The end of the welfare state: The view of the economist

Transcription

1 The end of the welfare state: The view of the economist Professor Nikos Maniadakis Associate Dean, National School of Public Health, GR

2 End of welfare state: fact, illusion or desire? Prof. Nikos Maniadakis

3 What is the welfare state? Political system based on the premise that the government (not others) has the responsibility for the well being of its citizens, by ensuring that a minimum standard of living is within everyone's reach. This commitment is translated into provision of: universal medical care, insurance against disability, sickness, and unemployment, family allowances for income supplement, old age pensions and universal education. Speaker

4 Is it necessary? There are many causes of inefficiency and market failures Uncertainty Derived demand for services Asymmetry of information - Lemon Externalities Barriers in markets Economies of scale Heterogeneity Which may lead to suboptimal equilibriums and loss of social welfare Which justifies the Government intervention as an inevitable saviour. Speaker

5 The net cost of this endeavour is significant Speaker

6 And is publicly funded Speaker

7 2.Information on data for Israel: Speaker Source : OECD (2012), Social Expenditure (SOCX) via w w w.oecd.org/els/social/expenditure

8 Costs are increasing by more than 10% per decade Speaker

9 .. And Therefore challenges Economic, fiscal, monetary, debt, credit trends Demographic trends and population aging Labour market employment and wage trends Cross boarder mobility of individuals Social trends and household synthesis Immigration trends and EU enlargement Globalisation, competition, mobility of firms Cost of welfare services and moral hazard Inefficiency and wastage of resources Speaker

10 ECONOMY

11 Economics and economics of wellfare Speaker

12

13 Speaker

14 LABOUR MARKETS

15 Unemployment rates increased Speaker

16 Changing patterns- 33% increase in part time Speaker

17 Inequality and poverty is increasing Speaker

18 SOCIAL TRENDS

19 Single person household societies Speaker

20 Single person families increase Speaker

21 IMIGRATION

22 Speaker

23 Speaker

24 COST OF SERVICES

25 25 Mean survical in metastatic colorectal cacer 1* 2* * 4 +91,2% 1* 6* *KRAS Wt Median Survival mcrc (months) 1.Siena S, et al. ASCO-GI Van Cutsem E, et al. ASCO-GI 2010; 3.Falcone A, et al. JCO 2007; 4.Saltz LB, et al. JCO 2008; 5Hurwitz HI, et al. NEJM 2004; 6. Maughan T. et al. ASCO GI De Gramont A, et al. JCO 2000; 8.Saltz LB, et al. NEJM 2000;

26 * 2 survival * 466 cost!!!!

27 INEFFIENCY

28 Inefficiency in health care

29 MOBILITY

30 Mobility stretches systems Speaker

31 DEMOGRAPHICS

32 Speaker

33 Mortality Rates are falling

34 Life Expectancy increases

35 Speaker

36 The number of elderly increases Population above 65

37 Per capita health expenditure as % of per capita GDP by age Source: The 2009 Ageing Report: economic and budgetary projections for the EU-27 Member States ( ). The European Commission (DG ECFIN) and the Economic Policy Committee (AWG)ISBN DOI / European Communities, 2009

38 Source: The 2009 Ageing Report: economic and budgetary projections for the EU-27 Member States ( ). The European Commission (DG ECFIN) and the Economic Policy Committee (AWG)ISBN DOI / European Communities, 2009

39 Pension will also grow Chart 6. Pension spending will grow but not as fast as elderly populations Expected change in the number of elderly (%) Expected change in the percentage of public pension expenditure in GDP (%) Korea Canada Ireland New Zealand United States 7 61 Slovak Republic Finland Netherlands Poland United Kingdom OECD Luxembourg Switzerland Slovenia France 0 42 Norway Czech Republic Denmark 5 34 Belgium Sweden 2 31 Spain 4 30 Austria Portugal 7 26 Hungary Greece 1 20 Italy Germany 5 11 Estonia - 11 Speaker

40 Speaker

41 Fertility is falling Speaker

42 Speaker

43 The synthesis of population changes Speaker

44 A sharp increase in dependency ratios

45 The mechanics

46 EFFECTS OF ECONOMIC CRISIS

47 The welfare state is growing Speaker

48 Source : OECD Social Expenditure database (w w w.oecd.org/els/social/expenditure). Speaker

49 Speaker

50

51

52

53 Private social spending is constantly increasing Speaker

54 Conclusions messages The welfare state is our most fundamental institutions in EU Despite beliefs and perhaps desires by some it is here to stay Despite scarcity of resources and economic turmoil is growing This is due to prevailing life expectancy & demographic trends Nonetheless socio-economic trends are threatening its survival Constant reforms needed to adopt it in an evolving environment There is a reallocation of resources and health care is losing Speaker

55 WELFARE STATE: NEED TO FIXED IT, CANNOT BE OUTSOURCED