Economic Policy Committee Research Articles

EU level actions and instruments to support the implementation of integrated care

Abstract Issue/Problem The significance of integrated care as a means for improving health outcomes and the effectiveness and sustainability of health and care systems is acknowledged in several policies at national and EU level, for example: the European Commission’s Communication on effective, accessible and resilient health systems, the 2017 European Semester: Communication on Country Reports, the Joint Report on Health Care and Long-Term Care Systems and Fiscal Sustainability by the European Commission and the Economic Policy Committee, the Companion Report 2017 of the State of Health in the EU and the most recent Commission Communication on the digital transformation of health and care in the Digital Single Market. As such, there may be no doubt about whether one needs to transform the health and care model and move to integrate care, but the question is how to design and implement integrated care successfully. One pre-condition for this to happen, is for health authorities to have adequate capacity and relevant know-how. Results The European Commission aims at assisting Member State authorities at national, regional and local levels to fulfil this pre-condition and proceed with their health system reforms. There is a number of instruments, initiatives and funding support to raise the capacity of national and regional healthcare authorities to adopt and scale up integrated care. Lessons There is an increasing demand and need to provide support and assistance to Member states to drive the transformation of healthcare systems towards more coordinated, integrated and sustainable healthcare systems.

Key Messages for a Frailty Prevention and Management Policy in Europe from the ADVANTAGE JOINT ACTION Consortium.

In the 2015 Ageing Report, the European Commission (EC) and the Economic Policy Committee stated that coping with the challenge posed by an ageing population will require determined policy action in Europe, particularly in reforming pension, health care and long-term care systems. The concern for this situation motivated the EC, the Parliament and many of the Member States (MS) to co-fund, in the 2015 call of the Third European Health Programme of the European Union 2014-2020, the first Joint Action (JA) on the prevention of frailty. ADVANTAGE JA brings together 33 partners from 22 MSs for 3 years. It aims to build a common understanding on frailty to be used in the MSs by policy makers and other stakeholders involved in the management, both at individual and population level, of older people who are frail or at risk for developing frailty throughout the European Union (EU). It is a formidable challenge but also a great opportunity for concerted action resulting in fostering effective and successful policies in frailty prevention and management in the participating MS. The Consortium has 2 years of hard work ahead to contribute to the needed change for frailty related disability free Europe. The first practical step towards this aim was the preparation of a document: the State of the Art on Frailty Report to support an overview of evidence of what works and what does not work on frailty prevention and management. Subsequently, this will be reflected in the advice that the JA will give to policy makers at MS level. Overall, these messages intend to be an instrument of added value to advocate for policy driven decisions on frailty prevention and management in the JA participating MSs and subsequently towards a frailty related disability free older population in Europe. The aim of this paper is to describe ADVANTAGE JA general structure, approach and recommendations towards a European health and social policy which will support frailty prevention in the participating MS.

Economic Growth and Fiscal Sustainability in the EU: The Impact of an Ageing Population

Economic Growth and Fiscal Sustainability in the EU: The Impact of an Ageing Population

Economic and Budgetary Effects of Pension Reforms in EU Member States

Carone and Eckefeldt evaluate the impact of recent pension reforms in EU countries on the basis of the 2009 round of long-term projections of pension expenditure carried out by the European Commission (DG ECFIN) and the Economic Policy Committee (Ageing Working Group). In the coming decades, demographic factors are projected to be the main driver of pension expenditure growth. They are expected to be partly counterbalanced by the decline in the coverage ratio (thanks to the increase in the retirement age), less generous public pension transfers and the increase in the employment rate, especially of older workers. In several countries these developments have been enhanced by recent reforms. A comparison of the 2009 projections with the previous 2006 ones indicate the impact of recent reforms: in many countries the fall in coverage is more accentuated in the latest projection, thus offsetting the demographic dependency effect to a greater extent. Moreover, in several countries the offsetting impact of the reduction in benefits has increased, compared with the 2006 projection. Both these developments reflect the effects of the pension reforms. The authors note that more policy action is necessary in many countries, in particular in order to increase the retirement age and the employment rate of older workers.

