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NTA Coordinators:
Ronald D. Lee and Andrew Mason
Series Editor: Sidney B. Westley
NTA Bulletin Advisory Committee:
Alexia Frnkranz-Prskawetz, Ronald D.Lee, Sang-Hyop Lee, Thomas Lindh,
Andrew Mason, Tim Miller, Germano
Mwabu, Naohiro Ogawa, and AdedoyinSoyibo
The lead institutions for the NTA projectare the Center for the Economics andDemography of Aging, University ofCalifornia at Berkeley, and the Populationand Health Studies Program, East-WestCenter. Regional centers are based at NihonUniversity Population Research Institutein Tokyo, the United Nations EconomicCommission for Latin America and theCaribbean in Santiago, the African EconomicResearch Consortium in Nairobi, and theInstitute for Future Studies in Stockholm.
Support for the project has been providedby the US National Institute on Aging;the John D. and Catherine T. MacArthurFoundation; the International DevelopmentResearch Center (IDRC); the UnitedNations Population Fund (UNFPA);the European Science Foundation; and agrant to the Nihon University PopulationResearch Institute from the AcademicFrontier Project for Private Universities.
National Transfer Accounts Bulletin
Population and Health StudiesEast-West Center1601 East-West RoadHonolulu, Hawaii 96848-1601
Telephone:+1.808.944.7566Fax:+1.808.944.7490Email:[email protected]:www.ntaccounts.org
The economic consequencesof population aging
Report on a technical policy seminar
Over the past year, the debt crisis in Europe and the United States (US) has
prompted many policymakers to seek options for reducing government
expenditures. Some are concerned that expanding elderly populations will
increase fiscal pressure on government-sponsored pension and healthcare system
Such concerns have prompted a consideration of pension and healthcare reform
including changes in the retirement age.
In other regions of the world, policymakers will face challenges of expandin
elderly populations in a more difficult contextwith weaker financial institu
tions and at lower levels of economic development. Although economists and
policymakers differ in their views on the fiscal consequences of population agin
many would agree that one of the most important public-policy challenges othis century is to provide pensions and healthcare for rapidly growing elderly
populations without placing unacceptable burdens on other age groups or
jeopardizing economic growth.
On 1920 September 2011, the United Nations Population Fund (UNFP
and the East-West Center (EWC) held a Technical Policy Seminar on the
Economics of Aging. The seminar was designed to assess: (1) the role of the
public sector in an aging and uncertain world; (2) the implications of populati
aging for social, economic, and population policy; and (3) remaining gaps in
knowledge that need to be addressed.
In opening the seminar, Werner Haug emphasized that developing economfacing the fiscal and institutional challenges associated with population aging
will have a very short timeframe in which to act. Some leaders have turned to
the United Nations (UN) for assistance in formulating appropriate programs
and policies, and UNFPA is currently working to develop a shared under-
standing of the economic and fiscal consequences of population aging and
to map out a coherent response. The technical policy seminar was designe
to contribute to this effort.
BULLETINDecember 2011
Number 3
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Changing populationage structures
Populations are becoming older, withfewer children and more elderly, in everyregion of the world. This process ofpopulation aging is primarily the resultof fertility decline. Over the past 40 years,total fertility rates (average number ofbirths per woman) have gone down in
all the worlds most populous regions(Figure 1). In Africa, Asia, and LatinAmerica, this trend is expected to continueover the next 40 years. Increasingly inthese economies and in the highlydeveloped economies where fertility isalready low, gains in life expectancy arealso contributing to population aging.
Today, in roughly half the worldseconomies, the population at working age isgrowing more quickly, in absolute numbers,than the population of children or theelderly. This creates a potentially favorable
age structure for economic growth.Among the economies covered by the
National Transfer Accounts (NTA) project,this demographic process has hardly startedin Nigeria. In 201015, the United Nationsestimates Nigerias total fertility at 5.4 childrenper woman and life expectancy at birthat 53 years (United Nations Secretariat2010). High fertility and low rates ofinfant and child mortality result in a veryyoung population, with 43 percent in theworking-age group of 2064, compared
with 53 percent age 019 and only 3percent at age 65 and above (Figure 2a).By contrast, the process of population
aging is well underway in Brazil, with atotal fertility rate in 201015 at 1.8children per woman and life expectancyat birth at 74 years. Fifty-nine percent ofBrazils population is in the working-agegroup, compared with only 34 percentage 019 and 7 percent age 65 and above(Figure 2b).
The other half of the worldliving inEurope, North America, and East Asia
has completed this phase of the demo-graphic transition. In these societies, highlife expectancies have combined withlowand in some cases very lowbirthrates to change the age structure ofpopulations still further. Often surprisinglyquickly, these populations will come toconsist of very few children, not manyworkers, and many old people.
Japan exemplifies this stage ofdemographic change, with total fertilityin 201015 estimated at only 1.4 children
15,000 10,000 5,000 5,000 10,000 15,000
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20-24
30-34
40-44
50-54
60-64
70-74
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Five-yearage
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Fig 2a. Ag and sx stt of th poplation of Nigia, 2010.Source:United Nations Secretariat 2010.
10,000 5,000 5,000 10,000
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egroups
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Fig 2. Ag and sx stt of th poplation of bazil, 2010.Source:United Nations Secretariat 2010.
6.7
5.5
2.4
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3.4
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2.3 2.0
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1
2
3
4
5
6
7
8
Africa Asia Europe Latin America Northern
America
Bir
thsperwoman
1970 1990 2010
Fig 1. Total ftility ats in ajo gions of th wold, 1970, 1990, and 20Source:Mauricio Soto, presentationat theTechnical PolicySeminar on the Economics ofAging.
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6,000 4,000 2,000 2,000 4,000 6,000
0-4
10-14
20-2430-34
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Fig 2. Ag and sx stt of th poplation of Japan, 2010.Source:United Nations Secretariat 2010.
segment of the population is centenariansover the past 50 years, the 100+ age group
has grown at an annual rate of 13 percent.
Why does populationage structure matter?
Changes in the age structure of a populationassume economic importance because of afundamental feature of the economic life-cycleworking-age adults produce morethrough their labor than they consume,while children and the elderly consumemore than they produce. This economicpattern is only possible because resourcesflow over time and across generationsthrough a complex system of social,economic, and political institutions.
2010 2030 2050 2010 2030 2050 2010 2030 2050 2010 2030 2050 2010 2030 2050
Africa Asia Europe Latin America Northern America
1218 16
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12
1913
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tion
4 57 7 7
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otalpopula
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Fig 3. Pntag of total poplation nd ag 15 and ag 65 and aovin ajo gions of th wold, 2010 and pojtd fo 2030 and 2050.Source:United Nations Secretariat 2010.
per woman and life expectancy at 84.Fifty-two percent of Japans population is
in the working-age group, while only 18percent are young, and 23 percent areelderly (Figure 2c).
