November 26, 2004

Four scenarios for the future of the public sector and healthcare

This study presents four long-term scenarios for the public sector and health care in the Netherlands.

In the two scenarios that stress the importance of collective provisions (Regional Communities and Strong Europe), the share of government production (public administration, defense and subsidised education) will increase from 10.5% of GDP in 2001 to about 12% in 2040. In the other two scenarios (Transatlantic Market and Global Economy), the government sector will decrease in size to 8% of GDP in 2040. Due to higher growth rates of GDP per capita, the growth of government services per capita is only marginally smaller than in the more collective scenarios.

Health care expenditures as a percentage of GDP will increase in all scenarios from 8.7% in 2001 to between 13.3% and 14.6% in 2040. In all scenarios, ageing and progress in medical technology are major driving factors of the growth in health expenditures.