It was striking that the conversation was dominated by healthcare. We distinguished between ‘true’ age-related healthcare costs, associated with chronic conditions and long term care, as opposed to the costs of the last year of life, which arise whenever someone dies and may actually be higher for early death (when people are more likely to benefit from costly interventions).
There was agreement that ageing is not the main driver of health costs, with improving technology and rising expectations considerably more important.
Participants questioned whether US health spending was an unusual outlier, or the inevitable trajectory for other advanced economies. While American delegates tended to be fatalistic about health costs, participants from other countries pointed to their success in checking rising costs and maintaining health spending at a lower share of GDP (usually with better health outcomes, since healthcare only has a small impact on a society’s health). Continue reading “Impacts of ageing for developed economies”
I recently spent three days at a conference on ageing in developed economies, hosted by the Ditchley Foundation at their splendid Oxfordshire pile. I was one of the rapporteurs for the event and asked to focus on the causes and impacts of population ageing.
Undaunted by the breadth of this exam question participants from Sweden, the UK, Canada, the US, Japan and the Netherlands pooled their evidence and insight to considerable effect. In this first blog, I précis our discussions on causes and trends (NB the whole conference was under the Chatham House rule).
Fertility – There was surprisingly little discussion of the impact of the post-1945 baby boomers (perhaps experts now take them for granted, or see them as only transitory phenomenon). By contrast there was intense debate on the subsequent slump in fertility observed since the 1960s across the developed world.
Fertility rates vary widely, with the USA and Scandinavia remaining fairly fertile, while Southern Europe and East Asia have seen fertility fall far below population replacement requirements. The latter will lead to population decline and for coming decades skew the age profile of the population upwards, for as long as older, more fertile generations remain alive.
Interestingly the UK, Germany and France seem to have had some success in improving fertility in recent years. There was scepticism about the effectiveness of deliberate pro-birth incentives but agreement that flexible work and supported childcare is very important (migrant mothers play a moderate role too).
However I was surprised to hear that the strongest determinant of variations in developed world fertility rates are our different attitudes to birth outside marriage. This lesson implies that conservative cultures may find it very difficult to increase fertility (it also adds a new dimension to the UK debate on using public policy to support marriage). Continue reading “Trends in ageing for developed economies”