Over the next 40 years, populationswill become older in all the most popu-lous regions of the world (Figure 3). InAfrica, Asia, and Latin America, the pro-portion under age 20 will decline, and theproportion age 65 and above will increase,although there is considerable variationwithin Asia. In Europe and NorthernAmerica, the proportion of children isalready small, but the proportion of elderlywill increase. This shift in the relative size ofpopulation age groups is occurring and willcontinue to occur at unprecedented speed.In Japan, for example, the fastest-growing
In the past, the main challenge waprovide for the resource needs of childbecause they were such a large compoof the population. This is still the casemany low- and middle-income economAs populations age, meeting the resouneeds of the elderly becomes more challing. In many economies today, howevpopulations have become increasinglyconcentrated in the prime working ag
the period of life during which more ibeing produced than consumed. This potentially favorable implications forstandards of living and economic grow
Conventional analysis of the econoimplications of population aging relion fixed age groups that often classifdependents as those under age 15 or agand above. This is a useful starting pobut Ronald Lee and Andrew Masonpresented the alternative NTA approaNTA recognizes variations in the extendependency among people of differe
ages by examining actual labor incomand consumption for each one-year agroup.
Labor income is a broad measure reflects variation across age in labor foparticipation, unemployment rates, howorked, and wages. NTA defines laboincome comprehensively to include thvalue of most productive work: the eaings of employees, employer-providebenefits, taxes paid to the governmentemployers on behalf of employees, thproportion of entrepreneurial income is a return to labor, and the estimatedvalue of unpaid family labor.
Consumption in NTA includes goand services from both public and privsources. Separate estimates of public aprivate consumption are constructed fevery NTA economy in three categorieducation, health, and other goods anservices. This provides comprehensiveestimates of human-capital spending bage for economies at widely varying leof developmentestimates that are no
available from other sources.One current shortcoming is that Nestimates of labor income do not incluthe value of time associated with childrearing and other at-home activities thdo not produce market goods or serviAs a consequence, womens labor is nofully documented, and consumption atransfers of nonmarket goods and servare undervalued. NTA researchers arecurrently exploring how to incorporatthe value of these elements more fully
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Keeping in mind these limitations, theNTA approach reveals remarkably similarpatterns among economies at widelydifferent stages of economic development.
In India and Germany, for example, percapita consumption exceeds labor incomefor two long periods of life (Figure 4).These bracket a surprisingly short periodlittle more than 30 yearsduring whichmore is being produced than consumed.
Striking differences occur, however,when population age structure is com-bined with per capita values to estimateconsumption and labor income for aneconomy as a whole. The lifecycle deficit,defined as consumption in excess of laborincome, is particularly high for the young
in India and for the old in Germany(Figure 5). The extraordinary differencesbetween India and Germany are drivenprimarily by differences in population agestructure, with many children in India
and many old people in Germany. Inaddition, in high-income economies suchas Germany, the elderly tend to consumea great deal of healthcare, reinforcing the
effect of the population age structure.The age patterns of consumption andlabor income that make up the economiclifecycle reflect the goals, institutions,economic conditions, social consensus, andpolicies that are unique to each society ateach point in time. Societies differ, forexample, in how much education theyprovide to children and how much theyspend on the healthcare needs of theirelderly. They differ in the age at whichyoung people enter the labor force and thesuccess of their transition into productive
employment. They differ in attitudes andpolicies concerning retirement, and theydiffer in levels of disability at old age.
Perhaps the most important genera-tional feature of any economy is the
resource flows between age groups thaunderlie the economic lifecycle. As withe age pattens of consumption and laincome, these flows are influenced by
unique features of each society. But for age group in any society, the gap betwconsumption and labor income must eqthe total of three resource flows: (1) nprivate transfers that occur primarily wifamilies plus (2) net public transfers thoccur through government taxes andprograms plus (3) asset-based reallocatthat include the use of asset income plany dis-saving or selling off of assets.
Estimates of the relative importanof private transfers, public transfers, aassets, available from the NTA website
(www.ntaccounts.org), provide imporinsights into changing social patterns the effects of public policy. Both familand governments may support the youand the old by transferring resources,
45
50 Labo omeinc
euros
o
ons
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25
30
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15
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Age
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Fig 5. Agggat lao ino and onsptiony ag in Gany, 2003.Source:Mason andLee 2011.
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es
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Fig 5a. Agggat lao ino and onsptiony ag in India, 2004.Source:Mason andLee 2011.
0
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Consumption
Labor income
Fig 4. P apita lao ino and onsptiony ag in Gany, 2003.Source:Mason andLee 2011.
0
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10,000
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20,000
25,000
30,000
35,000
40,000
0 10 20 30 40 50 60 70 80 90+
Rupees
Age
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Labor income
Fig 4a. P apita lao ino and onsptiony ag in India, 2004.Source:Mason andLee 2011.
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in both cases the support comes primarilyfrom working-age adults. Families aregenerally the primary institution support-ing children. The role of families in old-age support is more variedvery often,older family members provide moresupport to the young than they receive.
Governments at the local, regional,and national level play an importantrole by imposing taxes, most heavily on
working-age adults, and providing benefitsto all age groups, but particularly to theyoung and the old. Education, pensions,and healthcare are important examples ofpublic programs that transfer resourcesbetween age groups.
In addition to relying on income fromtheir labor and from transfers, peoplefund their own consumption and thesupport they provide to others throughincome earned from assets and, in somecases, from spending down their savings.They may accumulate assets during their
working lives or acquire assets throughgifts or bequests, most often from familymembers.
Support systems for children and theelderly vary widely, and these systemshave changed a great deal over time. Intraditional settings in the past, childrenrelied on their families and perhaps theirvillages for support. Children also oftenbegan working at early ages, and theelderly often worked and supportedthemselves until they died. The role ofassets is less clearly understood, but theaccumulation of capital in the form ofhousing, farms, and other businessesproduced returns that helped support allfamily members. In such situations,governments could play a useful role bymaintaining the security of assets andproviding an efficient and equitable legalenvironment, but they provided verylimited direct support to children or theelderly.
With social modernization and eco-nomic development, support systems have
changed in two ways: Public transfers tochildren have become more important,primarily in the form of education, andfamily transfers to the elderly havediminished. In some economies today,the elderly rely to a great extent on large-scale public transfer systems. In othereconomies, they depend much more onassets accumulated over their lifetimes.
Brazil and Mexico illustrate commonpatterns but also reveal some strikingdifferences (Figure 6). In both economies,
families provide most of the consumption
needs of children through private transfers.And in both, the elderly provide moreresources to their families than they receive,at least up to their mid-80s. But in Brazil,the elderly receive much larger publictransfers than do the elderly in Mexico,primarily in the form of pension benefits.Brazilians become net beneficiaries of publictransfers at age 52, while Mexicans paymore in taxes than they receive in publicbenefits until age 58. And throughout oldage, Brazilians receive significant pension
income. The elderly in Mexico contin
to work longer than the elderly in Braand tend to support themselves largelythrough asset income.
The key point from such an analyis that both population age structure athe special features of the economic lifcycle in each society have important ecnomic and policy implications. An anaof all these factors helps provide a basisunderstanding how policy might influethe relationship between age structure economic behavior in the future.
