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S&P Warns It May Cut 'Highly Rated' G20 Countries If They Don't Reform Their Healthcare System

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First Posted: 01/31/2012 2:35 am Updated: 01/31/2012 8:11 am


* Ratings of some developed nations at risk due to rising welfare costs

* Rapidly ageing populations mean more healthcare costs in future

* Japan, U.S., Europe particularly at risk

By Walter Brandimarte and Stanley White

NEW YORK/TOKYO, Jan 31 (Reuters) - Ratings agency Standard & Poor's warned it may downgrade "a number of highly rated" Group of 20 countries from 2015 if their governments fail to enact reforms to curb rising healthcare spending and other costs related to ageing populations.

Developed nations in Europe, as well as Japan and the United States, are likely to suffer the largest deterioration in their public finances in the next four decades as more elderly strain social safety nets, S&P said in a report.

"Steadily rising healthcare spending will pull heavily on public purse strings in the coming decades," S&P analyst Marko Mrsnik wrote in the report.

"If governments do not change their social protection systems, they will likely become unsustainable."

If no reforms are adopted, healthcare-related credit downgrades would likely start within three years, eventually leading to an increase in the number of junk-rated countries as of 2020, the study showed.

Byun Yanggyu, director of macroeconomics at the Korea Economic Research Institute warned developed nation will eventually become the victims of their social safety nets.

"The more developed countries get, the more complicated their welfare structures become. In order to cover all necessary means in terms of welfare, spending elsewhere will have to shift there," Byun told Reuters.

"I believe our country is headed more so in that direction...and it will dull our production in the end," he said. "There is a bigger chance that developed countries will be subject to a downgrade from this point of view."

Healthcare will likely be the fastest-growing expenditure for developed countries, which already have high social protections and rapidly worsening demographic profiles.

For example, Japan's population is expected to decline by 30 percent by 2060, with two out of every five people turning 65 or older, according to official data.

Japan's welfare spending, which includes pensions and health, is expected to reach nearly 108 trillion yen ($1.4 trillion) in the current fiscal year, around 22 percent of GDP.

By 2025/26, spending is forecast to hit 141 trillion yen.

"Over time it must be a real problem for Japan," said Adrian Foster, head of financial markets research at Rabobank International in Hong Kong. "There's a call for authorities to push through fiscal reform. When you look at the government they seem to lack any real ability to respond to it."


FALLING FERTILITY RATES

Falling fertility rates and a rapidly ageing population are problems facing most of Japan's richer neighbours too. South Korea, Singapore and Taiwan have flirted with policies aimed at boosting marriage and childbirth, but with limited success.

South Korea is the most dramatic example of the trend. In the past 40 years, as its economy has boomed, it has gone from having one of the highest birth rates among developed countries to one of the lowest. By 2050, almost 40 percent of the population is likely to be over the age of 65.

A report released by Seoul's Ministry of Strategy and Finance last July warned the national debt would jump to 138 percent of gross domestic product (GDP) in 2050 as pension and health insurance costs soar, from around 34 percent last year.

Emerging market countries, especially in Southeast Asia, have a little more room to manoeuvre due to more favorable demographic dynamics and economic growth, S&P said.

But even in that region the picture is changing -- in Thailand, for example, the proportion of the population aged over 60 is projected to rise to nearly a quarter by 2030 from around 13 percent now.

Asia, however, may suffer less from this demographic shift than Western nations because, by and large, the social welfare net in the region is not as extensive, Rabobank's Foster said.

"The fact that most of Asia doesn't have the entitlement society that the West has generated means the demographic timebomb is not going to be as significant," he added.

NEW TECHNOLOGIES

Demographics will not be the only factor driving up health-care costs. More expensive new technologies and broader treatment coverage may account for as much as two-thirds of the projected increase in healthcare spending, according to a study by the International Monetary Fund cited by S&P.

Pension system reforms alone would not be enough for G20 countries, S&P said in the report.

If legislation were enacted to contain future increases in age-related spending without also tackling healthcare spending, the results would be only slightly less severe than under a no-policy-change scenario.

"The probable increase in projected healthcare costs alone is so substantial that the impact of these reform efforts would not be enough to meaningfully reverse the resulting credit deterioration," S&P said.

Australia, which has more favourable demographics than most developed nations because it can easily attract skilled migrants, illustrates the problem.

A 2010 government survey projected population ageing would push total state spending from 22.4 percent of GDP in 2015/16 to 27.1 percent by 2049/50 -- with health accounting for two-thirds of that increase. As a result, spending would exceed revenue by 2.75 percent of GDP in 40 years.

S&P said it was not too late for G20 countries to tackle the problem, but reforms to contain age-related spending needed be coupled with efforts to balance budgets by 2016, which would be enough to offset rising healthcare costs by 2050.

"The results of this scenario point to overall stabilization of our hypothetical sovereign ratings," S&P said, noting, however, that the number of ratings in the lower investment-grade categories would still increase.

