Can healthy ageing moderate the effects of population ageing on economic growth and health spending trends in Mongolia? A modelling study

Abstract

Background Population ageing will accelerate rapidly in Mongolia in the coming decades. We explore whether this is likely to have deleterious effects on economic growth and health spending trends and whether any adverse consequences might be moderated by ensuring better health among the older population. Methods Fixed-effects models are used to estimate the relationship between the size of the older working-age population (55–69 years) and economic growth from 2020 to 2100 and to simulate how growth is modified by better health among the older working-age population, as measured by a 5% improvement in years lived with disability. We next use 2017 data on per capita health spending by age from the National Health Insurance Fund to project how population ageing will influence public health spending from 2020 to 2060 and how this relationship may change if the older population (≥ 60 years) ages in better or worse health than currently. Results The projected increase in the share of the population aged 55–69 years is associated with a 4.1% slowdown in per-person gross domestic product (GDP) growth between 2020 and 2050 and a 5.2% slowdown from 2020 to 2100. However, a 5% reduction in disability rates among the older population offsets these effects and adds around 0.2% to annual per-person GDP growth in 2020, rising to nearly 0.4% per year by 2080. Baseline projections indicate that population ageing will increase public health spending as a share of GDP by 1.35 percentage points from 2020 to 2060; this will occur slowly, adding approximately 0.03 percentage points to the share of GDP annually. Poorer health among the older population (aged ≥ 60 years) would see population ageing add an additional 0.17 percentage points above baseline estimates, but healthy ageing would lower baseline projections by 0.18 percentage points, corresponding to potential savings of just over US$ 46 million per year by 2060. Conclusions Good health at older ages could moderate the potentially negative effects of population ageing on economic growth and health spending trends in Mongolia. Continued investment in the health of older people will improve quality of life, while also enhancing the sustainability of public budgets.

Reforming Canada's federal health‐care funding arrangements

“…Of course, it is not inevitable that population aging increases provincial health expenditures. Williams et al (2019) find evidence that population aging is not an important driver of health expenditure growth. And as CIHI (2021b) notes, the share of Canada's population age 65 and older rose from 14 to 18 percent over the past decade, although the share of public health expenditures accounted for by this group increased from 44.5 percent to 45.1 percent.…”

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“…Rechel et al argue that the high costs associated with older people are caused by the fact that these are more likely to die within a year, when compared to younger people [27]. Recent studies by Raitano and Williams et al also confirm that aging is not a primary driver of health expenditure [11,12].…”

“…However, eventually, researchers included various non-macro-economic explanatory variables of PHE. Aging was given particular attention by researchers as they tried to understand whether demographic changes affect PHE [11,12]. Attention was also given to the political influences, such as type of government composition, year in government, political ideologies and years of election [13][14][15].…”

Research to inform health systems’ responses to rapid population ageing: a collection of studies funded by the WHO Centre for Health Development in Kobe, Japan

“…Economic modelling techniques were applied to analyse the effects of age and demographic structure on trends in health expenditures and the moderating effect of improved health in the older working-age population in six countries in WHO's Western Pacific Region. The paper presented in this supplement describes the simulation results for Mongolia, which suggested that good health at older ages could moderate the potentially negative effects of population ageing on economic growth and health spending [30]. This study sends an important message to policymakers who are concerned about decreased revenue and increased health expenditures due to population ageing: these consequences are not inevitable, but rather they can be significantly mitigated or altered by making policy choices that enable older people to live in good health.…”