52628, September.
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    Citations

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    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.

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    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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