Fiscal sustainability and policy implications: a post-crisis analysis for the euro area

In this paper, we examine the sustainability of euro area public finances against the backdrop of population ageing after the 2008?2009 recession. We argue that ageing costs may be higher than projected by the Working Group on Ageing Populations (AWG) of the EU's Economic Policy Committee, consider alternative indicators to quantify sustainability gaps for euro area countries and assess the appropriateness of different budgetary strategies to restore fiscal sustainability taking into account intergenerational equity. Our stylised analysis based upon lifetime contributions to the government's primary balance of different generations suggests that an important pre-funding of ageing costs is necessary to avoid shifting the burden of adjustment in a disproportionate manner to future generations. For many euro area countries this implies that the medium-term targets defined in the context of the revised Stability and Growth Pact would ideally need to be revised upwards to obtain significant surpluses.

Fiscal Sustainability Indicators and Policy Design in the Face of Ageing

Mainly due to increasing concerns about the potential impact of population aging the sustainability of public finances has become one of the key issues in fiscal assessments. This paper briefly reviews the different theoretical benchmarks and empirical tests for sustainability and assesses the sustainability of public finances in euro area countries on the basis of the latest projections of the Ageing Working Group of the EU Economic Policy Committee. Two alternative operational indicators for fiscal sustainability are proposed and appropriate policy options to restore fiscal sustainability are explored for three individual euro area countries. Pre-funding strategies that create the budgetary room that is needed to finance aging costs in advance require important consolidation efforts for most euro area countries and can imply aiming at significant budgetary surpluses in the coming years for some. However, a simplified technical exercise assessing the evolution of the fiscal burden of the average worker shows that such strategies generally imply a more even distribution of the fiscal burden across generations than more gradual adjustment strategies.

Fiscal Sustainability and Policy Implications for the Euro Area

In this paper we examine the sustainability of euro area public finances against the backdrop of population ageing. We critically assess the widely used projections of the Working Group on Ageing Populations (AWG) of the EU's Economic Policy Committee and argue that ageing costs may be higher than projected in the AWG reference scenario. Taking into account adjusted headline estimates for ageing costs, largely based upon the sensitivity analysis carried out by the AWG, we consider alternative indicators to quantify sustainability gaps for euro area countries. With respect to the policy implications, we assess the appropriateness of different budgetary strategies to restore fiscal sustainability taking into account intergenerational equity. Our stylised analysis based upon the lifetime contribution to the government's primary balance of different generations suggests that an important degree of pre-funding of the ageing costs is necessary to avoid shifting the burden of adjustment in a disproportionate way to future generations. For many euro area countries this implies that the medium-term targets defined in the context of the revised stability and growth pact would ideally need to be revised upwards to significant surpluses.

Assessing Italy's Reform Challenges: What Do Growth Accounting and Structural Indicators Say?

Italy’s overall GDP growth has been dismal in recent years and this poor performance has been compounded by a declining trend in labour productivity and total factor productivity growth. This paper looks into growth accounting and structural indicators and analyses Italy’s performance against other European countries. We look at the evidence provided by newly available information from the Lisbon Assessment Framework (LAF) developed by the Working Group on Lisbon Methodology (LIME) attached to the Economic Policy Committee and the European Commission services (DG ECFIN). Building upon the results of existing literature, we investigate whether this new evidence is supported by data from other sources and provides fresh insight into Italy’s reform process. The main message from the analysis of growth accounting and structural indicators appears to be that Italy’s GDP growth significantly underperformed that of the EU15 in 2001-2007 notwithstanding progress on reforms.

Preparing the Economic and Financial Committee and the Economic Policy Committee for Enlargement

The European Union’s Economic and Financial Committee (EFC) and Economic Policy Committee (EPC) are crucial forums for close policy dialogue between the member states, the Commission and the European Central Bank. In preparing the work of the Council and providing policy expertise, the committees exercise considerable influence over decision‐making in the field of European economic policy coordination. Enlargement has been a challenge to the functioning of these two expert groupings, which are often characterized as closed and secretive. In response to an enlarging membership, both committees revised their formal membership rules. This article argues, however, that analysing the impact of enlargement on the functioning of the two committees requires close attention to the set of informal practices and routines which have characterized the working methods applied prior to enlargement. Factors such as the turnover rate in membership and the transparency of the organizational structure therefore become increasingly important. The article cautions against a further formalization of decision‐making procedures in response to potential problems in the post‐enlargement context.