December 2011
-8,000
-6,000
-4,000
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0 10 20 30 40 50 60 70 80 9
Brazilianreais
Age
Public transfers Private transfers Asset-based reallocations
Fig 6a. P apita pli and pivat tansfs and asst-asd soflows y ag in bazil, 1996.Source:Calculated fromdataon the NTA website (www.ntaccounts.org).
Note:Negativevaluesfor netpublic andprivate transfers occur when an agegroupis givingmorethan it is receiving.
-80,000
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20,000
40,000
60,000
80,000
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Mexicanpesos
Age
Public transfers Private transfers Asset-based reallocations
Fig 6. P apita pli and pivat tansfs and asst-asd soflows y ag in mxio, 2004.Source:Calculated fromdataon the NTA website (www.ntaccounts.org).
Note:Negativevaluesfor netpublic andprivate transfers occur when an agegroupis givingmorethan it is receiving.
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growth, the links between the size of theworking-age population and a robusteconomy are far from automatic. Indeed,many economies have been unable toachieve strong economic growth evenwith favorable changes in the supportratio (Mason 2005).
As Michael Herrmann pointed outduring the technical policy seminar, anincrease in the working-age population
does not necessarily lead to an increasein employment. In fact, average laborproductivitythe amount produced perworkeris a far more important compo-nent of total output than the size of thelabor force per se. To meet the challengesof population aging, policymakers need toensure that growing working-age popula-tions are supported by robust employmentrates and rising labor productivity.
Understanding the role of demographicchange, employment rates, and labor pro-ductivity can help shed light on several
important policy issues: (1) why thedemographic dividend has been larger insome economies than in others; (2) howpolicies can build on expanding working-age populations to achieve economicgrowth; and (3) what policies might reduceadverse economic effects when the relativesize of the working-age population beginsto decline.
During the seminar, Heiner Flassbeckstressed the importance of maintainingstrong economic growth and robustemployment rates throughout the demo-graphic transition. Potential economicgains will only be realized if growth in theworking-age population is accompaniedby growth in the number employed.
Eventually, as pension and healthcarecosts rise with expanding elderly popula-tions, workers may have to set aside as muchas 25 percent of their wages to supporttheir old age. They will only be willing todo this if wages are rising and if they feelconfident that the funds they set asidetoday will be available, with appreciation, in
the future.Michael Herrmann observed thatlabor income in many advancedeconomies has remained stagnant or gonedown in recent years relative to the returnon capital (Figure 8). If economic growthis stagnant and unemployment or under-employment is high, as is the case todayin many economies, workers will be un-willing or unable to set aside funds forcurrent retirees or to save for their ownretirement.
December 2011
Source:Calculated from dataon the NTA website (www.ntaccounts.org).
Note:Theeffectivenumber of producers sums thepopulation in each one-yearage group, weighted toincorporate age differences in employment and productivity estimated for the baseyear.The effectivenumberof consumerssums thepopulation in each one-yearage group, weightedto incorporateagedifferences in consumption estimated for the baseyear.
Support Ratios(effective number of producersper 100 effective consumers)
Region and Economy Base Year 2010 2030 2050
Afia 66 75 86
Kenya (KE) 1994 63 71 79
Nigeria (NG) 2004 69 79 93
east Asia 88 80 68
China (CN) 2002 89 82 75
Japan (JP) 2004 78 71 60
South Korea (KR) 2000 94 84 71
Taiwan (TW) 1998 93 84 65
Soth and Sothast Asia 92 96 95
India (IN) 2004 92 100 100
Indonesia (ID) 2005 97 103 99
Philippines (PH) 1999 83 91 94
Thailand (TH) 2004 97 90 85
Latin Aia 90 92 86
Brazil (BR) 1996 84 87 78
Chile (CL) 1997 94 91 85
Costa Rica (CR) 2004 93 95 87
Mexico (MX) 2004 95 100 94
Uruguay (UY) 2006 85 87 85
eop & uS 84 75 69
Austria (AT) 2000 90 77 70
Finland (FI) 2004 82 73 71
Germany (DE) 2003 83 70 63
Hungary (HU) 2005 86 82 73
Slovenia (SI) 2004 76 64 56
Spain (ES) 2000 90 79 67
Sweden (SE) 2003 78 72 69
United States (US) 2003 89 82 81
Tal 1. Sppot atios fo 23 onois, 2010 and pojtd fo 2030 and 20
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Population aging and employment
Changes in population age structure overthe demographic transition stronglyinfluence the potential supply of laborrelative to the population as a whole.Changes in the size of the working-agepopulation do not necessarily lead tocorresponding changes in the employedworkforce, however, because of fluctua-
tions in labor-force participation rates andhours worked. Much of the discussion inthe policy seminar addressed how policyand non-demographic factors influencelevels of employment.
The most direct link between agestructure and the supply of labor is labor-force participation, which, in large part,reflects decisions to enter or to leave thelabor market. These decisions are influencedby factors such as employment conditionsand the availability of jobs, educationalneeds and opportunities, attitudes towards
female employment, and policies andpractices regarding older workers.
Labor-force participation dependslargely on three important demographicgroups: the young, women, and theelderly. The young are affected bypolicies and practices that determine theage at entry into the labor forcepoliciesand practices that vary widely. In low-income economies, young people tendto enter the labor force at early ages, buttheir earnings are often very low. In the
long term, many economies wouldprobably benefit more if young peoplecould delay their entrance into the laborforce and continue their education.
Today, large numbers of young adultsin both low- and high-income economiesare neither in school nor productivelyemployed. This problem is particularlypronounced because of the currenteconomic downturn, but youth unemploy-ment and underemployment appear to bea more systemic, long-term problem inmany economic settings. Steps to improve
employment rates for young peopleinclude job-training programs and otherinterventions intended to increase theiremployability, as well as policies thatpromote economic growth, job creation,and new employment opportunities.
Women are the second group with astrong influence on overall labor-forceparticipation. Many economies haveseen rapid increases in female labor-forceparticipation in recent decades, facilitatedin part by lower rates of childbearing.
Policies that enable women to remain inthe labor force while they raise childreninclude maternity and childcare leave andassistance with childcare through daycarecenters, after-school programs, or monetarysupport for childcare at home.
The third group that influences over-all labor-force participation rates consistsof older workers. Today, many economieshave mandatory retirement ages that
curtail work in the formal sector, whileothers have pension and tax systems thatcreate incentives for workers to retire early(Gruber and Wise 1999). For older peoplewho are healthy, Rob Vos stressed thepotential value of lifelong learning andother programs that encourage activeparticipation in the labor force and in thebroader community.
One of the major points of discussionamong policy analysts is whether increasedflexibility in employment practices, in-cluding job sharing and part-time work,
could increase labor-force participation,particularly for women and older workers.Current policies in some economies makeit difficult for women to continue in theworkforce after they have children. Seniority-based wage systems make it expensive forfirms to retain older workers, and policiesthat make it difficult for employers to reducetheir workforce when economic conditionsare unfavorable may discourage themfrom adding jobs when times are good.
