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          20 June 2019 - 18:15

          Letters from Bruxelles

          Demographic change and health expenditure

          One of the most important changes for the future of EU-28 will be demographic ageing, brought about by a combination of increased life expectancy and low fertility rates. At 1 January 2017, the EU-28 population was estimated at 511.5 million, with an average age of around 42 (worldwide the average age was below 30). Children (0-14 years) accounted for 15.6%, whilst people of working age (15-64) represented 65%, with a percentage of senior citizens (65 upwards) reaching 19.4% (2.4% higher than in 2007).

          Source: EUROSTAT

          The highest percentage of children compared to total population was in Ireland (21.1%), and the lowest in Germany (13.4%). As regards seniors, Italy (22.3%), Greece (21.5%) and Germany (21.2%) recorded the highest percentages, and Ireland the lowest (13.5%).

          Source: EUROSTAT

          This percentage of the population is increasing in every member state and over the last ten years has fluctuated between 4.9% in Malta, 4.4% in Finland and 1.4% in Belgium and Germany (0.1% in Luxembourg). The latest series of Eurostat demographic projections suggest that the EU-28 population will rise to peak at over 528 million around 2050, then gradually drop to 518 million by 2080.

          The decline and ageing of the European population could be partially offset if the current trends of migration from less developed countries persist in the future, even if they would in any event be incapable of causing a complete trend reversal.

          Source: EUROSTAT

          Source: EUROSTAT

          Source: EUROSTAT

          Even if the effects of demographic ageing on healthcare spending can occasionally be overestimated, it goes without saying that aging in good health should be the core objective of all public healthcare programmes in countries where the highest section of the age pyramid is expanding conspicuously. In fact, there are numerous areas of impact of ageing, from mental health to the estimated burden of illnesses such as influenza and hepatitis B, plus the impact of cardiovascular and oncological diseases. For all of this there is a growing need for coverage, which in all EU countries the public spending cannot cope now and probably will not be able to adequately guarantee in the future. The European Commission forecasts a further increase in the impact of public healthcare spending on GDP, which in the scenario outlined by the EU Working Group on Ageing will up to 2060 represent at least one more percentage point of GDP or, according to the group’s “risk scenario”, another 1.6 percentage points. If we consider private healthcare spending, the services paid out of taxpayers’ pockets in Italy reach €35.2 billion (50% more than at the start of the millennium), a value three times higher than that of France, twice that of the United Kingdom and one and a half times more than in Germany. Only 11% of Italians are beneficiaries of supplementary healthcare, versus 22% of Germans, 82% of Belgians and 95.5% of the French (source: Assidai).