Fiscal Sustainability and Policy Implications for the Euro Area

In this paper we examine the sustainability of euro area public finances against the backdrop of population ageing. We critically assess the widely used projections of the Working Group on Ageing Populations (AWG) of the EU's Economic Policy Committee and argue that ageing costs may be higher than projected in the AWG reference scenario. Taking into account adjusted headline estimates for ageing costs, largely based upon the sensitivity analysis carried out by the AWG, we consider alternative indicators to quantify sustainability gaps for euro area countries. With respect to the policy implications, we assess the appropriateness of different budgetary strategies to restore fiscal sustainability taking into account intergenerational equity. Our stylised analysis based upon the lifetime contribution to the government's primary balance of different generations suggests that an important degree of pre-funding of the ageing costs is necessary to avoid shifting the burden of adjustment in a disproportionate way to future generations. For many euro area countries this implies that the medium-term targets defined in the context of the revised stability and growth pact would ideally need to be revised upwards to significant surpluses.

Long-Term Labour Productivity and GDP Projections for the EU25 Member States: A Production Function Framework

This paper presents the results of long run labour productivity and GDP growth rate projections (until 2050) for each of the 25 EU Member States and provides a detailed overview of the forecast methodology used. These projections were undertaken in order to provide an internationally comparable macroeconomic framework against which to assess the potential economic and fiscal effects of ageing populations. This assessment was carried out as part of the work undertaken by the EU's Economic Policy Committee, in its Ageing Working Group, to project the public expenditure implications of ageing on pensions, health care, long-term care, unemployment insurance and education. The projections presented in this paper, using a common production function methodology for all 25 countries, show the GDP growth rate effects of an assumptions-driven extrapolation of recent trends in employment and labour productivity. In overall terms, the EU25 baseline projection suggests a significant slowdown in potential growth rates in the Union as a whole, with the EU25 growth rate projected to fall from around 2½% at present to half that rate over the period 2041-2050. Finally, various sensitivity tests are carried out to check the GDP per capita impact of some additional factors. Some of the interesting conclusions that emerge from these sensitivity tests include: ....the negative effect of a change in the age-structure of the population is fairly limited, although it is accepted that the labour productivity of an individual is likely to decline after the age of 55. A very strong fall in the productivity of older workers compared with that of prime-age workers would be required to significantly depress total labour productivity. Such an outcome, on the basis of current evidence, appears rather unlikely. ....changing the TFP growth rate targets (e.g. use of the 1990's average instead of the long-term 1970-2004 average) could strongly affect the projections.

An empirical investigaton of political economy factors behind structural reforms in OECD countries

This paper was originally prepared for the OECD Working Party No. 1 under the authority of the OECD’s Economic Policy Committee. Jens Høj and Giuseppe Nicoletti work for the OECD Economics Department as a senior economist in the Country Studies Branch and as Head of the Structural Policy Analysis Division 1, respectively. Vincenzo Galasso is an Associate Professor of Economics at Università Bocconi in Italy and Thai-Thang Dang is a private sector consultant. The authors wish to thank Jean Philippe Cotis, Jørgen Elmeskov, Michael P. Feiner, Christopher Heady, Nick Johnstone and many other colleagues in the OECD Economics Department as well as representatives from OECD member countries for useful comments on a previous version of the paper.

