Population Ageing - A Threat to the Welfare State?: The Case of Sweden

137 Pages·2010·1.562 MB·English

by  Tommy Bengtsson (auth.), Tommy Bengtsson (eds.)

Demographic Research Monographs
A Series of the Max Planck Institute
for Demographic Research, Rostock, Germany
Editor-in-chief
James W. Vaupel
Max Planck Institute for Demographic Research,
Rostock, Germany
For furthervolumes:
http://www.springer.com/series/5521
.
Tommy Bengtsson
Editor
Population Ageing -
A Threat to the
Welfare State?
The Case of Sweden
Editor
Prof.Dr.TommyBengtsson
LundUniversity
SchoolofEconomicsandManagement
CentreforEconomicDemography
Scheeleva¨gen15B
22363Lund
Sweden
[email protected]
ISSN1613-5520
ISBN978-3-642-12611-6 e-ISBN978-3-642-12612-3
DOI10.1007/978-3-642-12612-3
SpringerHeidelbergDordrechtLondonNewYork
LibraryofCongressControlNumber:2010931436
#Springer-VerlagBerlinHeidelberg2010
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Contents
1 Introduction ................................................................ 1
TommyBengtsson
References ..................................................6
2 TheAgeingPopulation ..................................................... 7
TommyBengtssonandKirkScott
2.1 Introduction..............................................7
2.2 FundamentalsofPopulationAgeing............................8
2.3 ConsequencesofanAgeingPopulation ........................12
2.4 CanWeIncreaseFertility?..................................16
2.5 IsImmigrationtheAnswer?.................................16
2.6 OtherWaystoSolvetheProblem?............................19
2.7 Summary...............................................20
References .................................................21
3 InThisWorldNothingIsCertainbutDeathandTaxes:
FinancingtheElderly ..................................................... 23
A˚saHansson
3.1 Introduction.............................................23
3.2 Background.............................................24
3.3 AreIncreasedTaxestheSolution?............................28
3.3.1 IncreasingTaxRates:ANon-solution.....................29
3.3.2 IncreasingtheTaxBase:APartialSolution.................36
3.4 DiscussionandConclusions.................................42
References .................................................44
4 AStablePensionSystem:TheEighthWonder ......................... 47
AgnetaKruse
4.1 Introduction.............................................47
4.2 TheSwedishPensionHistory................................48
v
vi Contents
4.3 AgeingandPensions ......................................50
4.4 PensionsinSweden:A4-tierSystem..........................51
4.5 FinancialStabilityintheSwedishPensionSystem................54
4.6 PoliticalSustainability.....................................55
4.6.1 FairnessasanEstimateofSustainability...................57
4.6.2 AFairStartingPoint?.................................61
4.6.3 WhenContributionsDeviatefromBenefits,
i.e.DeviationsfromtheDCFeature ......................61
4.6.4 Indexing...........................................62
4.7 ConcludingComments.....................................63
References .................................................64
5 WaysofFundingandOrganisingElderlyCareinSweden ............ 65
PerGunnarEdebalk
5.1 Introduction.............................................65
5.2 TheEstablishmentofOldPeople’sHomes......................67
5.3 TheDevelopmentofHomeHelpServices ......................70
5.4 TimesofReappraisalAround1990 ...........................71
5.5 ElderlyCareofTodayandFutureChallenges ...................72
5.6 FinancingofElderlyCare ..................................75
5.7 Conclusion..............................................78
References .................................................79
6 FinancingHealthcare:AGordianKnotWaitingtoBeCut ........... 81
Bjo¨rnLindgrenandCarlHampusLyttkens
6.1 Introduction.............................................82
6.2 TheSwedishHealthcareSystem .............................83
6.3 SimulatingtheDevelopmentofInpatientCare2000–2040..........86
6.3.1 SomeCharacteristicsoftheSimulationModel ..............88
6.3.2 Base-CaseScenario...................................89
6.3.3 ImprovedHealthProgressionwithandWithout
DecreasedRiskofDeath...............................90
6.3.4 IncomesofPeopleinOldAge...........................92
6.4 NotaNon-issue..........................................93
6.5 Non-solutionOne:TechnologicalDevelopment..................94
6.6 Non-solutionTwo:InstitutionalChange........................97
6.7 Non-solutionThree:ExplicitPrioritySetting
(orDoWeBelieveintheQALYandNothingbuttheQALY?)..... 100
6.8 TowardsaNon-non-solution(orSimulatingtoHaveanAnswer).... 101
References ................................................ 103
7 TowardsaNewSwedishModel? ........................................ 109
AndreasBergh
7.1 Introduction............................................ 109
Contents vii
7.2 TheSwedishModelSoFar ................................ 110
7.3 TheDemographicChallenges .............................. 113
7.4 ConcludingDiscussion.................................... 117
References ................................................ 118
Index ........................................................................... 121
.
Contributors
Tommy Bengtsson is Professor of Economic History and Demography at Lund
University. He is also Director of the Centre for Economic Demography at the
same university since 2006. Bengtsson has in recent years been co-author and
co-editor of several books released at internationally distinguished publishers
(MIT Press, OUP, and Springer), and one of which received a prize from the
American Sociological Association as Outstanding Book on Asia 2005. He has
alsohadseveralarticlespublishedininternationalandwell-knownjournalsapply-
ing peer-review selection, and is co-editor for a special publication series at MIT
Press.Hisinternationalpublications include Population,EconomyandWelfarein
Sweden (Springer-Verlag 1994), Population and Economy (Oxford University
Press2000,2nded.2003),LifeUnderPressure(MITPress2004),LivingStandards
in the Past (Oxford University Press 2005), and Kinship and Demographic
BehaviourinthePast(Springer2008).
Andreas Bergh received a Ph.D. in Economics 2003 from Lund University in
Sweden and was visiting scholar at Harvard in 2004 at the Centre for Basic
Research in the Social Sciences. His research concerns the welfare state as well
as institutional economics, and recent publications include European Economic
Review, European Sociological Review, Political Studies, and Social Science
Quarterly. He has also published a book titled Institutional Competition (Edward
Elgar) and is currently leading a research project on reform process in mature
welfarestates.HeiscurrentlyaffiliatedwithboththeRatioinstituteinStockholm
andLundUniversity.
PerGunnarEdebalkisPh.D.inEconomicHistoryandProfessorinSocialWork
atLundUniversity.Duringtheyears,hehasbeenheadingseveralresearchprojects,
the latest ones on Contractual Benefits in the Swedish Labour Market, on Quality
competition and Consumer Choice in Home-help Services, and on Elderly Care
andtheLocalAuthorities.Hispublishedworks,150intotal,includeArbetslo¨shets-
fo¨rsa¨kringsdebatten. En studie i svensk socialpolitik 1892–1934 (Lund 1975),
ix