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Ageing and the social and healthcare system. Public spending and its effects on equality, dependency and insurance in Spain

13rd National Competition for Economic Research Grants

Public economics

Senior Researcher : Manuel García Goñi

Research Centre or Institution : Universidad Complutense de Madrid


The ageing of society is one of the major challenges facing developed countries. Spain is no exception. Different population forecasts show that, from 2017 on, the number of deaths could exceed the number of births for the first time; Spain would therefore start to lose population, especially citizens between the ages of 20 and 49 and children under the age of 10. Meanwhile, a significant increase in the population over the age of 64 is expected.

The consequences of ageing are multiple and of different kinds, such as, for example, economic, social and cultural, and they are often interrelated. In this research project, we shall focus on those aspects related to public healthcare and social protection spending, and possible social exclusion and poverty in old age related to health.

There is a positive correlation between ageing and the incidence of chronic diseases, and a high concentration of healthcare spending on elderly chronic patients. This means that one of the great challenges for the public economy is the transition of the public healthcare system from a model focussed on care for acute conditions towards one which places the emphasis on care for chronic conditions. Analysing this transition is one of the main aims of this research. In addition, we will consider the changes that must take place in the social protection system due to the growth of the elderly population. Specifically, we will focus on the appearance of new needs or demands related to long-term care and its provision by both formal and informal carers. Meanwhile, there is also increasing concern at the increase in the risk of social exclusion and poverty in old age, especially that which could be caused by suffering from illnesses which require such care, though actions have already been taken, such as the passing of the Dependency Law. Another major challenge is the development of an insurance market for long-term care which cannot arise spontaneously due to different problems of asymmetrical information and limited rationality. In this project, we will quantify those problems, of both supply and demand, and we will put forward recommendations for the drafting of public policies to enable the creation and funding of that market in Spain, and to contribute to efficient integration of the healthcare and social systems in a sustainable way.

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