2010 년도연구용역보고서 인구고령화여건에서의효율적인재정운용방향 - 외국사례분석과시사점 - - 2010. 11. - 이연구는국회예산정책처의연구용역사업으로수행된것으로서, 보고서의내용은연구용역사업을수행한연구자의개인의견이며, 국회예산정책처의공식견해가아님을알려드립니다. 연구책임자 고려대학교이만우
목차 요약 Ⅰ. 서 Ⅱ. 인구고령화현황 1. 2. OECD Ⅲ. 복지지출동향 1. 2. OECD Ⅳ. 외국의연금과보건지출대응사례와시사점 1... (1) (2).. 2... Ⅴ. 인구고령화여건하에서의효율적인재정운용 - 2 -
1. 2. 3... Ⅵ. 결론및정책방안 참고문헌 - 3 -
표차례 < 1> 65 < 2> < 3> < 4> OECD 65 (2000~2040 ) < 5> OECD < 6> < 7> < 8>, 1 GDP, < 9> OECD < 10> < 11> (2005) < 12> < 13> < 14> < 15> GDP < 16> < 17>, < 18> < 19> < 20> IMF 2010 9 < 21> < 22> < 23> 1 1 < 24> 65 < 25> < 26> OECD < 27> - 4 -
그림차례 < 1> < 2> < 3> EU < 4> () < 5> < 6> < 7> < 8> < 9> OECD 1 < 10> OECD (2006) - 5 -
요약 ( 7%) ( 14%) ( 24, 115, 45, 61, 73 ) 18 ( 20%) ( 12, 39, 37, 18, 21 )8...,.. 1980 ~1990., ( ).,,,.. - 6 -
. 2060., ( ) (Built-in stabilzer)..,. 55% World Bank 60~70%. 20%. 1996 39% 2001 25.6%, 2005 22.8%. 12.5%, 7.5%. (50%) (25~40%) (30%) 2 1. (,,,, ).,..,,,. 2001-7 -
Riester Pension Basis Pension Plan.. (Stakeholder Pension)(), Roth IRA, SEP IRA ()..,. 55~56 OECD 65~66 10. 10.. 2009 ~2030 2% 2010 76, 2020 140, 2030 293 GDP 2009 972 2021 2, 2029 3, 3% 2020 7.7%, 2030 10.6%..,,.,, - 8 -
., ( ) ( )...., (Generic),.. PAYGO(Pay-As-You-GO), (CAP).,. OECD(2006). (Ahrend et al.(2006)). OECD(2007). - 9 -
. - 10 -
Ⅰ.,. 65 2004 7.2% 2019 14%, 1926 20%, 2005~2010 9.8% 6.8%. GDP 8.5%(2004 ) 22.4%(2050 ) 13.9%p (,2009), (2004) (,, ) GDP 4.95%(2004 ) 9.3%(2020 ), 23.4%(2050 ), 29.9%(2070 ). 2004 14% 2020 24%, 2050 45%, 2070 50%.....,,.,., 1980 ~1990. - 11 -
,...,,.. Ⅱ, Ⅲ, Ⅳ.. Ⅴ, Ⅵ. Ⅱ. 1. 2009 65. ( 28, 33 2) 60 65-12 -
, ( 61 ) 60. ( 2 ) 55, 50 55. 2009 10 1 65 65 10.7%, 2000 1) (7% ), 9 (2018 ) (14%), 2026 ( 超 )(20%). < 1 > 65 ( :, %) 1980 1990 1999 2000 2009 2010 2018 2026 38,124 42,869 46,617 47,008 48,747 48,875 49,340 49,039 65 1,456 2,195 3,224 3,395 5,193 5,357 7,075 10,218 3.8 5.1 6.9 7.2 10.7 11.0 14.3 20.8 * :,,2006 2009 65 8.6%, 65 12.7%, 65 ( 100 ) 68.6, 10 7.4.. < 1 > (%) 30 25 20 15 10 5 0 남자 27.0 여자 17.8 21.6 12.7 13.0 4.8 6.4 8.6 9.0 13.4 8.6 8.9 2.8 3.8 5.2 5.5 1980 1990 1999 2000 2009 2010 2020 2030 * :,,2006 1) - (aging society): 65 7% ~14% - (aged society): 65 14% ~20% - (super-aged society): 65 20% - 13 -
