Evolution of outpatient healthcare expenditure, a dynamic micro-simulation using the Destinie model

The expenditures to cover the risk of illness, which amounted 3.4% of GDP in 1960, reached almost 12% in 2011: their share is comparable to the one of pensions' expenditures. In this context, the evolution of health expenditures is an important parameter for ageing economies, which face more and more pressure on public finances. This study offers a first projection of these expenditures (outpatient care and medical goods) on a microeconomic basis. Such a model allows to complement macroeconomic analyses because it anticipates the changes in health expenditures due to socio-demographic changes in France until 2060 and, hence, to help defining public policies. The increase of outpatient care expenditure until 2060 depends on the hypotheses about life expectancy, and especially its sharing between good and bad health. The variation of time spent in good health after 60 years old is bigger across education level than between men and women. After 60, women, and especially very educated women, spend more years in bad health than the others.