Even with supportive policies, retire-ment for many older workers is less a matterof choice and more a consequence of thenatural decline in ability and the rise inspecific disabilities that come with aging.David Canning sounded an optimisticnote by pointing to the improvements inhealth that will allow adults to work to anolder age in many economies. NaohiroOgawa was more cautious. While pointingto dramatic improvements in life expectancy,he observed that it remains an openquestion whether the elderly in Japanand other East Asian economies are also
enjoying more years of good health.For the elderly who remain healthy,working longer will only be an attractiveoption if they are productive and areearning wages that are commensuratewith their level of productivity. Youngand old workers and women often earnlow wages, even when they work fulltime.
Sang-Hyop Lee showed that olderworkers in many economies tend to havelow productivity and earn low wages. Aswould be expected, working longer has a
larger effect on income in economies wolder workers earn relatively high wagThis is the case in most European economies. In Mexico, by contrast, in 2036 percent of people age 6575 were stin the labor force, but their average wawere low. Raising the average retiremeage in this situation does not have a laeffect on the financial resources availato the elderly. Ryan Edwards pointed
that, within a single economy, there arstrong individual-level differences in dsions about when to leave the workforoften related to social-economic class.
Many of the policy options discusduring the seminar addressed the issuelabor supply under conditions of populaaging, particularly by enabling older peto choose to work. Michael Herrmannnoted that in a situation of high unempment, raising the retirement age will expthe working-age population but notnecessarily the number of fully employ
workers. This naturally leads to thequestion of whether the real problem groups with low employment rates mibe the availability of jobsthe demanfor labor rather than the supply. Certaeconomies experience periods, such aspresent, during which many people wwant to work cannot find employmentsuch a situation, policies that encouragefacilitate an increase in the supply of labare unlikely to have a favorable effect.
Heiner Flassbeck and Detlef Kottemphasized the importance of maintaiconsumer demand to support bothimmediate economic recovery and lonterm employment growth. Austeritymeasures designed to reduce debt anincrease saving rates are, from theirperspective, exactly the wrong approacfor dealing with both the current eco-nomic crisis and the longer-term issuof population aging and employment.
Population aging and investm
in human and physical capital
Policies that encourage economic growhigher productivity, and higher income workers are key components of any succful response to population aging. Todaeconomic recovery and restoring fullemployment are essential, but in the lonterm, investment in health and educationin infrastructure and other physical capiwill be key factors in raising labor protivity and accelerating economic grow
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Investment in child healthand education
Increased spending on childrens healthand education has been one of the mostimportant benefits of population aging.In low-fertility economies, human-capitalspending on each child is about four timesthe average annual labor income of aprime-age (3049) adult, while in high-fertility economies human-capital spendingper child is only about twice the averageannual labor income of this age group(Figure 9). As the process of populationaging progresses and working-age popula-tions become smaller relative to thenumber of elderly retirees, increasinghuman capital spending is one of the mostpromising strategies available to offset theanticipated decline in the support ratio.With greater spending on the health andeducation of children, future generationsof workers should be more productive,
even if there are fewer of them.Although education is essential,programs that focus on child health arealso important. In stressing the economicbenefits of investing in childrens health,David Canning reported that malariaprevention and vaccination against measlesand tetanus produce long-term gains ineducation and lifetime earnings. Improvednutrition in early childhood has similarbenefits.
Investment in adult healthInvestment in adult health can have animportant influence on worker productivityand economic growth. Health affectsworker absenteeism, educational perform-ance, and the acquisition of skills. Anddisability and physical decline affectdecisions to leave the workforce as wellas the productivity of those who remainemployed.
Investments that maintain healthat older ages also provide important eco-nomic benefits. Labor-force participationand wages do not decline just becausepeople are older, but also because olderpeople have declining health and risingrates of disability. These trends lead togreater needs for healthcare and long-termcare. To the extent that the link betweenage and health can be alteredallowingfor healthy agingsome of the adverseeffects of population aging will be moder-
ated. If poor health (morbidity) can becompressed to the last years of life, theprospects for delaying retirement andcontrolling healthcare costs could besignificantly improved.
Are todays older
populations staying healthy?
The health status of older adults
has important implications for the
economic impact of population
aging. Elderly people who are
healthy incur fewer healthcarecosts and are more likely to
remain in the workforce.
Trends in health status and
levels of disability have been
studied extensively in the United
States (US) and more recently in
other high-income economies.
In the 1970s, disability levels in
various age groups in the US
appeared static, but from the
mid-1980s to the early 2000s,
disability appeared to be declining
for all but the oldest age groups.
Over the past 10 years, how-
ever, the picture has become
more complex. Disability rates in
the US have continued to decline
among those 85 and older, but
they have been relatively flat for
those 6584,and appear to be
rising modestly for those 5564
(Freedman et al. 2011). Rising
disability rates in the working-age
population appear to be associ-
ated with increasing obesity
(Battacharya et al. 2008).
The evidence from other
economies paints a mixed picture.
Recent studies concluded that
during the 1990s activities-of-
daily-living (ADL) disability rates
went down in Denmark, Finland,
Italy, and the Netherlands but
went up in Belgium,Japan, and
Sweden (Lafortune et al. 2007;
Robine et al. 2008).
December 2011
Fig 9. Tad-off twn ftility and han apital spnding.Source:Mason andLee 2011.
Note:Human capital spending is total spending perchild given percapitahealth spending at age017andpercapitaeducationspending at age024 in thebase year.To enablemeaningful comparisons,human capital spending is expressedas a percentage of theaverageannual labor incomeof prime-age(3049) adultsin each economy.SeeTable 1 for country designations.Light blue dots are for Asia; dark
bluedotsare for Latin America; light green dotsare for Europeand the US; and darkgreen dotsare forAfrica.
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Investment in physical capital
Although participants in the seminaragreed on the importance of productiveinvestment in promoting economic growth,they did not agree on the relationshipbetween investment and saving. RonaldLee and Andrew Mason contended that aspopulations age, households will prefer toincrease the amount of assets they hold inorder to meet their retirement needs. Thisresponse will be strongest in economieswhere the elderly rely heavily on theirown financial resources during retirement,and it will be weakest in economies wherethe elderly rely on transfers from theiradult children or the government.
NTA provides useful data on the roleof assets as a source of support for theelderly in a wide range of economicsettings. Apart from labor income, theelderly rely on three sources of supportto fund their consumption: on public
transfers, including pensions and publiclyfunded healthcare less taxes; on privatetransfers, typically from younger familymembers, less transfers that the elderlymake to their families; and on assets,which include real assets such as farms,businesses, and homes, and financialassets such as stocks, bonds, mutualfunds, publicly and privately fundedpensions, and personal savings.
Analysis of NTA data shows thatsources of old-age support are extra-
ordinarily diverse (Figure 10). In Europeand Latin America, public transfer systems,including pensions and publicly fundedhealthcare, provide about two-thirds ofthe consumption needs of the elderly. InBrazil, Austria, Sweden, and Hungary, theelderly rely almost exclusively on publictransfers.
Within Asia, private transfers areimportant in China, Thailand, Taiwan,and South Korea, but not in Japan. Inthose economies lying along the right sideof the triangle in Figure 10, net privatetransfers are close to zero. In those lyingoutside the triangle to the right, theelderly actually give more to their childrenand their grandchildren than they receive.