International and Domestic Product Classifications

The globalization of the world economies (U.S. trade share in 1998 was 29.3 percent) necessitates improved economic statistics. The interest in developing conceptual economic frameworks for industry and product classification systems has intensified because of the need for data to be comparable for domestic production and trade with information from other countries in that comparability allows for more meaningful analyses of international trade relationships. However existing product data systems are organized differently one from the other, and this presents difficulty in the construction of complete and consistent data bases. Indeed, while this issue of international comparability of data is being discussed in many fora, e.g., APEC, UN, WCO, etc., practicality dictates that the Harmonized System (HS) should serve as the foundation for the goods definitions in any new product (goods and services) classification system developed for the United States. Domestically and internationally there is a need for: (1) a wherever-produced, product-oriented system, (2) a highly disaggregated level of product detail, (3) comparability between domestic production and trade data statistics, and (4) more adequate detail as to services industries. Addressing each of these issues is of major importance. This is so because the data obtained from existing production and international trade classifications are inconsistent; i.e., none of the domestic or nternational product classifications is based upon a single unifying, or even the same, economic concept. The Office of Management and Budget established the Economic Classification Policy Committee with the charge of initiating a fresh slate examination of economic classification systems. This U.S. effort was joined by the other members of the NAFTA, and the three countries agreed that conceptually based classifications would be adopted. In 1997, work on constructing a supply-side, production-oriented industry classification resulted in the adoption of the North American Industry Classification System (NAICS). Work within NAFTA has now begun on developing a demand-side, market-oriented product classification. The resulting North American Product Classification System (NAPCS) is intended to provide the requisite comparability of product data. This paper describes several existing classification systems for products and illustrates some of the problems that will be encountered in implementing a demand-side product classification. The paper is designed to serve as background in defining NAPCS.

The Economic Impact of Ageing Populations in the EU25 Member States

This paper presents an assessment of the overall economic impact of ageing for the EU Member States. It draws upon the macroeconomic assumptions developed by the Ageing Working Group attached to the Economic Policy Committee and the Directorate General for Economic and Financial Affairs for the purpose of making age related expenditure projections. The paper presents and analyses projections of the impact of ageing populations on the labour market using a refined cohort approach by age and gender, as well as projections for potential economic growth rates up to 2050. The projections point to pressing economic policy challenges for the EU. From an economic perspective, potential growth rates and living standards are projected to fall to levels below those observed in recent decades: moreover, the sources of economic growth will alter over time, with productivity becoming the dominant source. Fiscal challenges will come from both a higher share of the total population in older age cohorts and a decline in the share of the population that is economically active. As regards policy conclusions, the paper underlines the critical need for further labour market reforms, and the possible need for the EU to look beyond the Lisbon employment targets and deadlines. Even if the EU as a whole achieves the Lisbon employment targets, this will not be sufficient to offset the effects of demographic change and considerable unused labour capacity would remain in many Member States. The paper also argues that ageing is an evolving process, and that a key challenge will be to develop labour market and welfare state policies that are sustainable in the face of uncertain economic and demographic developments. Current financing problems in pension schemes stem to a large extent from the failure of contribution/entitlement parameters in public pension schemes to adjust in the face of increased life expectancy. It will be important to ensure that retirement behaviour takes due account of future increases in life expectancy.

Long-Term Labour Force Projections for the 25 EU Member States: A Set of Data for Assessing the Economic Impact of Ageing

This paper presents the methodology and results of labour force projections over the long term (until 2050) for each of the 25 EU Member States. These projections were undertaken in order to provide the background technical inputs for the assessment of the potential economic and fiscal impact of an ageing population. This assessment is carried out in the framework of the EU Economic Policy Committee's Ageing Working Group by projecting public expenditure on pensions, health care, long-term care, unemployment insurance and education. The projections presented in this paper are based on a common methodology for all countries and the first to include estimates for the new Member States. They show the outcome for the labour force of extrapolating recent trends in labour market behaviour (entry and exit rates from the labour market). These base case projections reflect the working assumption of no policy change and are neither forecasts nor predictions in that they are not based on any assessment of more or less likely future changes in working patterns or economic conditions. To summarise the outcome of projections, the baseline scenario indicates that, notwithstanding the projected increase in the participation rates and the reduction in unemployment rates, the pace of labour force and employment growth in the EU25 will be weakly positive over the next 15 years and will turn negative over the period 2018 to 2050. This is mainly the outcome of projected declining trends for the working-age population and a shift in the age structure of the population towards older, less participating groups - a consequence of the baby-boom generation approaching retirement and the succeeding lower-birth-rate cohorts reaching working age.

