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2010 | Buch

Introduction Kapitel lesen Erstes Kapitel lesen

Population Ageing - A Threat to the Welfare State?

The Case of Sweden

herausgegeben von: Tommy Bengtsson

Verlag: Springer Berlin Heidelberg

Buchreihe : Demographic Research Monographs

Enthalten in: Springer Professional "Wirtschaft+Technik" , Springer Professional "Wirtschaft"

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Über dieses Buch

Tommy Bengtsson Population ageing, the shift in age distribution towards older ages, is of immense global concern. It is taking place to a varying degree all over the world, more in Europe and some Asian countries, less on the African continent. The worldwide share of people aged 65 years and above is predicted to increase from 7. 5% in 2005 to 16. 1% in 2050 (UN 2007, p. 11). The corresponding ?gures for developed countries are 15. 5 and 26. 2% and for developing countries 5. 5 and 14. 6%. While population ageing has been going on for some time in the developed world, and will continue to do so, most of the change is yet to come for the developing world. The change in developing countries, however, is going to be much faster than it has been in the developed world. For example, while it took more than 100 years in France and more than 80 years in Sweden for the population group aged 65 and above to increase from 7 to 14% of the population, the same change in Japan took place over a 25-year period (UN 2007, p. 13). The scenario for the future is very similar for most developing countries, including highly populated countries like China, India and Brazil. While the start and the speed differ, the shift in age structure towards older ages is a worldwide phenomenon, stressing the signi?cance of the concept global ageing.

