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While rising health care expenditures as a percentage of national income is a well-known and widely documented feature across the industrialized world, it has proved difficult to quantify the effects of the underlying cost drivers. The main difficulty is to find suitable proxies to measure medical technological innovation, which is believed to be a major determinant of steadily increasing health spending. This paper’s main contribution is the use of data on approved medical devices and drugs to proxy for medical technological progress. The effects of these variables on total real per capita health spending are estimated using a panel model for 18 OECD countries covering the period 1981-2009. The results confirm the substantial cost-increasing effect of medical technology, which may account for at least 50% of the explained historical growth of spending. Excluding the approval variables causes a significant upward bias of the estimated income elasticity of health spending and negatively affects some model specification tests. Despite the overall net positive effect of technology, the effect of two subgroups of approvals on expenditure is significantly negative. These subgroups can be thought of as representing ‘incremental medical innovation’, while the positive effects are related to radically innovative pharmaceutical products and devices. The results are consistent with those reported in other studies which suggest that some new products, despite their high price when they are introduced, can ultimately save money by reducing spending on other medical interventions.
The Federal Planning Bureau presents its latest medium-term outlook (2012-2017) on 14 May 2012. The Economic Outlook 2012-2017 for Belgium is set against the background of budgetary consolidation and weak economic growth in Europe.
Since 1987, the Federal Planning Bureau has been providing long-term projections focused on the evolution of social expenditure within an overall framework of public finance. This outlook is based on different scenarios. This publication describes the methodology to construct the socio-economic and macroeconomic scenarios and illustrates it by presenting the main results from the 2011 projection made for the Annual Report of the Study Group on Ageing. The methodology proceeds as follows. The population projection is first split into four socio-economic categories: the school population, the potential labour, the disabled persons and the others. The macroeconomic scenario subsequently determines the evolution of employment and productivity. Finally, the second phase of the socio-economic projection disaggregates employment and unemployment further and estimates the number of pensioners.
One of the main sections in the current draft of the 2011-2012 Interprofessional Agreement concerns the welfare adjustment of social benefits. This draft results from a long process and fits in with the law concerning the Solidarity Pact between the Generations, which established a structural mechanism at the end of 2005, linking social benefits to welfare evolution. This working paper ‘Welfare adjustment of social benefits’ describes the first stage of that process: estimating the disposable financial means for the welfare adjustment of social benefits for the period 2011-2012, to which the Federal Planning Bureau contributed. In the employees scheme these means amount to 233.8 million in 2011 and to 497.9 million in 2012, of which the draft of the Interprofessional Agreement proposes to utilize merely 60%. Furthermore, this paper offers an overview of Belgian social policy by portraying its main turning points on the one hand and analysing the evolution of the average amounts of the main social benefits since 1980 on the other. The outcome is marked with contrast: over the period 1980-2009 the relative standard of living globally improved for pensioners, as opposed to the unemployed and the disabled.
This report describes the organization of the Belgian long-term care system. It can be characterized as a mixed system with extensive public care provision and substantial support from informal care mainly within the family. While the current volume and quality of services appears to be adequate, the future increase in the number of dependent elderly persons over the next two decades as a result of demographic ageing can be expected to become a serious challenge, both in terms of required formal and informal care capacity and financially.
In the context of a European-funded sixth framework project called AIM, a dynamic microsimulation model MIDAS is being developed for Belgium, Germany and Italy. This is a joint effort by three institutions, the German DIW, the Italian ISAE and the Belgian FPB. This model MIDAS simulates future developments of the adequacy of pensions, following wherever possible the projections and assumptions of the Ageing Working Group. This paper describes the model MIDAS in detail. It next presents and discusses some simulation results for Belgium, Germany and Italy. Finally, the simulation results of two alternative policy scenarios are presented and discussed.
The Working Paper looks at the strategy that has been implemented in Belgium since the beginning of the decade to finance the future increase in public spending due to population ageing. This strategy is laid down in the Stability Programmes and in the Ageing Act and is supported by a broad social and political consensus. It implies building up budget surpluses, which has not been done so far. The paper analyses the long-term effects of such a situation, for example as regards the trade-off between the various policies that could be implemented to face the budgetary challenges posed by ageing populations.
