Heidelberg-Studie 2000

Umfrage zum Leben und poltischen Problemen in Heidelberg. 1219 Telefoninterview

The "red herring" after 20 years : ageing and health care expenditures

One of the most important controversies in the health economics discourse of the last twenty years concerns the question whether the imminent ageing of the population in most OECD countries will place an additional burden on the tax-payers who finance public health care systems. These systems are usually pay-as-you-go financed with taxes or contributions depending on labor income and pensions. Population ageing due to rising longevity and below-replacement fertility in coming decades will lower the population share of working-age persons and raise the share of pensioners. Since labor income exceeds pensions by far, this will weaken the tax base so that tax or contribution rates will rise notably.publishe

Wie nachhaltig sind die gesetzliche Kranken- und Pflegeversicherung finanziert?

Sollten die Ausgaben der gesetzlichen Kranken- und der sozialen Pflegeversicherung langfristig stark steigen, werden sowohl die jüngere Generation durch höhere Beiträge als auch die Älteren durch mögliche Leistungseinschränkungen belastet. Auf Grundlage einer neueren nichtparametrischen Schätzung wird eine Simulation der zukünftigen Entwicklung der Beitragssätze in den beiden Zweigen der deutschen Sozialversicherung vorgestellt. Abhängig von verschiedenen Annahmen über das künftige Wachstum des BIP pro Arbeitnehmer ergibt sich dabei ein Gesamtsozialversicherungsbeitragssatz bis 2040 von nahe 50 %. Damit ist die Tragfähigkeit des deutschen Sozialversicherungssystems stark gefährdet.publishe

Health care expenditures and longevity : is there a Eubie Blake effect?

It is still an open question whether increasing life expectancy as such causes higher health care expenditures (HCE) in a population. According to the “red herring” hypothesis, the positive correlation between age and HCE is exclusively due to the fact that mortality rises with age and a large share of HCE is caused by proximity to death. As a consequence, rising longevity—through falling mortality rates—may even reduce HCE. However, a weakness of many previous empirical studies is that they use cross-sectional evidence to make inferences on a development over time. In this paper, we analyse the impact of rising longevity on the trend of HCE over time by using data from a pseudo-panel of German sickness fund members over the period 1997–2009. Using (dynamic) panel data models, we find that age, mortality and 5-year survival rates each have a positive impact on per-capita HCE. Our explanation for the last finding is that physicians treat patients more aggressively if the results of these treatments pay off over a longer time span, which we call “Eubie Blake effect”. A simulation on the basis of an official population forecast for Germany is used to isolate the effect of demographic ageing on real per-capita HCE over the coming decades. We find that, while falling mortality rates as such lower HCE, this effect is more than compensated by an increase in remaining life expectancy so that the net effect of ageing on HCE over time is clearly positive

Berufskunde

SIGLEIAB / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische Informationsbibliothek2. Auflage April 1995, Ausgabe 1995DEGerman