Ageing and the long-run fiscal sustainability of health care across levels of government
OECD economies are undergoing a seemingly inevitable process of population ageing
that has been changing income and consumption patterns. Notably, the demand for health
services is expected to increase, while labour forces are projected to shrink. Both
factors are projected to negatively impact the sustainability of health systems –
the former through an increase in government expenditures on health and the latter
through a decrease in government revenues. As health systems and their funding streams
tend to be at least partially decentralised in most OECD countries, this fiscal pressure
is expected to be asymmetric across levels of government. The objective of this paper
is to provide order-of-magnitude estimates of the possible effects of population ageing
on government finances across OECD countries, and to discuss reforms to fiscal federalism
and intergovernmental relations with the purpose of funding expenditures at all levels
of government.
Available from June 30, 2022
In series:OECD Working Papers on Fiscal Federalismview more titles