< 2 > ( :, %, / 100 ) 1980 1990 1999 2000 2009 2010 2020 2030 19,236 21,568 23,458 23,667 24,481 24,540 24,680 24,190 65 545 822 1,223 1,300 2,113 2,190 3,303 5,218 ( ) (2.8) (3.8) (5.2) (5.5) (8.6) (8.9) (13.4) (21.6) 18,888 21,301 23,159 23,341 24,265 24,334 24,646 24,444 65 911 1,373 2,000 2,095 3,080 3,167 4,398 6,593 ( ) (4.8) (6.4) (8.6) (9.0) (12.7) (13.0) (17.8) (27.0) 1) 59.7 59.8 61.2 62.0 68.6 69.2 75.1 79.1 :,, 2006 : 1) = 65 / 65 100 (0~14 ) 100 65 2009 63.5 10(1999 ) 32.3 31.2. 2016 100.7. < 3 > 1980 1990 1999 2000 2009 2010 2016 2020 2030 * 11.2 20.0 32.3 34.3 63.5 67.7 100.7 125.9 213.8 2. OECD OECD 2000 14%,,,,,,, 2000 65 15%. < 4 > OECD 65 (2000~2040 ) (%) (%p) (%) (%p) 2000 2040 2000 2040 12.4 22.5 10.1 7.2 27.8 20.6 15.5 29.6 14.1 14.2 24.0 9.8 16.8 27.4 10.6 4.6 15.4 10.8 12.5 24.6 12.1 13.6 25.5 11.9 13.8 28.8 15 15.2 26.3 11.1-14 -
14.8 24.1 9.3 12.2 24.1 11.9 14.9 26.2 11.3 16.3 24.0 7.7 16.1 26.6 10.5 11.4 23.2 11.8 16.4 29.7 13.3 16.9 30.7 13.8 17.3 28.2 10.9 17.3 25.2 7.9 15.1 25.7 10.6 15.3 33.1 17.8 11.7 22.6 10.9 5.7 14.3 8.6 18.1 33.7 15.6 15.9 25.4 9.5 17.4 35.3 17.9 12.4 20.4 8.0 OECD 14.9 27.0 12.1 : OECD(2004), Core Study of Long-Term Care ( 7%) ( 14%) ( 24, 115, 45, 61, 73 ) ( 18 ). ( 20%) ( 12, 39, 37, 18, 21 ) ( 8 ). < 5> OECD 65 7% 14% 20% 7 14% 14 20% 1970 1994 2026 24 12 1932 1972 2012 40 40 1929 1976 2021 47 45 1927 1988 2007 61 19 1942 2013 2028 71 15 1887 1972 2012 85 40 1864 1979 2020 115 41 * : United Nations - 15 -
Ⅲ. 2) 1. 2010 8.3 81.2 27.7%, 8.8% (2.9%) 3. < 6> (:,%) 2010 2008 2009 257.2 284.5 292.8(100) 8.3 2.9 ( ) 67.7 74.6 81.2(27.7) 6.6 8.8 189.5 194.0 211.6(72.3) 1.7 0.8 * : OECD 22 1980 GDP 16% 2005 20%,,,, ( GDP ). < 7> Year 1980 1985 1990 1995 2000 2001 2002 2003 2004 2005 10.6 12.5 13.6 16.6 17.8 17.3 17.5 17.8 17.7 17.1 22.5 23.8 23.9 26.5 26.4 26.6 27.0 27.5 27.3 27.2 23.5 26.0 24.9 26.2 25.3 25.8 26.2 26.5 26.6 26.4 2) OECD (social expenditure) (, 1998). OECD (Social Security) ' (, 2002: 44). - 2006 1.15 21.42 16.41 13.88 13.56 19.92 19.52 19.61 35.57 43.02 46.32 34.48 < : IMF, GFSY 2008) > - 16 -
13.7 17.0 18.1 18.9 16.5 17.0 17.1 17.2 16.6 16.5 24.8 23.2 25.1 28.9 25.8 26.1 26.8 27.8 27.7 27.1 18.0 22.5 24.2 30.9 24.3 24.2 25.0 25.8 26.0 26.1 20.8 26.0 25.1 28.6 27.9 27.9 28.6 29.0 29.1 29.2 22.7 23.2 22.3 26.5 26.2 26.3 27.0 27.3 26.7 26.7 10.2 16.0 16.5 17.3 19.2 20.6 20.0 19.9 19.9 20.5 18.0 20.8 20.0 19.9 23.3 23.5 24.0 24.4 24.7 25.0 10.6 11.4 11.4 14.3 16.5 17.4 17.8 18.1 18.2 18.6 - - 2.9 3.3 5.0 5.4 5.3 5.6 6.3 6.9 20.6 20.2 19.1 20.8 19.7 20.8 22.0 23.4 23.9 23.2-1.9 3.6 4.7 5.8 6.5 6.8 7.3 7.2 7.4 24.8 25.3 25.6 23.8 19.8 19.7 20.5 21.2 21.1 20.9 17.2 17.9 21.8 18.9 19.4 18.6 18.7 18.2 18.0 18.5 16.9 17.8 22.3 23.3 21.3 22.2 23.6 24.5 23.2 21.6 10.2 10.4 12.9 17.0 19.6 19.9 21.3 22.9 23.1-15.5 17.8 19.9 21.4 20.3 20.0 20.4 21.0 21.2 21.2 27.1 29.4 30.2 32.1 28.5 