La dynamique des dépenses de santé. France : l'impact du vieillissement sur les dépenses de santé à l'horizon 2020

Bui Dang Ha Doan discusses the fact that spending on health is rising faster than the gross domestic product (GDP) in all industrialised countries. This phenomenon has caused considerable concern for some time and has already given rise to many plans for reform which have been implemented to varying degrees and with varying success.
Since the rise is generally the result of increases in both supply and demand (which are, therefore, obviously, mutually reinforcing), French authorities have tried to limit France’s number of doctors in hope that this would bring about a fall in the quantity of medicines prescribed as well as medical facilities. This measure was expected to lead to a reduction in health spending between now and 2005, if not before.
The author shows, however, that the ageing of the population alone, and in particular the extremely rapid growth in the numbers of very old people, will automatically lead to a steep rise in health expenditures. This will occur because of the age factor (the health costs of a grandmother are five-times higher than those of her granddaughter) and also the generational factor (tomorrow’s grandmothers will have higher expectations of care than those of previous generations).
In short, the author argues that any let-up in the growth of health spending as a result of rationing supply in the next ten years can only be temporary, and furthermore, this will be the case, no matter how the health system is organized.