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* Ratings of some developed nations at risk due to rising welfare costs * Rapidly ageing populations mean more healthcare costs in future * Japan, U.S., Europe particul...
* Ratings of some developed nations at risk due to rising welfare costs * Rapidly ageing populations mean more healthcare costs in future * Japan, U.S., Europe particul...
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oilfield
small manufacturing business owner
10:19 PM on 01/31/2012
we have utopiacare now....why would we need reform?
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09:26 PM on 01/31/2012
Gee I wonder why S&P didn't mention downgrading the U.S. because of it's multi-trillion dollar imperialistic war expenditures which will likely continue into the distant future.

This is obviously the beginning of the ruling class' propaganda push to convince the masses to accept austerity so that the wars can continue to be financed. These aristocratic parasites are truly despicable...
11:56 AM on 01/31/2012
Behold! The word has come down from on High! The God of ratings has spoken! Get your life in order lowly G20 countries, for a day of reckoning is coming. So spoke the wise "analysts" who forgot to warn us about so many debacles (housing, S&L's, derivatives, et.,) they got paid to rate, but failed to pass along to us. Can we survive their judgement? I think so. I think so.
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pinknlynn
No EtchaSketch in 2012!
04:33 PM on 01/31/2012
Great post!
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Philip F Harris
Author, publisher, blogger
11:34 AM on 01/31/2012
I'm sorry, but these guys should be shut down-at least investigated. Public policy is supposed to be by the will of the people, not by back room financial dictators. They are adding to all of the financial woes in pursuit of their own social agenda which is all too right wing. These threats and the actions they are invoking in the EU is destroying the lives of millions-and for what? A freaking piece of paper.
11:09 AM on 01/31/2012
American health care is so utterly broken. And, it's not a system, except to generate profit. If profit is the word for "ill-gotten gains", and, loot.

Two cases in point:

First, there's medical records. They are now less a tool for doctors and more a cash cow for non-medical entrepreneurs who wouldn't know the Hippocratic Oath from salty sailors' epithets.

For a chronic progressive condition for which I've been treated for years, I find out my "old" files---X-rays, MRI, other diagnostic tool results, etc. from 2005---were sent to offsite storage. To get them will cost me $100 and an Act of Congress. I need them to show new Drs, who in some cases, appear to have found a way to practice medicine without viewing a patients disease history, even in the case of progressive disease.

Second, it appears that young adults---18-30---are being targeted for fraudulent charges by unscrupulous health care providers.

They know that young adults often still partially rely on their parents for financial support, but, that those parents have great difficulty seeing the billing records because they don't live in the same households as their grown children, and due to confidentiality laws. And, they know that young people are inexperienced in keeping up with such matters, which tries the patience and taxes the resources of the best of us.

I've just so had it with American medicine.
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HUFFPOST SUPER USER
lrobb
Southern Rational
10:57 AM on 01/31/2012
I sincerely hope future posters resist the temptation to shoot the messenger. Most on this site believe excellent health care and a social safety net are "rights." No, they are not.

Government services are limited by two things. The first is taxes and fees collected, and the second is the willingness of our citizens to be taxed and charged. The first is entirely dependent on the second, and Americans are mostly against increasing the amount they currently pay to the government.

Given the facts on the ground, our response to health care and social safety net costs should be obvious. What programs or processes produce the best results at the least cost? What are we doing which is discretionary rather than necessary?

Whether or not we get downgraded depends on acknowledging it will be politically almost impossible to raise taxes sufficiently enough to even keep services at their present levels much less expand them and coming to a different paradigm for the role of government overall.
10:34 AM on 01/31/2012
S&P should have to show their figures. It is bad now because the government is not getting the income they would if people had good paying jobs. The government has to get good jobs back and take the welfare for the rich and corporations off the table. Tax incomes are down for the US because everyone is near poverty and the well off get too many tax breaks. This has been going on for years. In 1972 I worked for an accountant. He kept books for an a doctor that made $96 that year. My husband made $25 and the doctor paid less taxes than we did because he had tax accountants in Oklahoma that he paid to keep his taxes low. He had a good year for income but paid a higher tax than he thought he should. The accountants in Oklahome were going to get him more deductions for the next year so he could pay even less. I quit my job over that situation. It is totally unfair.
10:36 AM on 01/31/2012
Sorry should have been $25K and 96K.
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Wayne Caswell
Consumer Advocate & Founder of Modern Health Talk
10:08 AM on 01/31/2012
It's not just about how we pay for medical care in aging populations. It's also about how we improve health and wellness to lessen the need for it, and how we approach dieing with dignity rather than applying extreme measures to eek out another week, month or year.
09:26 AM on 01/31/2012
How does S&P get a vote on what other countries do with their healthcare systems? Especially as they stood by and let the health care industry rape Americans...and no kiss.
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shankapotomus
Carter and Clinton = deregulation.
09:33 AM on 01/31/2012
You think it was bad its going to get worse now.
11:47 AM on 01/31/2012
And don't forget their role in the housing bonds debacle. Rating agencies are just as guilty of sin as some of the the other scammers loose on the countryside. I sometimes wonder, who the hell made them God! Let's take their fees away!