28.9 29.5 30.4 29.9 29.4 13.5 14.5 13.4 17.5 17.9 18.4 19.2 20.3 20.3 20.3 16.7 19.8 17.0 20.2 19.2 20.1 20.0 20.5 21.1 21.3 13.1 13.1 13.4 15.3 14.5 15.1 15.9 16.2 16.1 15.9 OECD 16.0 17.7 18.1 19.9 19.3 19.7 20.3 20.8 20.6 20.6 * : OECD Social Expenditure Data Base, 2010 2. OECD GDP. OECD GDP 3). (18.6%), (18.6%), (18.4%) (29.2%), (28.5%), (28.9%), (27.4%), (27.2%), (26.4%). 1 GDP,,,,, GDP. 1 GDP. 3) (0~14 세인구 +65 세이상인구 )/(15~64 세인구 ) * 100-17 -
1 GDP /GDP 27,337 18.4 18.0 28,358 23.1 26.0 27,098 26.1 27.2 29,593 18.6 17.8 14,861 19.8 20.1 29,218 22.6 29.2 26,218 22.6 24.8 26,562 24.6 28.5 25,465 24.7 27.4 17,016 26.5 24.3 25,378 27.2 24.4 26,538 26.1 16.9 15,916 10.4 6.1 49,154 20.5 20.8 9,149 7.9 11.8 28,700 20.2 21.8 21,228 18.1 18.5 36,585 23.5 23.9 17,913 23.3 21.1 21,348 24.6 19.6 26,902 27.1 28.9 29,510 24.1 26.4 6,046 8.8 13.2 27,068 24.3 21.8 34,953 18.6 14.8 * : (2005) < 8>, 1 GDP, OECD,,, OECD 7.5, 6.6%. - 18 -
Country < 9 > OECD 4) Australia 17.1 4.4 0.2 2.4 5.9 2.8 0.4 0.5 0.3 0.1 Austria 27.2 12.6 0.4 2.4 6.8 2.8 0.6 1.1 0.1 0.3 Belgium 26.4 7.2 2.0 2.3 7.3 2.6 1.1 3.3 0.1 0.4 Canada 16.5 3.7 0.4 0.9 6.8 1.0 0.3 0.6 0.4 2.2 Denmark 27.1 7.3 0.0 4.3 5.9 3.4 1.7 2.8 0.7 1.0 Finland 26.1 8.5 0.9 3.8 6.2 3.0 0.9 2.0 0.3 0.5 France 29.2 10.9 1.8 1.9 7.8 3.0 0.9 1.7 0.8 0.4 Germany 26.7 11.2 0.4 1.9 7.7 2.2 1.0 1.7 0.6 0.2 Greece 20.5 10.8 0.8 0.9 5.6 1.1 0.1 0.4 0.5 0.4 Ireland 16.7 2.9 0.8 1.6 6.5 2.5 0.6 0.9 0.5 0.3 Italy 25.0 11.6 2.5 1.7 6.8 1.3 0.6 0.5 0.0 0.0 Japan 18.6 8.6 1.3 0.7 6.3 0.8 0.3 0.3.. 0.3 Luxembourg 23.2 5.2 2.0 3.3 7.0 3.6 0.5 1.0 0.2 0.4 Netherlands 20.9 5.5 0.3 3.6 6.0 1.6 1.3 1.5 0.3 0.6 New Zealand 18.5 4.2 0.1 2.9 6.9 2.6 0.4 0.4 0.8 0.2 Norway 21.6 6.3 0.3 4.4 5.8 2.8 0.7 0.5 0.1 0.6 Spain 21.2 7.9 0.6 2.5 5.8 1.1 0.8 2.2 0.2 0.2 Sweden 29.4 9.6 0.6 5.6 6.8 3.2 1.3 1.2 0.5 0.6 Switzerland 20.3 6.6 0.4 3.3 6.1 1.3 0.7 0.9 0.2 0.7 U. K 21.3 6.1 0.2 2.4 7.0 3.2 0.5 0.3 1.4 0.2 U. S 15.9 5.3 0.8 1.3 7.0 0.6 0.1 0.3.. 0.6 oecd avg. 22.4 7.5 0.8 2.6 6.6 2.2 0.7 1.2 0.4 0.5 Korea 6.9 1.5 0.2 0.6 3.2 0.3 0.1 0.2.. 0.7 : OECD Social Expenditure(2010) 2005 GDP 29.4% 9.6%, 6.8%, 5.6%, 3.2%, 1.3%, 2.7%,. 1980 ~2005 25 GDP 22.7%~27.1% 4) 1.,, 3., () 4.,, 5.,, (, ) 6. () 7. () 8. 9.,, * :.,, 2009-19 -
, (2.2%), (1.9%), (1.7%), (1.0%)., (1.3%). (0.6%), (0.1%), (0.3%) 1%. 25 8%p (5.5%p ), (1.7%p).,, 1%. 40%, 37%, 8%, 15%. < 2> * : OECD Social Expenditure Data OECD,.. - 20 -
Ⅳ. 1...,.. 1980 ~1990.,,, (NDC). 1889 70 OECD 77.7. 65 28% OECD 23.8% OECD. 2005 12.4% (14%), (12.6%) (OECD 7.2%), 53.3% OECD 59%, 61.7% OECD 71.9%. - 21 -