Inhaltsverzeichnis

Frontmatter
Chapter 1. Introduction
Abstract
Population ageing, the shift in age distribution towards older ages, is of immense global concern. It is taking place to a varying degree all over the world, more in Europe and some Asian countries, less on the African continent. The worldwide share of people aged 65 years and above is predicted to increase from 7.5% in 2005 to 16.1% in 2050 (UN 2007, p.11). The corresponding figures for developed countries are 15.5 and 26.2% and for developing countries 5.5 and 14.6%. While population ageing has been going on for some time in the developed world, and will continue to do so, most of the change is yet to come for the developing world. The change in developing countries, however, is going to be much faster than it has been in the developed world. For example, while it took more than 100 years in France and more than 80 years in Sweden for the population group aged 65 and above to increase from 7 to 14% of the population, the same change in Japan took place over a 25-year period (UN 2007, p. 13). The scenario for the future is very similar for most developing countries, including highly populated countries like China, India and Brazil. While the start and the speed differ, the shift in age structure towards older ages is a worldwide phenomenon, stressing the significance of the concept global ageing.
Tommy Bengtsson
Chapter 2. The Ageing Population
Abstract
The process of population ageing that has been occurring in Sweden can be expected to continue during the coming decades, the population pyramid will become increasingly rectangular, and possibly even demonstrate a shrinking base. This will lead to increasing challenges in terms of financing pensions, elderly care and healthcare. These problems will continue for at least the next 30 years with no demographic solution available. Immigration is not likely to offset population ageing to any larger degree, and even dramatic increases in fertility rates would take 25–30 years to have any positive effect. Since increasing tax rates seems unlikely, the most viable solution lies in an expansion of the workforce and the resulting increase of the tax base. If we rely solely on increasing the retirement age to provide the increased hours worked, we would need to raise the minimum retirement age by roughly 5 years until 2050. While this might be possible, it is more likely that the solution lies not in this or any other single measure but in a combination thereof. However, expanding hours worked not only requires incentives but also job opportunities. Thus the policy should aim not only at expanding labour supply side but also labour demand.
Tommy Bengtsson, Kirk Scott
Chapter 3. In This World Nothing Is Certain but Death and Taxes: Financing the Elderly
Abstract
This chapter discusses possible ways to finance the increased demand for resources from the elderly through the tax system. Maintaining the benefits at today’s level will require either increased tax burden on those working or an expanded tax base. As a country with one on the world’s highest tax burdens, Sweden has little or no room to raise additional tax revenues through increased tax rates without causing substantial welfare costs. There is, however, some room to raise additional tax revenues by increasing the number of hours worked in the economy. This will likely not be enough however and alternative ways need to be sought and found in order to finance the increased demand from the elderly.
Åsa Hansson
Chapter 4. A Stable Pension System: The Eighth Wonder
Abstract
Ageing, with increases in the old-age dependency ratio, puts a strain on pension systems organised as a pay-as-you-go system. The major part of the Swedish pension system is a pay-as-you-go one, but the specific Swedish design mitigates much of this strain. It is maintained to be financially stable. The question asked in this chapter is whether the system will be politically as well as financially stable in the future. The design is described and analysed with respect to sustainability. Political sustainability is analysed from the viewpoint of fairness, assuming that a fair system will be more stable than a system that is perceived not to be fair. The analysis of fairness is divided into fair outcome and fair procedure. Outcome varies much with chosen measure. The procedure has it draw-backs, but seems fair enough provided a well-functioning labour market.
Agneta Kruse
Chapter 5. Ways of Funding and Organising Elderly Care in Sweden
Abstract
Elderly care in Sweden is an important municipal task and a more specialised care was introduced in 1918. Since then the development of elderly care has evolved in terms of a three stage process and each phase has been characterised by path-dependent processes. Critical junctures have been reached around 1950 and around 1990. Since 1990 the municipalities have been given extended options to organise elderly care and they are now trying to find means of increasing efficiency in elderly care. One possibility has been to privatise parts of the care. The demographic challenge of an ageing population will affect the possibilities to finance elderly care in the future. This will probably lead to a new critical juncture at which the State will take financial responsibility for elderly care and introduce elderly care insurance.
Per Gunnar Edebalk
Chapter 6. Financing Healthcare: A Gordian Knot Waiting to Be Cut
Abstract
The difficulties in financing healthcare in Sweden will increase in the future. Based on simulations with a dynamic micro-simulation model (SESIM), where individual healthcare expenditure is a function of inter alia health status, we expect a 30% increase between 2000 and 2040 in the total number of bed days for the whole population, due mainly to an increasing population of the oldest old. Hence, the ageing of the population is not just an issue of shifting the cost of dying to older ages. At the same time, the development of new technologies and the way these are disseminated across patient groups will continue to raise the cost of high-quality care. While there is likely to be some scope for greater efficiency on the supply side, changes in the institutional structure are unlikely to be drastic and even drastic policies may have relatively little to offer in practice. Explicitly giving low priority to elderly patients in the way implied by straightforward QALY calculations or the “fair innings” argument will hardly be accepted by Swedes in general. Hence, in the absence of politicians with the impact of someone like Alexander the Great, the future seems to have in store longer queues, greater reliance on private insurance, and political equivocation.
Björn Lindgren, Carl Hampus Lyttkens
Chapter 7. Towards a New Swedish Model?
Abstract
The Swedish welfare state has always attracted interest among welfare state scholars, and it has been labelled universal, social democratic and institutional – among other things. Since 1980, however, the Swedish welfare state has been altered and reformed in several ways. Taking a very strict view on what the Swedish model entails, the model is arguably dead. Still, most welfare state scholars agree that despite some cutbacks, Sweden remains a universal welfare state, and the reforms have been described as liberalization without welfare state retrenchment. Most likely, public commissions have served as early warning systems, providing valuable information to decision makers and facilitated the creation of political consensus. The pension reform is the paramount example, but it remains to be seen whether similar reforms will be implemented for healthcare and elderly care.
Andreas Bergh
Backmatter
Metadaten
Titel
Population Ageing - A Threat to the Welfare State?
herausgegeben von
Tommy Bengtsson
Copyright-Jahr
2010
Verlag
Springer Berlin Heidelberg
Electronic ISBN
978-3-642-12612-3
Print ISBN
978-3-642-12611-6
DOI
https://doi.org/10.1007/978-3-642-12612-3

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