Population Ageing - A Threat to the Welfare State?

by Bengtsson, Tommy

• ISBN13: 9783642126116
• ISBN10: 3642126111
• Edition: 1st
• Format: Hardcover
• Copyright: 2010-07-29
• Publisher: Springer Nature

Summary

This book is the first to take a comprehensive view of the challenges that population ageing present in the near future taking Sweden as the case. Can the increasing number of retirees per worker be stopped by immigration or increasing fertility or will we need to increase pension age instead? Cost for the social-care system is readily increasing; even more is the costs for health care. Can the galloping costs be funded by an increase in taxes or do we need to make reforms, similar to the ones already made in the pension system, which has been used as a model for many other countries. The fact that it is difficult to make health care dependent on personal contributions, as is the case of the pension system, funding of health care is a true test of solidarity across generations. The book ends with a discussion on whether the demographic challenge to the welfare system is also a threat to the welfare state as such.

Table of Contents

Introduction	p. 1
References	p. 6
The Ageing Population	p. 7
Introduction	p. 7
Fundamentals of Population Ageing	p. 8
Consequences of an Ageing Population	p. 12
Can We Increase Fertility?	p. 16
Is Immigration the Answer?	p. 16
Other Ways to Solve the Problem?	p. 19
Summary	p. 20
References	p. 21
In This World Nothing Is Certain but Death and Taxes: Financing the Elderly	p. 23
Introduction	p. 23
Background	p. 24
Are Increased Taxes the Solution?	p. 28
Increasing Tax Rates: A Non-solution	p. 29
Increasing the Tax Base: A Partial Solution	p. 36
Discussion and Conclusions	p. 42
References	p. 44
A Stable Pension System: The Eighth Wonder	p. 47
Introduction	p. 47
The Swedish Pension History	p. 48
Ageing and Pensions	p. 50
Pensions in Sweden: A 4-tier System	p. 51
Financial Stability in the Swedish Pension System	p. 54
Political Sustainability	p. 55
Fairness as an Estimate of Sustainability	p. 57
A Fair Starting Point?	p. 61
When Contributions Deviate from Benefits, i.e. Deviations from the DC Feature	p. 61
Indexing	p. 62
Concluding Comments	p. 63
References	p. 64
Ways of Funding and Organising Elderly Care in Sweden	p. 65
Introduction	p. 65
The Establishment of Old People's Homes	p. 67
The Development of Home Help Services	p. 70
Times of Reappraisal Around 1990	p. 71
Elderly Care of Today and Future Challenges	p. 72
Financing of Elderly Care	p. 75
Conclusion	p. 78
References	p. 79
Financing Healthcare: A Gordian Knot Waiting to Be Cut	p. 81
Introduction	p. 82
The Swedish Healthcare System	p. 83
Simulating the Development of Inpatient Care 2000-2040	p. 86
Some Characteristics of the Simulation Model	p. 88
Base-Case Scenario	p. 89
Improved Health Progression with and Without Decreased Risk of Death	p. 90
Incomes of People in Old Age	p. 92
Not a Non-issue	p. 93
Non-solution One: Technological Development	p. 94
Non-solution Two: Institutional Change	p. 97
Non-solution Three: Explicit Priority Setting (or Do We Believe in the QALY and Nothing but the QALY?)	p. 100
Towards a Non-non-solution (or Simulating to Have an Answer)	p. 101
References	p. 103
Towards a New Swedish Model?	p. 109
Introduction	p. 109
The Swedish Model So Far	p. 110
The Demographic Challenges	p. 113
Concluding Discussion	p. 117
References	p. 118
Index	p. 121
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