The Challenge of Public Pension Reform in Advanced and Emerging Economies

Clements, Benedict; Coady, David; Eich, Frank; Gupta, Sanjeev; Kangur, Alvar; Shang, Baoping; Soto, Mauricio

doi:10.5089/9781616354138.084

Cited by 25 publications

(27 citation statements)

References 41 publications

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“…Since 1970, total actual per capita health care spending has increased four‐fold worldwide, and spending as a share of gross domestic product has nearly doubled in both advanced and emerging economies . Meanwhile, fiscal resources have remained the most important barrier to universal health care coverage in most countries .…”

Section: Introductionmentioning

confidence: 99%

Teaching medical students about cost-effectiveness

Iscoe¹,

Lord²,

Schulz³

et al. 2017

Clin Teach

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We developed and evaluated a workshop comprising a lecture, a small-group exercise and a group discussion to instruct medical students on interpreting cost-effectiveness analyses (CEA), applying CEA to patient care and discussing the cost of care with patients. From January 2014 to September 2015 the workshop was administered to five cohorts, 120 students in total, in the internal medicine clerkships at two US medical schools. Pre- and post-intervention confidence in various domains was assessed with a Likert-type scale ranging from 1 to 4. The overall response rate was 87.9 per cent. The proportion of students reporting high confidence scores (3 or 4) rose significantly (p < 0.01) in each domain: from 16.2 to 76.9 per cent for calculating an incremental cost-effectiveness ratio (ICER); from 16.0 to 79.6 per cent for interpreting quality-adjusted life-years (QALYs); from 8.7 to 71.3 per cent for using CEA in patient management; and from 15.3 to 71.4 per cent for discussing costs with patients. Students rated the overall quality of the course as 3.82 out of 5. Rising and burdensome health care costs have driven interest in the practice of high-value care IMPLICATIONS: Our experience of developing, evaluating and refining an HVC course targeted at medical students taught us that such a course is needed, can be educational and can be well-received. Future research is needed to assess the effects of curricula on clinical practice.

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Section: Introductionmentioning

confidence: 99%

Teaching medical students about cost-effectiveness

Iscoe¹,

Lord²,

Schulz³

et al. 2017

Clin Teach

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“…Countries could also encourage and complement behavioral shifts by investing in schooling that will enlarge the effective labor force or by emphasizing healthy living and disease prevention throughout life. 22 Institutional changes are also needed to address the new demographic realities. Government-initiated policies and educational programs to promote ½nancial literacy among older adults may help them make better choices about the forms, accessibility, and security of their assets.…”

mentioning

confidence: 99%

Global Population Aging: Facts, Challenges, Solutions & Perspectives

Bloom

Canning

Lubet³

2015

Daedalus

238

182

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We are in the midst of an unprecedented transition in global demography. The world's population is aging rapidly, and older adults compose a larger proportion of the world's population than ever before-a share that will only increase over the next century. By 2050, the percentage of the United States' population that is aged sixty years and older will grow from the current ½gure of about 20 percent to 27 percent. The global number of centenarians worldwide-those aged one hundred years and older-is expected to more than double by 2030, with projections of nearly 3.4 million by 2050. 1 Three major factors are driving this transition: decreasing fertility, increasing longevity, and the aging of large population cohorts.Falling fertility rates are the main determinant of population aging. Low fertility rates lead to smaller youth cohorts, which create an imbalance in the age structure: older age groups become larger than their younger counterparts. Thanks to accessible and effective birth control, increased child survival, and cultural changes, birth rates have dropped dramatAbstract: The rapid aging of populations around the world presents an unprecedented set of challenges: shifting disease burden, increased expenditure on health and long-term care, labor-force shortages, dissaving, and potential problems with old-age income security. We view longer life spans, particularly longer healthy life spans, as an enormous gain for human welfare. The challenges come from the fact that our current institutional and social arrangements are unsuited for aging populations and shifting demographics; our proposed solution is therefore to change our institutions and social arrangements. The ½rst section of this essay provides a statistical overview of global population aging and its contributing factors. The second section outlines some of the major challenges associated with widespread population aging. Finally, the third section of the essay describes various responses to these challenges, both current and prospective, facing individuals, businesses, institutions, and governments.

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“…The second strand exploits cross-country evidence of variation of pension arrangements (and saving) and aggregate saving. Examples include Bailliu and Reisen (1998);López-Murphy and Musalem (2004); Bebczuk and Musalem (2006); Clements et al (2011);and Bebczuk (2015a). A common thread across these studies is that they uncover a positive but very small impact of funded pension regimes on nonpension saving.…”

Section: Box 12 (Continued) (Continued On Next Page)mentioning

confidence: 99%

“…Yet its spending on pensions was similar to what France and Italy were spending in the 1980s, and they were much older at that time (with 14 percent of the population 65 and older). Estimates by Clements et al (2011) suggest that, if unreformed, Brazil will be spending 16 percent of GDP on pensions in 2050. Pension spending is lower in most other countries in the region, thanks more to lack of coverage than adequate sustainability.…”

Section: Box 71 (Continued)mentioning

confidence: 99%

Ahorrar para desarrollarse: Cómo América Latina y el Caribe puede ahorrar más y mejor

Cavallo¹,

Serebrisky²,

Frisancho³

et al. 2016

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Inter-American Development BankThis book is distributed under the terms of the Creative Commons AttributionNonCommercial-NoDerivatives 3.0 IGO license (http://creativecommons.org/ licenses/by-nc-nd/3.0/igo/) and may be reproduced with attribution to the Inter-American Development Bank (IDB) and for any non-commercial purpose. No derivative work is allowed.Any dispute related to the use of the works of the IDB that cannot be settled amicably shall be submitted to arbitration pursuant to the UNCITRAL rules. The use of the IDB's name for any purpose other than for attribution, and the use of IDB's logo shall be subject to a separate written license agreement between the IDB and the user and is not authorized as part of this CC-IGO license. Note that the link provided above includes additional terms and conditions of the license.The images or other third party material in this book are included in the work's Creative Commons license, unless indicated otherwise in the credit line; if such material is not included in the work's Creative Commons license and the respective action is not permitted by statutory regulation, users will need to obtain permission from the license holder to duplicate, adapt or reproduce the material. Open Access This work is distributed under a Creative Commons AttributionNonCommercial-NoDerivatives 3.0 IGO license (http://creativecommons.org/ licenses/by-nc-nd/3.0/igo/) and may be reproduced with attribution to the InterAmerican Development Bank (IDB) and for any non-commercial purpose. No derivative work is allowed. Any dispute related to the use of the works of the IDB that cannot be settled amicably shall be submitted to arbitration pursuant to the UNCITRAL rules. The use of the IDB's name for any purpose other than for attribution, and the use of IDB's logo shall be subject to a separate written license agreement between the IDB and the user and is not authorized as part of this CC-IGO license. Note that the link provided above includes additional terms and conditions of the license. The images or other third party material in this book are included in the work's Creative Commons license, unless indicated otherwise in the credit line; if such material is not included in the work's Creative Commons license and the respective action is not permitted by statutory regulation, users will need to obtain permission from the license holder to duplicate, adapt or reproduce the material. This work is subject to copyright. All commercial rights are reserved by the Inter-American Development Bank, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, ev...

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The Challenge of Public Pension Reform in Advanced and Emerging Economies

Cited by 25 publications

References 41 publications

Teaching medical students about cost-effectiveness

Teaching medical students about cost-effectiveness

Global Population Aging: Facts, Challenges, Solutions & Perspectives

Ahorrar para desarrollarse: Cómo América Latina y el Caribe puede ahorrar más y mejor

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