FORECASTING THE DEMAND FOR HEALTH CARE IN OECD NATIONS AND CHINA
Robert W. Fogel
This article argues that the nations of the Organisation for Economic Co-operation and Development (OECD) are facing a potential disaster: intergenerational conflicts between the large number of workers approaching retirement at an earlier age than ever before in history and the smaller number entering the labor market. These nations are confronted with the choice of whether to default on commitments to pensions and health care, to reduce benefits, or to increase the taxes borne by younger workers. The author argues that this new intergenerational conflict is the result of "technophysio evolution", a synergism between technological and physiological improvements that has produced a form of human evolution that is biological but not genetic, rapid, culturally transmitted, and not necessarily stable. The author goes on to argue that an important aspect of technophysio evolution has been a change in the structure of consumption and in the division of discretionary time between work and leisure. The ongoing debate over whether or not the rapid advances in biotechnology will spare OECD nations' health systems from a financial crisis is addressed. Finally, the implications this argument has for forecasting China's future health care costs are discussed. Copyright 2003 Western Economic Association International.
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