The extent to which the elderly relyon assets for support varies widely. Inseveral economies, assets fund from one-to two-thirds of their lifecycle deficit. In afew economies, including the United States,
the elderly are even more reliant on assets.One surprising feature of these resultsis that in low-income economies wherepublic transfer systems are poorly developed,the elderly rely more on assets than ontransfers from their children. A numberof considerations should be kept in mind,however. First, these patterns are stronglyinfluenced by groups with the mostincome. Second, the elderly who arepoor undoubtedly have few assets, butthey also have children who can provide
little support. Third, in situations whethe elderly tend to live with their adulchildren, it is inherently difficult to demine whether they are relying on theichildren (and their labor income) for sport or whether the children are relyinon their elderly parents (and assets theaccumulated during their working yea
In considering the relative merits transfers versus assets as sources of sup
for the elderly, Lee and Mason arguedhigher saving will lead to greater investmto higher productivity and wages, andhigher standards of living (Lee, Masonand Miller 2003). In the right circumstances, they contended, the increasedsaving and investment that accompanpopulation aging will lead to a secondemographic dividend. In addition tbenefits for the domestic economy, anincrease in the demand for assets may lead to higher demand for foreign assesupporting productivity gains in the
receiving economies.Detlef Kotte, Heiner Flassbeck, an
Michael Herrmann, on the other handcontended that higher saving rates dnot necessarily lead to higher productiinvestment. Investment can be financthrough expansionary monetary policyand saving can be the result of investmrather than the other way around. Theemphasized that higher saving can redconsumption ofand demand forgoods and services, which could discoage investment, slow output growth, ahave a negative effect on employmentThe result would be to weaken thecapacity of the working-age populatiosupport a larger number of dependent
The big question is whether the athat people accumulate are actually inveproductively: What are governments aprivate institutions doing with the mothat people are saving? Are they makininvestments that will promote economgrowth, raise worker productivity, andsustain high employment rates in the
future?Thus the participants did not agreon one important question: Whetherhigher saving or higher consumption better for economic growth. They didagree on two other points, however. Fincreasing saving in the midst of a deerecession is ill-advised and is very unlito lead to more rapid economic growtAnd second, creating a favorable invesment environment is essential to meetthe needs of an aging society.
AT
ES
SE1/3
1/32/3
2/3
Assets
Publictransfers
Familytransfers
TH
JP
KR
TW
PH
CL
1/32/3
MX
US
SI
BRDECR
CN
IN
HU
UY
Fig 10. Th old-ag sppot syst: Pli tansfs, faily tansfs, andasst-asd flows as a popotion of th lifyl dfiit (gap twn onsp-tion and lao ino) at ag 65 and aov in 17 onois in a nt ya.Source:Mason andLee 2011.
Note: SeeTable 1 forcountry designations. Light blue dots are for South andSoutheast Asia; dark blue
dots are for LatinAmerica; light greendots are for Europeand theUnitedStates; anddark greendotsare for East Asia.
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The impact of population aging onpensions and healthcare systems
Populations today are aging at very differ-ent rates, and the pension and healthcaresystems that serve them also differ widelyin terms of design and coverage. Over thenext decades, there may be some saving inhealthcare and education as the numberof children diminishes. But many
economies will face fiscal pressure as thenumber of taxpayers who fund publicprograms declines relative to the numberof elderly who rely on pensions andhealthcare benefits. Rob Vos showed thatthe combined costs of pensions andhealthcare programs are projected toincrease over the next 50 years in 10European economies and decline, onlyslightly, in one (Figure 11).
Economic growth generally leads toincreases in tax revenues that can be usedto support pension and healthcare pro-
grams. But program costs are also likelyto rise with economic development.
Six main factors will determine thelevel of aggregate expenditures:
I Changes in population age structurethat influence eligibility for benefitsand the utilization of publicly fundedgoods and services
I The proportion of the populationthat is covered by pension and health-care systems
I The generosity of the benefits providedI Prices of goods and services, particularly
in healthcare
I Technological developments that affectcosts and the demand for healthcare
I Regulations and inefficiency thatinfluence administrative costs
Richard Hinz showed that pensioncoverage is closely correlated with eco-nomic development (Figure 12), and hespeculated that coverage by healthcaresystems probably follows a similar pattern.Hinz presented research that he conductedwith Asta Zviniene projecting aggregateexpenditures on pension and healthcarebenefits for four scenarios over the next60 years. Their model is designed toilluminate the consequences of expecteddemographic and economic trends, bothwith pension and healthcare programsunchanged and with specific policyadjustments.
The first scenario represents high-income economies with relatively oldpopulations and mature pension andhealthcare systems. These tend to havevery high coverage rates. Virtually allworkers are contributing, and virtuallyall of the elderly are receiving benefits.Examples include Japan, Australia, NewZealand, Canada, the US, and mostEuropean economies.
The second scenario describes economiesthat are experiencing population aging alongwith rapid economic growth. These include
the Asian TigersSouth Korea, Taiwan,Brunei, and Singapore. Their pension andhealthcare systems are relatively immature.
The third scenario represents lowincome economies with much youngepopulations, such as those of Africa,South and Southeast Asia, and parts oLatin America. These economies havegenerally introduced pension and healcare systems quite recently, and coveratends to be low.
The fourth scenario describes middincome economiessuch as China,Malaysia, Chile, Mexico, and RussiaThese economies are beginning with tlow coverage and low levels of benefits
characteristic of low-income settings bhave populations that are aging as rapas in many high-income economies.
December 2011
Fig 11. Pojtd hangs in dgt osts latd to poplation agingin 11 eopan onois as a pntag of GDP, 20102060.Source:Rob Vos, presentation at theTechnical Policy Seminar on theEconomics ofAging.
500 1000 2500 5000 10000 25000 50000
0
.25
.5
.75JPN
KOR
CAN
AUS
USA
MEX
BGD
BTN
CH N
IN D
ID N MD V
NPLPAK
PHL
LKA
THA
VNM
Coverage rateRelative to working-agepopulation
National income per head,log scale
Fig 12. Pnsion ovag and p apita GDP.Source:OECD andWorld Bank 2009.
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Pension systemsHinz and Zvinienes model suggests thatif the effective retirement age remains at60 and current benefit formulas remainunchanged, economies at every level ofdevelopment will experience significantlyhigher costs. High-income economieswith mature systems could see the shareof their Gross Domestic Product (GDP)allocated to pensions triple by 2070, from
5 percent to 16 percent, due primarily tochanges in population age structure. Newlyhigh-income economies with rapidlyaging populations could experience aneven faster rate of cost increasedrivenby population aging, expansion of cover-age, and income growthmoving from2 percent to 16 percent of GDP.
Lower-income economies couldexperience the dual impact of risingincomes and expanding coverage, alsoresulting in steep cost increases from 2percent to 14 percent of GDP. Middle-
income economies could experience costincreases from 4 percent to 16 percent ofGDP, due to population aging as well asexpanding coverage.