. 1995 10 23% 2005 OECD. OECD 16% 30%. 61 95% GDP 120%. < 10> (%) (%) - 65-9.4-55 - - 63 65 3.6 6.0 60 60 - - 60 60 - - - - 57-65 - - - 67 12, - 65 65 67 26-65 8.4-67 62 67 60 65 6-8 2.0 61 65 - - 61 65 - - - 10.4 65/60-10.4-67 5-6.7 8.0 63 65 6.8 6.8 63 65 2.8 2.8 * :Casey(2003) - 22 -
.,. 1994 5) (Multi-pillar System). 1, 2, 3.,,, (Defined Contribution). (DB Defined Benefit Plan). (DC Defined Contribution Plan, ),. (ILO) 6). 4. 1 (Minimum Anti-Poverty Pension), 2 ( 40~50%) 5) World Bank(1994). Averting the Old Age Crisis. A World Bank Policy Research Report. Oxford: Oxford University Press. 6) International Labour Office(2000). Social Security Protection in Old-Age International Labour Conference 76th Session. Geneva - 23 -
, 3.. 4. 2 (NDC: Notional Defined Contribution) NDC (,2000). NDC(Notional Defined Contribution),,. NDC NDC DC. (, 2005) NDC. (DC) NDC. NDC GDP,,. NDC ( (2005) )., NDC. - 24 -
,, NDC (,2005) 2005 (1994 ), ILO. 11 (2005) 0 X X x " (social), ( ) 1 X 2 X 3 x X X 4 X X X (DB NDC) ( DB DC) (/ DB DC) ( ), (), (), ( ) : X, X, X, x. : The World Bank, Old-age Income Support in the 21st Century, 2005. (2005b) (Parametric Pension Reform) (Systemic Pension Reform).,,, - 25 -
., (1) A. 1960,. OECD 1958 64.5 1993 62.2 1958 61.8 1993 60.7. 10 7),. OECD 65. 67,,,,, 65,,. B. OECD 2007 OECD 62.9 62.3%.,.,, 7) LIMRA's MarketFacts Quarterly(2010 ) - 26 -
,... 55-64 (2000) < 12> 61 35 + + + 48 44 + + + 42 30 + 56 37 + + + + 38 16 + + + + 45 17 + + + + + 84 47 + 46 18 + + 69 57 + 58 22 + - 72 65 + + + + 66 40 + + + 68 52 + + * +,,, - (Casey2003) C. 1986 20 1988 5 40 8 15, 10 25. D. : 1986 25% 20% 1986 1.0% 0.75% - 27 -
. (2)., EU OECD. A.,. GDP. 2004 (Built-in stabilzer) 8). B. 1990 2000,. 8) 후술함 - 28 -
. DB DC, DB DC.,.,,,,. (2007) (2008) (auto enrolment; )... pension credit( 2003 ), (targeting). 2000 (Riester Rente)() - 29 -
, ( ). C. (Gradual Retirement Schemes) 1976 EU10..,,. (Barr, 2004) 4 9). EU 2000 2020 (pillar) 1 2000 55% 20 40%, 2 30% 35%, 3. 4 5% 9) Reday-Mulvey & Giarini(1995): 4 (fourth pillar). 4 1, 2 3. - 30 -
2020 15%. < 3> EU : Reday-Mulvey(2005), Working Beyond 60 -Key Policies and Practices in Europe. (2009) 5,,. < 4> () : (2009),., - 31 -
. 55, 60, 58 61..,. 15 37.5... 55~56 OECD 65~66 10. 10. < 13> 50% 50. < 13> (:%) 50~54 55~59 60~64 65~69 70~74 75 47.72 21.09 18.87 7.77 2.59 1.97 49.63 17.39 17.69 6.60 6.00 2.70 52.47 22.50 17.69 4.45 1.93 0.96 43.59 15.46 19.17 10.82 6.96 4.02 * : KLISP(2003): - 32 -
