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.

The Role of the European Union in the World. European Policy Brief No. 22, March 2014

Despite the hopes raised by the most recent Treaties, the Lisbon Treaty in particular, the European Union has been unable to strengthen, let alone develop its role on the international stage. A couple of weeks away from the European Parliament elections, we need to ask ourselves what can reasonably be done by the upcoming Parliament to ensure that significant progress is made with respect to the EU’s foreign policy. Some of this progress could result from the implementation of the European Security Strategy or originate from the role and initiatives of the High Representative/Vice-president of the Commission. In addition, rethinking specific approaches could allow for significant improvements in key areas such as the EU’s dealings with neighbouring countries, its commercial relationship with the US, its energy security or its common security and defence policy.