Not all participants in the seminaragreed that rising pension costs are aproblem, noting that pension systems donot represent costs as such, but are merelychannels to redistribute resources. Never-theless, Hinz and Zviniene modify theirsimulation to illustrate how pension costscan be reduced by policy adjustments.These modifications show that:
I Raising effective retirement ages from60 to 65 would have only a modesteffect on costs. Longer periods ofwork, however, would produce higherrevenues for pension systems thatwould help to alleviate fiscal pressures.In addition, the resulting increase inlabor supply could potentially raisethe level of GDP.
I Indexing pensions by price ratherthan by wages after the initial level
of benefits is established at retirement,when combined with an increase inretirement age, could reduce the levelof projected expenditures by nearlyone-half.
The simulation results suggest that insome settings the design and evolution ofpension-system parameters is potentiallyas important as the underlying changes inpopulation age structure in determiningfuture costs. Adjustments in benefits will
be particularly critical in low-incomesettings where current individual-levelbenefits tend to be highas much as 135percent of per capita GDP, compared with33 percent in high-income economies.
Using data from high-incomeeconomies, Mauricio Soto demonstratedthe tradeoffs between three approachesto pension reform: curtailing eligibility(e.g., by increasing the retirement age),reducing benefits (for example, by index-ing benefits to prices rather than wages),
and increasing contributions (Figure 13).With no increases in payroll taxes and nocuts in benefits, average statutory retire-ment ages would have to increase byabout 2.5 years over the next 20 years tokeep spending on pensions constant inrelation to GDP. Relying only on benefitreductions would require an average 15-percent across-the-board cut in pensions,while relying only on increased contribu-tions would require an average rate hikeof 2.8 percentage points.
To keep pension spending as a share
of GDP from rising after 2030, additionalreforms would be needed. For each decade,retirement age would have to increase byabout one year, benefits would have to becut by about 6 percent, or contributionrates would have to be increased by about1 percentage point. Policymakers whowish to control pension costs need toassess how the various policy optionswould affect fairness and equity anddetermine the optimal approach for eacheconomic setting.
Comparing data from 19 economat widely different stage of developmeSang-Hyop Lee observed that raising tnormal retirement age will have a limieffect in low-income economies, whermany of the elderly continue to work where their earnings are low. With economic development, workers tend toretire early, and raising the eligibility afor pensions triggers only a small increin the actual average retirement age. Inassessing the effects of pension polici
on saving rates, Lee found that decreapension benefits produces a much largincrease in saving than raising the age which workers are eligible to receive apension.
Another option for pension reforminvolves switching from a pay-as-youor paygo system, in which retirees recpensions that are funded by the currencontributions of younger people who still working, to fully or partially fundsystems, in which pension benefits arebased on the earlier contributions mad
by the individual retiree. This amounta shift from public transfers toward mreliance on assets. Indeed, a funded pesion system functions as a type of saviplan that could, potentially, lead toproductive investments in the econom
Heiner Flassbeck described a crisisituation for the pay-as-you-go pensiosystem in Kazakstan in the late 1990s(Hoffmann et al. 2001). At that time,workers were paying 25 percent of wafor pension benefits, but the unemploym
0
2
4
6
8
10
12
14
16
0 0.5 1 1.5 2 2.5 3
R
eductioninbenefits
(percent)
Increase in retirement age(years)
2.82.11.40.70
Increase in payroll taxes(percentage points)
Fig 13. Tad-offs twn th appoahs to pnsion fo:raising th tint ag, ding nfits, and inasing ontitionsSource:Mauricio Soto, presentationat theTechnical PolicySeminar on the Economics ofAging.Basedon IMF2012 (forthcoming).
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rate was 20 percent and the governmentowed US$600 million in pension arrears.In response, the Kazakstan governmentchose to shift to a fully funded pensionsystem.
To improve the financial status of apension system, Flassbeck recommends:(1) raising the age of retirement; (2) usinggeneral taxes to finance disability, survivors,and social pensions; (3) abolishing unjus-
tified entitlements; and (4) introducingindividually identifiable contributions.Any of these measures can be introducedwithin the framework of a pay-as-you-gosystem.
In the case of Kazakstan, he predictedthat switching to a fully funded pensionsystem would add considerably to admin-istrative costs and would contribute littleor nothing to capital investment becausemost of the pension funds would beinvested in government bonds. Whenchanging from a pay-as-you-go to a fully
or partially funded system, the question is:Does additional saving lead to productiveinvestment or not? If not, then changingthe system does not help and may evenmake the situation worse.
Michael Hermann pointed out thatfully funded pension systems may increaseincome inequality. Because they are basedon long-term returns to investment, theymay also be less reliable than pay-as-you-go systems. To minimize risk, pensionfunds often invest in government bonds,so in terms of investment, they are not allthat different from pay-as-you go systemsthat are also backed by governments.
Jorge Bravo agreed that in some cases,such as Kazakstan, switching to a fundedpension system has not resulted in greaternational saving or investment. Anotherexample is the Argentinean pensionsystem, whose funds were nationalized in2009 and transferred to a state-managedpay-as-you-go system.
A well-managed pension fund, how-ever, can make a positive contribution to
national saving, investment, and growth.One example is Chile. As is often thecase, when Chiles pension system wasreformed, a large proportion (more than40 percent in 1983) of the fund wasinitially invested in public debt. By thelate 2000s, however, public instrumentshad declined to less than 10 percent of thefund as opportunities to invest elsewhereopened up.
Although it is difficult to disentanglecausal effects, there is little doubt that
after Chiles funded system was intro-duced national saving and investmentgrew significantly. Chiles pension fundhas become a major institutional investor,holding large shares of private-sectorstocks and bonds, and a major supplierof medium- and long-term financing,including more than 40 percent ofmortgages in the country. Because ofother problemssuch as limited coverage
among low-income workersthe systemwas reformed in 2008 to introduce uni-versal and minimum benefits.
Turning to another issue, DavidCanning reported on a study in 40 high-and middle-income economies designedto assess whether pension reform actuallyinfluences people to retire later. In everyeconomy there is a trend for people to savemore and retire earlier as their incomesincrease. The optimal response to a longerhealthy lifespan, however, would be towork longer. His findings show that
pension systems that specify a youngretirement age and provide generousbenefits often lead to early retirement andlow levels of saving. A package of reformsthat includes removing incentives to retireearly and switching to a fully or partiallyfunded system can reverse this trend.
Healthcare systemsProjections of future expenditures onhealthcare are more complicated thanprojections of pension costs. The effectsof demographic change interact with theexpansion of access to healthcare that
generally accompanies economic growwith age-related patterns of healthcareutilization, and with the relationshipof healthcare consumption to income(healthcare as a luxury good). Basedobservations in a variety of settings, Hand Zvinienes model assumes that hecare spending increases by 1.28 percenfor every 1-percent increase in GDP.
Population aging and expanded ac
alone can lead to rising healthcare costsimilar to those for pensions, with chafrom the current situation much largelow-income settings. But if healthcarconsumption in todays low-incomeeconomies increases with aging and wrising incomes more rapidly that GDPit has in high-income settings, then thaggregate costs of healthcare could soobecome a very large share of economicoutput, reaching as high as 34 percentGDP. Together, healthcare and pensiocosts could equal as much as one-half
economic output within 60 years if this no change in the generosity of progor benefit formulas.