10).. (1) 1999 1 (AFP) (ATP),, (Premium Pension) (Guaranteed Pension). (Notional Defined Contribution) 16%,. (Guaranteed Pension),. 1,, 2 ( ), 3. 1999 Premium Pension(; PP). 18.5% 16% (NDC; notional defined contribution), 2.5% Premium Pension., 10). - 33 -
.,.,. (PPM), (AP7-Fund).. (2) 1) 1, 2, 3. 1 (,, ),. 2 50%,. 2001. 3 2001. 2) 1.,, 1. - 34 -
< 14> ( : %) 1 88.1 76.6 58.3 94.9 90.9 75.4 72.6 90.9 2 4.3 15.1 39.2 2.5 0 19.8 17.4 0 3 5.3 5.9 0 0 6.9 3.5 7.8 5.7 * :,, 2009.11.. 2000.. 70%. 3) 2001.., 19.1% 2030 22%.. ( ). 11). 11) - 35 -
Riester Pension 1),., 14,,,. 2) (subsidies) (1) (2)(tax exemption advantages) (basic subsidies) (child subsidies)..,. 154(20), 185(30) 2008 300(50).,. 2002,. 3) 2,100(350) (2008 ).,,.,,.,. 4) 60,. Basis pension plan 1) 2005 Basis pension plan,,,,,. 2) - 36 -
20,000(3,400), 40,000(6,700) 2008 66%. 2% 2025 100%. 2004 20%., 2007 65 67 2012, 2024 2 2029 67. 45 ( ) 2020 46%, 2030 43% 2020 20%, 2030 22%.. (3) 1 2. 20 60,,. (15 ).. OECD 59% 33.9% OECD 71.9% 47.1%. (20004 ). 1/3-37 -
2009 1/2 5 100 ().. 13.58% 12) 2004 10 0.34% 2017 18.30%, 13,300 280 2017 16,900. 50%. GDP 8.7% OECD 7.2% 45%. (4). 40 21%.., (Pension Test),. 65 (2004, 8%). 2004 GDP 59% 2020 GDP 80%. 1960. 2002 12) 1999 ( 30% ) 2003 4 17.35% 13.58%. - 38 -
() 3.3%, 1.3%. < 5> 2005 21.6% 2030 30%. 63 100%. 63 68,., 53 ~62 1.9%, 63~68 4.5%.,. 100%, (20%) (80%). (5),, 3 1 (Pay-as-you-go),. 2.. - 39 -
2008 64%. 56.4%, 83%. 24%(OECD, Pension at a Glance, 2009). 2010. 2007 GDP 13%, OECD 7.2%(2005 ), EU27 10.1%(2007 ). < 15> GDP (: %) 1990 1995 2000 2005 2007 3.9 3.5 3.1 3.4 4.0 7.3 6.3 5.7 5.8 6.6 5.2 5.9 5.9 6.3 6.6 6.1 6.2 7.5 7.3 7.8 7.9 9.0 8.6 8.1 8.4 9.2 10.5 9.8 10.2 9.5 8.0 9.7 8.4 9.4 10.0 10.0 10.5 11.0 11.4 10.4 5.0 7.4 8.2 10.2 11.4 9.9 9.6 10.7 11.5 11.7 11.7 2.6 12.3 12.6 12.8 10.6 12.0 11.8 12.4 13.0 10.1 11.4 13.6 14.0 14.0 * : Pension at a Glance(2009) < 16> (:%) ( ) 0.5 0.8 1.0 1.5 2.0 80.1 80.1 80.1 80.1 76.4 57.3 56.2 66.5 56.2 56.2 56.2 56.2 53.3 61.7 53.3 53.3 48.5 46.0 43.0 43.0 43.0 43.0 42.6 32.0 95.7 95.7 95.7 95.7 95.7 95.7 39.8 68.4 45.6 34.2 22.8 17.1 67.9 67.9 67.9 67.9 67.9 67.9 90.1 99.4 91.0 88.1 84.3 82.5 88.9 93.4 90.0 88.3 86.6 85.8 81.2 81.2 81.2 81.2 81.2 66.7 61.5 76.6 64.6 61.5 75.6 81.3 33.5 51.0 36.6 30.8 21.3 16.0 * : Pension at a Glance(2009) - 40 -