The New Aerospace Diplomacy: Reconstructing Post-Cold War US-Russian Economic Relations

Post-Cold War U.S.-Russian diplomacy reveals the increased importance of new diplomatic actors and processes, whilst underscoring the continued key role of state-state negotiation in reconstructing the bilateral relationship between the United States and post-Soviet Russia. The Clinton administration and Yeltsin government negotiated measures to promote political stability, democratization, and conversion to a neoliberal market economy in Russia, a centrepiece of which was the integration of Russia’s globally competitive aerospace sector into the global production chain. Establishing the Gore-Chernomyrdin Commission, a top-level binational economic and technology policy committee, and signing a bilateral trade liberalization treaty on commercial satellite launch services paved the way for public-public and public-private bilateral space cooperation, and for major private joint ventures between US and Russian aerospace firms.

The Treasury, Public Investment And The Development Of Hydro-Electricity In The North Of Scotland, 1951-64

During 1957 the Government's Economic Policy Committee undertook a review of the costs and development of the nationalised industries within the UK in the period immediately after I960. 1 Partly this reflected a change in Treasury perceptions on the management of future demand by the industries for State investment, but it also reflected a deep desire within the then Conservative Government that public sector costs should be sufficiently constrained to alleviate pressure on the balance of payments and reduce taxation. The electricity industry was seen as the largest single item within the programme of public investment, with an estimated growth of consumption of 10 per cent per annum forecast until the mid nineteen sixties. A key element of the review related to the borrowing requirement of the industries and its long-term impact on bank and other domestic interest rates. The Cabinet concluded:

Vieillissement de la population et dépenses publiques de soins de santé et de soins aux personnes âgées

The aim of this paper is to present projections of public expenditure on health care and long-term care for the elderly, in view of ageing populations, undertaken by the Working Group on Ageing of the European Economic Policy Committee and presented to the ECOFIN Council in 2001. These projections cover almost all of the fifteen EU Member States, and make initial projections of expenditure for the first half of the current century (2000-2050). The expenditure projections were produced using a common methodology, a common demographic projection and commonly agreed macroeconomic assumptions. Projections of health care expenditure and long-term care expenditure were run separately in order to analyse the implications of ageing for the two different expenditure components. In summary, the projections reveal that the impact of ageing for public finances, from increased public expenditure on health and long-term care, is likely to be significant in the first half of the current century. The results of the projections are to be understood as reflecting the impact of future demographic changes on overall levels of health and long-term care expenditure – one way of interpreting the projections is to treat them as a picture of what expenditure levels would be today if we had the demographic com- position of future years. As such, these numbers are subject to both upside and downside risks. Upside risks stem from the fact that key non-demographic drivers of health and long-term care expenditure are not explicitly modelled in the projections. Moreover, assumptions for the developments of expenditures per head are mostly lower than those that would be predicted from long-term historical trends. Downside risks stem from the fact that the relationship between age and health status, and thus age and care needs, is likely to change over time.

Vilho Harle, International Tension: An Application of Cohesion Theory and Event Analysis to East-West Relations During the Post-War Years, Tampere, Finland: University of Tampere, Institute of Political Science, Research Reports, no. 39, 1975. iv, 270 pp. Carl H. McMillan, editor, Changing Perspectives in East-West Commerce, Lexington, Mass.-Toronto-London: Lexington Books, D.C. Heath and Co., 1974. xxix, 207 pp. $14.00. Carl H.

Vilho Harle, International Tension: An Application of Cohesion Theory and Event Analysis to East-West Relations During the Post-War Years, Tampere, Finland: University of Tampere, Institute of Political Science, Research Reports, no. 39, 1975. iv, 270 pp. Carl H. McMillan, editor, Changing Perspectives in East-West Commerce, Lexington, Mass.-Toronto-London: Lexington Books, D.C. Heath and Co., 1974. xxix, 207 pp. $14.00. Carl H.

The Police and the Community. Robert F. SteadmanReducing Crime and Assuring Justice: A Statement on National Policy. Committee for Economic Development, Research and Policy Committee

Previous articleNext article No AccessBook ReviewsThe Police and the Community. Robert F. Steadman Reducing Crime and Assuring Justice: A Statement on National Policy. Committee for Economic Development, Research and Policy CommitteeCharles H. ShiremanCharles H. Shireman Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Social Service Review Volume 47, Number 4Dec., 1973 Article DOIhttps://doi.org/10.1086/643058 Views: 1Total views on this site Copyright 1973 The University of ChicagoPDF download Crossref reports no articles citing this article.