Tim Miller observed that Hinz anZvinienes forecasts for pension systemin middle-income economies match wwith data for Latin American economthat have not undertaken pension refoThe model for healthcare, however,projects much higher costs that currenpredicted for Latin America (Figure 1Over the next 40 years, Miller and hiscolleagues estimate that healthcare coswill increase from 1.6 times in Urugu
December 2011
Fig 14. Halth xpndits as a sha of GDP: ratio of pojtd shain 2050 to that of 2010 fo 10 Latin Aian onois, opad withHinz and Zvinins odl.Source:TimMiller, written contribution to theTechnical Policy Seminar on theEconomics ofAging.
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to 2.7 times in Cuba. This is similar tothe results of Hinz and Zvinienes modelthat include aging and access only, butnot rising consumption that results in costinflation. These comparisons suggestthat: (1) In middle-income economies,expenditures on pensions and healthcarecould double or triple relative to GDP;and (2) the fiscal impact of populationaging is highly sensitive to policy reform.
Several speakers addressed the issueof rapidly escalating healthcare costs. Allwould agree on the importance of keepingcosts under control by avoiding unjustifiedexpenditures that are not linked to im-provements in healthcare services. Andno one would argue in favor of limitingexpansion of the healthcare sector as longas it actually delivers more healthcarewhile contributing to higher employment,income, and economic growth. If peoplechoose to spend a larger proportion oftheir resources on healthcare as they
become wealthier and older, this willrequire structural change in the economy,but it is not, in itself, a source of concern.
Three policy issues arise, however.The first is that people may not actuallybe choosing to spend more on healthcare;rather, they may end up spending moreas a distortion of priorities because theyoften do not pay for healthcare them-selves. The second issue is that fundinglarger health sectors through higher taxescould undermine work or investmentincentives.
The third issue concerns the ineffi-ciency of many healthcare systems. DavidCanning argued that healthcare systems inmany economies could potentially providehigh levels of health at much lower coststhan they do today. Particularly largegains could be achieved in the US. Hedescribed the potential cost savings thatcould be achieved by improving efficiency,without lowering the care provided, as thegood news about healthcare.
Mauricio Soto estimated the average
impact of five types of reform on publichealthcare spending in 2030 as a percentof GDP: budget caps (including budgetconstraints and central governmentoversight); public management andcoordination (including gatekeepingprocesses that require referrals for accessingspecialized care and subnational governmentinvolvement); market mechanisms(including choice of insurers and
providers, private provision, and theability of insurers to compete); demand-side reforms (including expansion ofprivate insurance and cost sharing); andsupply controls (including regulation ofthe healthcare workforce) (Figure 15).
The impact of these simulated reformsappears to be modest. They might well fallshort of what would be needed to stabilizepublic-healthcare-spending-to-GDP ratiosat moderate levels. This suggests that addi-tional efforts may be needed to stabilizespending, or fiscal adjustments might beintroduced that rely on cuts in other areasor increases in revenue.
It is important to note that the possiblesavings linked to various reforms aresubject to uncertainty. Some reformscould be complementary, implying thatthe savings under any particular reformmay be understated. But simultaneousreforms across different aspects of thehealth system might also be undesirableor counterproductive. Thus, the effect of
the reforms across categories depicted inFigure 15 cannot necessarily be aggregated.In discussing healthcare for Japans
aging population, Naohiro Ogawa empha-sized a demographic change that goesbeyond fiscal constraints. As in other EastAsian economies, elderly Japanese tradi-tionally lived with their adult childrenand were cared for by their middle-ageddaughters or daughters-in-law. In 1950,
there were 31 women in Japan age 40for every elderly person age 80 and abin 2010, there were only three. Given demographic reality, more of the elderwill inevitably be cared for in institutiThis transition from a home-based tomarket-based system will make the coof long-term care for the elderly morereadily measurable and possibly veryhigh.
Using the multibillion-dollar healcare industry as an example, MichaelHerrmann proposed that the macro-economic impact of population agincan be most appropriately understooda process of structural change (Herrm2011). This process will create winnerand losers among firms and will impotransitory costs on some workers, but will not necessarily have a negative imon economies as a whole.
Expansion of the healthcare induscan provide attractive investment opptunities, employment opportunities, a
labor income. If markets function welthey should respond efficiently to theschanges in demand and supply. Thusfrom a macro-economic perspective,Herrmann contended that it is notmeaningful to say that healthcare expeditures amount to a cost within GDP.Rather, everything in a macro economthat is a cost to some is an income toothers.
0.49
0.6
.
0.370.4
0.5
DP
0.26
0.2
0.3
rcentofG
0.080.05
0
0.1P
Marketmechanisms
Publicmanagement
Budget caps Demand-sidereforms
Supplycontrols
Fig 15. Avag ipat of fo oponnts on halth spnding y 20Das lativ to th aslin as a pnt of GDP.Source:Mauricio Soto, presentationat theTechnical PolicySeminar on the Economics ofAging.Based on OECDHealthDatabaseandIMF staff estimates.
Note:Unweighted averages of the impact of reforms.
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Future directions
This seminar provided a useful opportunityto present findings from the NTA projectto an audience of economists in academicinstitutions and United Nations agencies.Further presentations and discussionhighlighted important policy concernsfrom multiple perspectives. Much of thediscussion focused on the macro-economic
effects of population aging, includingstructural changes in markets and theimpact of older populations on patternsof saving and investment. The participantsalso discussed the impact of populationaging on pension and healthcare systems,including forecasts of the level of fiscalpressure that can be expected and the prosand cons of various approaches to containcosts. These include:
I Relaxing mandatory retirementprovisions
I Investing in education and health asfertility declines
I Indexing pension benefits to changesin prices rather than wages
I Switching from pay-as-you-go topartly or fully funded pension systems
I Reducing inefficiencies in the deliveryof healthcare
Tim Miller mentioned that severalgroups have produced long-term forecasts
of pension and healthcare costs. He sug-gested that it might be useful to ask variousteams to produce models for comparisonbased on a common set of inputs.
In closing the seminar, Jose MiguelGuzman commented that much of thediscussion concerned issues of populationaging in high-income economies. Helooks forward to another technical policyseminar on the economic effects of popu-lation aging that focuses on the problemsfacing developing economies.
References
Bhattacharya, Jay, Kavita Choudhry, and Darius Lakdawalla. 2008. Chronic disease andsevere disability among working-age populations. Medical Care. 46(1): 92100.
Bloom, D.E., and D. Canning. 2001. Cumulative causality, economic growth, and thedemographic transition. In N. Birdsall, A.C. Kelley, and S.W. Sinding, editors.Population matters: Demographic change, economic growth, and poverty in the developingworld. Oxford: Oxford University Press, 165200.
Bloom, D.E., and J.G. Williamson. 1998. Demographic transitions and economicmiracles in emerging Asia. World Bank Economic Review12(3): 41956.
