The Fall of the East German Birth Rate After Unification: Crisis or Means of Adaptation? CES Germany & Europe Working Papers, No. 05.6, 26 June 1995

Since the fall of the Wall, Eastern Germans have drastically changed their demographic behavior. Marriages and births have dropped to an unprecedented low level. Our paper tracks birth rates of the East German population, past, present, and future. We propose a simulation model of future cohort fertility. The hypotheses we develop build on the historical record of reproductive behavior in the German Democratic Republic (GDR) since 1960 and on an analysis of the pattern of change between 1990 and 1994. The particular emphasis lies in the assumption that East German couples will rapidly westernize their family size by trying to reach completed fertility levels of the corresponding West German cohort. This implies that the resulting adaptation process includes the postunification crisis as a logical first step.

Aging and the governance of the healthcare system in Japan. Bruegel Working Paper 2014/14, December 2014

Japan is the most rapidly aging country in the world. This is evidence that the social security system, which consists of the pension system, healthcare system and other programmes, has been working well. The population is shrinking because of a falling birth rate. It is expected that the population will fall from 128 million in 2010 to 87 million in 2060. During this period, the ratio of people aged 65 or over will rise from 23 percent to 39.9 percent. Japan’s age dependency ratio was 62 in 2013, the highest among advanced nations. It is expected to rise sharply to 94 in 2050 (see Figure 1 on page 4). A total reform of the Japanese social security system, therefore, is inevitable. From the point of view of fiscal reconstruction, reform of the healthcare system is the most important issue. The biggest problem in the healthcare system is that both the funding system and the care-delivery system are extremely fragmented. The government is planning its reform of the healthcare system based on the principle of integration. Other advanced economies could learn from the Japanese experience.