. 58.7, 24.5. < 17>, 58.9 65 82.2 23.3 60.2 65 81.9 21.7 58.7 60 83.2 24.5 62.1 65 82.2 20.1 62.4 65 82.4 20.0 65.6 66 81.8 16.2 60.8 65 82.5 21.7 66.6 65 81.6 15.0 61.4 65 82.9 21.5 65.7 65 82.6 16.9 63.2 65 82 18.8 OECD 63.5 64.5 82.4 18.8 EU 61.7 64.3 81.5 19.8 * : OECD, Pension in France and aboard, 2010, 60 62 60 4 2018 62 (55 ) (65 ) 2. (6) 1 (1 ), 2 (state second pension : S2P), 3 AVCs FSAVSs. 1 (National Insurance),,. 44, 39, 65, 60. 2 2,, - 41 -
. 2,. 2.., (appropriate personal pension) (ordinary personal pension). 2, 2 (3 ). 1999... 3, 2. (Stakeholder pension).,.,, 2.,,.,. 2 ( 2 ). (contracting-out) - 42 -
2..,,,. 2007 2012 60, 65 2010 2020 65. 2007 65 68 2024 2046. (2008 ) (individual account). 4%, 3% ( 1% 3 ), (,tax credit) ( 1% ). (auto enrollment) 2012 ( )..,., 2004-43 -
(Built-in stabilzer). 2004, t (t-1) (t-2). 0.9 90%. 5 2004.. (Implicit Debt).., - 44 -
.,,,. 2001 13) Riester Pension Basis Pension Plan.,. 2004 14). (Stakeholder Pension) Roth IRA, SEP IRA. IRA IRA Traditional IRA Roth IRA. SEP IRA (Simplified Employer Pension Plan). SEP IRA 2010 4 9000. 20%. 100%. 59 10% 70 (RMD)., ( 0 ). 13). 14) 이순재 (2010) - 45 -
( ).... (55 ) (60~65 ) (Bridge Pension). 55 64 10 65,. 65.. (, ) - 46 -
. 2.. OECD(1996),,,.... () 15),,,,. 15) : :,. - 47 -
,,,,.. (1). 1).,,.,... 48,150, 4,012.5 (2008 ). 1 2 2 1,,,,, - 48 -
., 0.2%. 2) 16),,, 2007,,.,..,. (, ),.. 1 ( 6.1 5.8 ).. DRG 1,750 (95% ) DRGs 16) (2010 ). - 49 -
. DRG, ( )., ( ).,., 2% 1% (2008.1.1 )., 1%. 1... 2009.1.1 ( ).. 2009.1.1 ( )., ' '. 1883 14.9%(2008.7),,. 2011, - 50 -
. 3)., DRG, ( ),,,. DGR ( ) ( DRG () )... (2) 1),, 17) 3 17) 1 2,, - 51 -
(2006 ).,.,,,......... 2) ( ).. (risk selection), (premiun differentiation).,. - 52 -
,. < 18> ( ), (), 74% 96% 10% 18 ( ), DRG( ), * : (2010), 3), 2%.,... - 53 -
.,,. (3) 1) 18)....,.. Daily Cash-Benefit Insurance. Daily Cash-Benefit Insurance,.. DRG. 2) 18) National Health Service(NHS:,, ), Social Health Insurance(SHI:,,, ), Private Insurance(). - 54 -
. ( (1 6,500 US$), GDP 10.8% ( 3 ), 4~6%) 2007., (4) 1) (Hôpital) (DRG) (cabinet) (Clinic) (DRG) (cabinet). ( ),.,,,. 2004. 16.. ().,. 40-55 -
. 2009 2 30%( 70%, 50% ). 2)..,. Ⅴ. 1...,,,. EU(2009) 2010 2060 EU GDP 5%p (IMF(2009) G7 4%p ). 9.8%(2005~2010),. - 56 -
10.. 2009 74 6 ( 10.2% ), 2009 80 5 18.9%. < 6> (:%) * : (2010 ) (2004) 19) GDP 2004 4.95% 2020 9.3%, 2050 23.4%, 2070 29.9%, 2004 9.9% 2020 12.8%, 2050 27.0%, 2070 33.7%. GDP.,, 2004 14% 2020 24%, 2050 45%, 2070 50%. 19),,,, GDP. - 57 -
(2009 ) 2009 GDP 9.5% 2050 21.6%, 27% 43~48%.,,,, 5 GDP 13.9%p(2004 8.5 2050 22.4%) (8.3%p), 4 5.6%p.. KDI (2009) 2008 GDP 4% 2030 11.8%.., ( (, ),, ). 2.. 2050 GDP 3% IMF 2050 G20 12. < 19> * (GDP, %) G20-58 -