Freedman, Vicki A., Brenda C. Spillman, Robert F. Schoeni, Patti M. Andreski, JennifeC. Cornman, Eileen M. Crimmins, James Lubitz, Linda G. Martin, Sharon S. Merkin,Teresa E. Seeman, and Timothy A. Waidmann. 2011. Trends in late-life activitylimitations: An update from five national surveys. Paper presented at the annual meetinof the Population Association of America. 29 March2 April, Washington, DC.
Gruber, J., and D.A. Wise. 1999. Introduction and summary. In J. Gruber and D.A.Wise, editors. Social security and retirement around the world. Chicago: University ofChicago Press, 43774.
Herrmann, Michael. 2011. Population aging and economic development: Anxieties andpolicy responses. Journal of Population Aging. 4(4).
Hoffmann, Lutz, Peter Bofinger, Heiner Flassbeck, and Alfred Steinherr. 2001. Kazakst19932000. Heidelberg: Physica Verlag.
International Monetary Fund (IMF). 2012 (forthcoming). The challenge of public pensioreform in advanced and emerging economies. IMF Policy Paper. Washington, D.C.
Kelley, A.C., and R.M. Schmidt. 2001. Economic and demographic change: A synthesiof models, findings, and perspectives. In N. Birdsall, A.C. Kelley, and S.W. Sinding,editors. Population matters: Demographic change, economic growth, and poverty in thedeveloping world. Oxford: Oxford University Press, 67105.
Lafortune, Gatan, Galle Balestat, and the Disability Study Expert Group Members.2007. Trends in severe disability among elderly people: Assessing the evidence in 12 OECDcountries and the future implications. OECD Health Working Papers No. 26. Paris:Organization for Economic Cooperation and Development (OECD).
Lakdawalla, Darius, Dana P. Goldman, Jay Bhattacharya, Michael Hurd, Geoffrey Joycand Onstantijnw Panis. 2003. Forecasting the nursing home population. Medical Ca41(1): 820.
Lee, R., Mason, A., and Miller, T. 2003. From transfers to individual responsibility:Implications for savings and capital accumulation in Taiwan and the United States.Scandinavian Journal of Economics. 105(3): 33957.
Mason, A. 2001. Population change and economic development in East Asia: Challenges mopportunities seized. Stanford: Stanford University Press.
Mason, A. 2005. Demographic transition and demographic dividends in developed anddeveloping countries. Paper presented at the United Nations Expert Group Meetingon Social and Economic Implications of Changing Population Age Structures.31 August2 September, Mexico City.
Mason, A., and R. Lee. 2011. Population aging and the generational economy: Key finding
In R. Lee and A. Mason, editors. Population aging and the generational economy: A globperspective. Cheltenham, UK: Edward Elgar, 331.
Organization for Economic Cooperation and Development (OECD) and World Bank.2009. Pensions at a glance. Special edition: Asia/Pacific.http://www.oecd.org/dataoecd/33/53/41966940.pdf. Accesses 15 December 2011.
Robine, Jean-Marie, Siu Lan K. Cheung, Shiro Horiuchi, and A. Roger Thatcher. 2008Is the compression of morbidity a universal phenomenon? Paper presented at the Living t100 and Beyond Symposium. 79 January, Orlando, Florida.
United Nations Secretariat, Population Division, Department of Economic and SocialAffairs. 2010. World population prospects: The 2010 revision.http://esa.un.org/unpd/wpp/index.htm. Accessed 15 November 2011.
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Agenda
Monday, 19 September 2011
Opning aks: Werner Haug (UNFPA)
Ovviw: poplation aging and
onoi hallngs
Moderators: Jose Miguel Guzman (UNFPA)and Edgard R. Rodriguez (IDRC)
Presenters: Ronald D. Lee (UC Berkeley)
and Andrew Mason (EWC)Discussant: Detlef Kotte (UNCTAD)
Poplation aging and th ao onoy
Moderator: Michael Herrmann (UNFPA)Presenter: Heiner Flassbeck (UNCTAD)Discussant: Rob Vos (UN DESA)
Pnsion systs and soial pottion
Moderator: Michael Herrmann (UNFPA)Presenter: Richard Hinz (World Bank)Discussant: Mauricio Soto (IMF)
evning: book lanh fo Population aging
and the generational economy
Tuesday, 20 September 2011
Poplation aging and ising
haltha osts
Moderator: Hania Zlotnik (UN DESA)Presenter: David Canning
(Harvard University)Discussant: Naohiro Ogawa (NUPRI)
Lao akt hallngs
Moderator: Jorge Bravo (UN DESA)Presenter: Sang-Hyop Lee(University of Hawaii)
Discussant: Ryan Edwards (Queens College)
Wap-p disssion
Participants
Jog bavo
Chief, Population and Development SectionUnited Nations Department of Economic
and Social Affairs (UN DESA)
David canning
Professor, Department of Populationand International Health
Harvard School of Public HealthHarvard University
ryan edwads
Associate Professor of EconomicsQueens College and the Graduate CenterCity University of New York
Hin Flassk
Director, Division on Globalizationand Development Strategies
United Nations Conference on Tradeand Development (UNCTAD)
Jos migl Gzan
Chief, Population and Development BranchTechnical Support DivisionUnited Nations Population Fund (UNFPA)
Wn Hag
Director, Technical DivisionUnited Nations Population Fund (UNFPA)
mihal Hann
Technical Adviser, Population andEconomic Development
United Nations Population Fund (UNFPA)
rihad Hinz
Human Development Network,Social Protection
The World Bank
Dtlf Kott
Macro-economic Consultantand Former Chief of Macro Economicsand Development Policy
United Nations Conference on Tradeand Development (UNCTAD)
ronald D. L
Edward G. and Nancy S. Jordan EndowChair in Economics; Professor ofDemography; and Director, Center onEconomics and Demography of Agin
University of California, Berkeley
Sang-Hyop L
Associate Professor, Department of EconoUniversity of Hawaii at Manoa
Andw mason
Senior Fellow, East-West CenterProfessor, Department of EconomicsUniversity of Hawaii at Manoa
Naohio Ogawa
DirectorNihon University Population Research
Institute (NUPRI)
edgad r. rodigz
Senior Program Specialist
International Development Research Cof Canada (IDRC)
maiio Soto
Technical Assistance AdvisorInternational Monetary Fund
ro Vos
Director, Development Policy andAnalysis Division
United Nations Department of Economand Social Affairs (UN DESA)
Sidny b. Wstly
Communications SpecialistEast-West Center
Hania Zlotnik
Director, Population DivisionUnited Nations Department of Econom
and Social Affairs (UN DESA)
UNFPA, the United Nations Population Fund, is aninternational development agency that promotes the rigof every woman, man, and child to enjoy a life of healthand equal opportunity. UNFPA supports countries inusing population data for policies and programs to reducpoverty and to ensure that every pregnancy is wanted,every birth is safe, every young person is free of HIV, anevery girl and woman is treated with dignity and respect
The East-West Center promotes better relations andunderstanding among the people and nations of theUnited States, Asia, and the Pacific through cooperativestudy, research, and dialogue. Established by the USCongress in 1960, the Center serves as a resource forinformation and analysis on critical issues of commonconcern, bringing people together to exchange views,build expertise, and develop policy options.