title: The sustainability of European health care systems: beyond income and aging.
abstract: During the last 30 years, health care expenditure (HCE) has been growing much more rapidly than GDP in OECD countries. In this paper, we review the determinants of HCE dynamics in Europe, taking into account the role of income, aging population, technological progress, female labor participation and public budgetary variables. We show that HCE is a multifaceted phenomenon where demographic, social, economic, technological and institutional factors all play an important role. The comparison of total, public and private HCE reveals an imbalance of European welfare toward the care of the elderly. European Governments should increasingly rely on pluralistic systems to balance sustainability and access and equilibrate the distribution of resources across the functions of the public welfare system.
authors.affiliation: IMT Lucca Institute for Advanced Studies, Piazza San Ponziano, 6, 55100, Lucca, Italy. pammolli@gmail.com
authors.forename: Fabio
authors.initials: F
authors.lastname: Pammolli
authors.forename: Massimo
authors.initials: M
authors.lastname: Riccaboni
authors.forename: Laura
authors.initials: L
authors.lastname: Magazzini
mesh_terms: D000375:Aging; D004651:Employment / Q000191:economics* / Q000706:statistics & numerical data; D018166:Health Care Reform / Q000191:economics / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D015397:Program Evaluation / Q000191:economics* / Q000379:methods / Q000706:statistics & numerical data; D012946:Social Welfare