(A) 37 48 29 35 20 35 (B) 495 335 280 158 683 409 B/A( ) 13.4 7.0 9.7 4.5 34.2 11.7 : * 2050 3%, 4% : Fiscal Implication of the Global Economic and Financial Crisis(IMF, 2009.6) IMF 2010 3 1/20.. < 6> * (GDP, %) * EU. - 59 -
< 7> (GDP, %) * : OECD(2007) IMF 9. < 20> IMF 2010 9 2010 2050 2010~ 2010 2010~ 2010 2050 2010 2050 2050 ~2050 2050 5.9 8.6 2.7 4.8 8.5 3.7 10.7 17.1 6.4 3.1 4.8 1.7 6.5 11.6 5.1 9.6 16.4 6.8 8.5 15.8 7.3 5.1 10.1 5.0 13.6 25.9 12.3 4.7 5.9 1.2 7.6 13.4 5.8 12.3 19.3 7.0 2.2 2.6 0.4 2.2 4.4 2.2 4.4 7.0 2.6 13.5 14.2 0.7 8.7 14.6 5.9 22.2 28.8 6.6 10.2 12.3 2.1 7.9 14.4 6.5 18.1 26.7 8.6 1.7 0.9-0.8 0.9 1.8 0.9 2.6 2.7 0.1 0.9 2.1 1.2 1.3 2.6 1.3 2.2 4.7 2.5 14.0 14.7 0.7 6.3 11.0 4.7 20.3 25.7 5.4 10.3 11.0 0.7 6.9 12.8 5.9 17.2 23.8 6.6 0.6 4.4 3.8 4.0 9.2 5.2 4.6 13.6 9.0 2.4 3.5 1.1 3.2 6.4 3.2 5.6 9.9 4.3 9.4 18.8 9.4 3.6 6.7 3.1 13.0 25.5 12.5 2.2 7.1 4.9 2.9 5.5 2.6 5.1 12.6 7.5 1.3 2.3 1.0 3.2 5.7 2.5 4.5 8.0 3.5 7.3 11.4 4.1 3.6 7.2 3.6 10.9 18.6 7.7 6.7 8.1 1.4 8.0 14.2 6.2 14.7 22.3 7.6 4.9 5.7 0.8 6.7 14.9 8.2 11.6 20.6 9.0 G-20 5.8 7.4 1.6 5.3 10.4 5.1 11.1 17.8 6.7 7.1 8.3 1.2 7.6 13.9 6.3 14.1 22.2 8.1 3.8 6.1 2.3 2.0 5.2 3.2 6.4 11.3 4.9-60 -
IMF 5 ( 60%, 40%) 2030-3.3% (2030 ) 3.9% G20. 2050 9%,. 3...... (1) 1).. 2007 2 9% 40 2008-61 -
50% 2009 0.5%p 2028 40%., 20) 2043 2,465(1,056, 2005 ) 2060. 2047, 2064. < 21> () () 9.0% 50%( 40%) 2060 12.4% 40% 2041 19.5% 40% 1) 9.9% 25% 2069 2) 6 14.996% 50%(, 2020 ) 2100 1 *: 1) 2006 2006 4.1 2) 1. OECD(2001).,,,. (NDC). 20) : -, (,,,, ),,, - 62 -
21). NDC ILO (1 ), 40~50% (2 ), DC (3 ), 4 2 NDC.. 2) OECD(2001 ) ( 20%) (20%),.. 2007 OECD 60%. 21) OECD(Pension at a Glance 2009), (2008) 9%. - 63 -
55% World Bank 60~70%. 35% 20% ( 12.5%, 7.5% ). (50%), (25~40%), (30%) 2 1., 2.,, 50%,. 2000. 1960 Contract out (), 1985.,., 90%..,.,,. 22) 22) (Defined Benefit), (Defined Contribution), (IRA; Individual Retirement Account) 2010 1 3.2% 10% - 64 -
1994 23) (2001 ) 1996 39% 2001 25.6%, 2005 22.8%. 50 3.9%., 24),. PA,. 300. 930, 50 700, 300, 1,060.. 25).,. 10%.,. 23). 24) ( PBGC ). 25),. - 65 -
(2) 1) < 22> OECD. OECD OECD. 1 < 22> OECD (1993~2006) (: %) 1993 5.68 5.88 2.98 5.14 15.53 4.33 9.89 3.99 5.50 7.44 9.46 6.91 1994 6.19 3.08 7.42 5.29 13.19 3.29 8.80 1.59 7.10 5.39 16.26 7.06 1995 7.04 15.54 7.02 2.82 26.03 5.22 20.39 6.98 4.90 5.67 13.23 10.44 1996 7.84 2.74 4.46 4.62 24.90 3.29 9.99 5.48 6.82 5.29 17.50 8.45 1997 6.56 1.87 0.54 1.36 29.07 3.61 8.30 2.05 2.92 5.21 9.25 6.43 1998 7.70 3.39 2.69 2.20 23.35 7.41 7.93 5.92 6.70 5.71 0.21 6.65 1999 8.33 3.55 3.04 2.02 24.62 6.90 