Population Aging and the Sustainability of the Welfare State

Gusmano, Michael K.; Okma, Kieke G. H.

doi:10.1002/hast.915

Cited by 33 publications

(24 citation statements)

References 14 publications

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“…When contemplating these challenges, it can be argued that, in the absence of solid and versatile policies, a major restructuring of economic activity in both the public and private sectors might bring the end of the "welfare state" [14]. However, the majority of studies do not seem to support the argument that population aging will cause uncontrollable public sector expenditure [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Population Aging and Public Health Support on EU Labor Markets

Cristea

Noja

Ștefea

et al. 2020

IJERPH

155

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Population aging and public health expenditure mainly dedicated to older dependent persons present major challenges for the European Union (EU) Member States, with profound implications for their economies and labor markets. Sustainable economic development relies on a well-balanced workforce of young and older people. As this balance shifts in favor of older people, productivity tends to suffer, on the one hand, and the older group demands more from health services, on the other hand. These requisites tend to manifest differently within developed and developing EU countries. This research aimed to assess population aging impacts on labor market coordinates (employment rate, labor productivity), in the framework of several health dimensions (namely, health government expenditure, hospital services, healthy life years, perceived health) and other economic and social factors. The analytical approach consisted of applying structural equation models, Gaussian graphical models, and macroeconometric models (robust regression and panel corrected standard errors) to EU panel data for the years 1995–2017. The results show significant dissimilarities between developed and developing EU countries, suggesting the need for specific policies and strategies for the labor market integration of older people, jointly with public health expenditure, with implications for EU labor market performance.

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Section: Introductionmentioning

confidence: 99%

The Impact of Population Aging and Public Health Support on EU Labor Markets

Cristea

Noja

Ștefea

et al. 2020

IJERPH

155

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show abstract

“…As noted above, most people over 65 live independently and consider themselves in good health (see also Gusmano and Okma 7 ). We argue that redefining 'aging' for the purpose of LTC takes much of the sting out of the 'tsunami of aging' debate (for this argument see Gusmano and Okma 7 ).…”

Section: Howmentioning

confidence: 97%

“…There is little or no relation, however, between population aging and the level of healthcare spending. [5][6][7] Some nations with much older population than the United States, for example Japan, Germany, or the United Kingdom, spend much less on healthcare, often with better outcomes in terms of life expectancy or child mortality. The incomes of health professionals, the use of medical technology and the organization of healthcare services are all factors that have played a greater role in determining the level of health spending than aging.…”

Section: Introductionmentioning

confidence: 99%

“…13,14 Some studies show that the total value of transfers of the older generation to their children and grandchildren is larger than the net cost of (public) pensions and long-term care (LTC). Many of the currently retired support their offspring financially and materially in paying for education, lending money to buy an apartment or house, and providing childcare or transportation services to grandchildren (see Gusmano and Okma 7 ). Depicting populations over 65 as 'frail dependent elderly' is at least misleading.…”

Section: Introductionmentioning

confidence: 99%

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Aging, Pensions and Long-term Care: What, Why, Who, How? Comment on "Financing Long-term Care: Lessons From Japan"

Okma

Gusmano

2019

Int J Health Policy Manag

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Japan has been aging faster than other industrialized nations, and its experience offers useful lessons to others. Japan has been willing to expand its welfare state with a long-term care (LTC) insurance to finance home care and nursing home care for frail elderly. As Ikegami shows, it created new facilities and expanded specialized staffing for home care, developed a country-wide assessment system and shifted responsibilities between the central and local authorities over that assessment and the determination of co-payments for LTC. Faced with rapid growth in demand for LTC, the government felt the need for new cost control measures. The Japanese experience illustrates that new social policies take time to develop. There is often a need to adjust. But there are also other lessons. The main one is that there is no direct relation between the degree of population aging and total health spending. While aging requires adjustments in the organization of care, and expanding LTC for frail elderly, international studies show there is no need to worry about the ‘unaffordability’ of aging. In this commentary, we have framed four "What, Why, Who, and How" questions about LTC to (re-)define the borderlines between public and private responsibilities for the range of activities for which some (but certainly not all) frail elderly as well as many non-elderly require support in daily life.

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“…Michael Gusmano and Kieke Okma take on the notion that older adults are a financial drain on aging societies. Their essay draws on examples from a range of aging societies, where “claims about the unaffordability and unsustainability of social policies supporting older people have become common currency, often disguised as concerns about intergenerational justice.” Their essay points out that dependency on social welfare policy occurs throughout a person’s life and that the economic contributions of older adults often include intergenerational caregiving and other support for family members in the labor force. They conclude that it is time to “stop blaming” older adults for rising health care costs.…”

Section: Policy Recommendations and Political Challengesmentioning

confidence: 99%

Becoming Good Citizens of Aging Societies

Berlinger¹,

Solomon²

2018

Hastings Center Report

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The ethical dimensions of an aging society are larger than the experience of chronic illness, the moral concerns of health care professionals, or the allocation of health care resources. What, then, is the role of bioethics in an aging society, beyond calling attention to these problems? Once we’ve agreed that aging is morally important and that population‐level aging across wealthy nations raises ethical concerns that cannot be fixed through transhumanism or other appeals to transcend aging and mortality through technology, what is our field’s contribution? We argue that it is time for bioethics to turn toward social justice and problems of injustice and that part of doing so is articulating a concept of good citizenship in an aging society that goes beyond health care relationships.

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Population Aging and the Sustainability of the Welfare State

Cited by 33 publications

References 14 publications

The Impact of Population Aging and Public Health Support on EU Labor Markets

The Impact of Population Aging and Public Health Support on EU Labor Markets

Aging, Pensions and Long-term Care: What, Why, Who, How? Comment on "Financing Long-term Care: Lessons From Japan"

Becoming Good Citizens of Aging Societies

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