Trends and dilemma s in an aging society

Transcriptie

1 Trends and dilemma s in an aging society Martin van Rijn, CEO PGGM March 11 th 2011

2 Roadmap PGGM in a nutshell Societies in transformation and the impact on collective schemes The strategy for a pension service provider 2

3 Cooperative: members Originates from (20) pension schemes in health care and social services sectors Institutional clients: 5 Pension service provider (not the fund!): 2.3 mln participants, 101 bln AUM Yearly turnover (2009): 250 million N o 2 in Netherlands, N o 3 in Europe 3

4 Societies in Transformation

5 Trends and developments Ageing and vitality Public domain under pressure Global shift Exponential times Economical circumstances, post crisis Communalization and other social cultural trends 5

6 Facing the challenges of the future Developments have effect on: Ageing health, pensions Technology health Social-cultural health, pensions Productivity-gap health and other public services [Baumol Law] 6

7 The importance of a sustainable public domain The need to meet forthcoming challenges Increasing burden on resources (finances and capacity) The need for public support for solidarity Between low and high income (income equity) Between the healthy and the sick (risk equity) Between generations (intergenerational equity) The need to focus on efficiency In order to maintain/improve the current level of public services in an affordable manner. 7

8 8 Impact on collective schemes

9 Ageing and pensions First pillar (state pensions): PAYG and therefore increasing burden on society Second pillar (mandatory supplementary pensions): Funded, but increasing life expectancy has impact on DBsystem Third pillar (voluntary schemes): Relatively small, but growing in importance 9

10 Ageing and healthcare More expensive healthcare: 1. Pressure on public finances 2. Pressure on solidarity More demand 3. Increasing need of labour force capacity 10

11 1. Pressure on public finances: Primary expenditures of the public sector (in % change ) Due to ageing 11

12 2. Pressure on solidarity: increase of risk solidarity (current prices) Curative care Share of net beneficiaries 16% 13% Yearly solidarity transfer 17,8 bln 43,3 bln Average per capita payment of netcontributors (+120%) Long term care Share of net beneficiaries 6% 10% Yearly solidarity transfer 16,0 bln 34,2 bln Average per capita payment of netcontributors (+108%) 12

13 The need for solidarity increases, but the support is under pressure Ongoing individualization The healthcare costs incurred further to lifestyle (and hence at least partially controllable) will be greater and more visible Fear of basic cover being restricted Image of a sector that squanders money (not providing value for money) 13

14 3. Increasing need of labour force capacity 22% Labour force in Health Care Sector as % of Total Labour force 20% 18% 16% 14% 12% 10% productivity grow th 0% productivity grow th 1% and 0,5% productivity grow th 2% and 1% 14

15 The strategy for a pension service provider 15

16 The future of health care effects also our members Health is a social goal; it brings prosperity to citizens and people state health as their most important value. A healthy society helps economy, e.g. (1) as healthier workforce, (2) healthy people spend and therefore stimulate economic growth, (3) health correlates with equity. Our members are care providers and future users 16

17 The importance for a membership organization Growing health care costs of PGGM-clients Hospital miljoen ziekenhuisopnames verpleegdagen 250 medisch specialisten en 800 verplegers nodig 950 miljoen ziekenhuisopnames verpleegdagen 950 medisch specialisten en 3000 verplegers nodig GP 23 miljoen huisarts consulten 150 huisartsen nodig 90 miljoen huisarts consulten 480 huisartsen nodig Pharmacy 90 miljoen In totaal worden er 4,5 miljoen medicijndoosjes aan deze groep verstrekt. 350 miljoen In totaal worden er 17 miljoen medicijndoosjes aan deze groep verstrekt. Fysiotherapy 17 miljoen Meer dan een half miljoen fysiotherapiesessies 275 fysiotherapeuten benodigd 70 miljoen Meer dan 2 miljoen fysiotherapiesessies 1100 fysiotherapeuten benodigd AWBZ Long term care 650 miljoen Meer dan PGGM deelnemers in een bejaarden of verzorgingstehuis deelnemers gebruiken thuiszorg FTE s verzorgend personeel miljoen Meer dan PGGM deelnemers in een bejaarden of verzorgingstehuis deelnemers gebruiken thuiszorg FTE s verzorgend personeel billion 5.1 billion

18 Money is not enough The problem is that within 20 years money as such is not the main issue.. the ageing has led to more retired people than people who can take care of them instead of moneytransfer, financial providers deliver services and organize the care. (Bakas/Peverelli The Future of Finance) 18

19 Pensions, care and housing have similar careers AGE AGE >75 Pensions Saving (related to income) Withdrawal Health status Healthy Minor complaints Limited Housing Solo/ Duo Family Empty nest Modified 19

20 The future of pensions: New old age Housing Health Pension 20

21 What do we need? Consistent development in public domain New legislation Alliances with similar organisations 21

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