Demography and Social Health Insurance

Most of all OECD-countries face an ageing process of their populations over the next four decades. However, these processes differ considerably among the different countries. This work wants to analyze how the demographic changes affect the social health insurance systems and their finances of six selected OECD-countries, namely Austria, France, Germany, Switzerland, the UK and the U.S., over the long-run using the method of generational accounting. A focus is also set on the fiscal consequences of the medical-technical progress. It can be stated that all analyzed programs will have discrepancies between their expected revenues and transfer payments. The demographic component is only the minor part given that the medical-technical progress will occur in the future like it did over the last three decades. However, also the growth rate due to the medical-technical progress differ significantly between the analyzed countries. In conclusion all systems will have to face rigorous reforms.