10.88 6.67 9.38 6.26 15.42 8.83 2000 10.91 4.60 2.47 3.03 18.80 6.48 14.85 5.71 6.97 6.92 17.29 8.91 2001 8.75 5.19 3.89 2.30 13.55 11.69 5.43 12.56 7.93 8.51 19.80 9.06 2002 8.78 6.69 3.35-1.06 11.35 11.07 6.83 7.92 9.91 8.97 7.11 7.36 2003 6.35 6.61 2.49 1.27 13.27 12.96 10.40 5.10 8.75 8.26 11.27 7.88 2004 9.83 5.18-0.10 1.09 13.91 5.05 6.91 2.02 9.03 6.86 8.41 6.20 2005 7.02 4.87 2.49 2.18 7.66 3.06 5.47 3.77 6.68 6.84 11.70 5.61 2006 8.22 3.98 2.32 0.11 12.11 4.08 1.81 5.00 8.31 6.75 11.29 5.82 * : OECD Health data < 8> OECD 1 * : OECD, (2010) - 66 -
2001~2006 2001 2002 2010 9 4 847( 4 500 ). 2010 (2010 6 500) (2010 1 3 ).. 2008 65 9.6% 29.9%. < 23> (: %) 2001 2002 2003 2004 2005 2006 2007 2008 6.9 7.2 7.5 7.9 8.3 8.6 9.2 9.6 17.7 19.3 21.2 22.8 24.4 25.9 28.2 29.9 * :.2009 1 1 2010 6 65 10.12%(493 ) 10% 23 3 6. < 24> 1 1 (:,%) 1 1 1 / 1 2002 2003 2004 2005 2006 2007 2008 403,598 440,356 475,092 524,593 599,260 677,319 723,545 1,086,971 1,242,751 1,370,487 1,549,492 1,804,583 2,182,101 2,267,817 269.3 282.2 288.5 295.4 301.1 322.2 313.4 * :, 2009 65 2002 10% 2006 (65 1 2005 ). - 67 -
< 25> 65 (:,,,%) 2001 2002 2003 2004 2005 2006 2007 65 3,216 3,345 3,541 3,748 3,919 4,073 4,387 65 23,565 27,153 32,757 38,411 45,576 55,989 69,537 65 1 ( ) 61,062 67,66 77,090 85,403 96,911 114,553 132,090-10.78 13.96 10.78 13.48 18.40 15.31 *, (2009) 4.5%, 1.9% GDP 0.4%. 2001 ~2006 37~39% 2009 ~2030 2% 2010 76, 2020 140, 2030 293 GDP 2009 972 2021 2, 2029 3 3% 2020 7.7%, 2030 10.6%.. 2) A.,,.. - 68 -
,.. DGR ( DRG () ).,,... B. : (2007. 41.3%, 33.5% OECD ),... - 69 -
... 26).. (1).,,.. 2010 57 9 27) 71.5%. 2009 7.6%, 2009 2.7% 26). 27) - 70 -
45%, 12.3%, 10.2%.. < 26> 2010 2011 2012 2013 2014 71,689 82,603 90,649 99,486 109,528 49,753 55,221 59,693 64,592 70,012 52,113 57,813 59,574 61,084 65,514 90,780 101,188 116,075 132,351 149,818 18,187 18,858 20,736 23,170 25,613 37,806 39,161 41,396 43,808 43,422 21,063 22,316 23,644 25,057 26,555 85,393 91,011 104,184 107,399 125,076 27,201 29,471 36,332 40,615 43,377 274,000 295,779 320,844 347,102 373,736 322,980 341,017 369,191 398,922 429,033 166,504 192,571 213,925 237,923 266,861 241,425 249,905 259,577 270,603 280,812 1,458,893 1,576,913 1,715,819 1,852,113 2,009,357 49.8 50.0 50.3 50.4 50.6 1,469,107 1,579,290 1,697,736 1,825,066 1,961,946 50.2 50.0 49.7 49.6 49.4 2,928,000 3,156,203 3,413,556 3,677,179 3,971,303 5.( : )... - 71 -
(2) 1) PAYGO(Pay-As-You-GO) 28). 1970., (Sustainability).. GDP.,. 29) (Fiscal discipline). 2) A. 1995 (Spending Cap), 28),, (IMF, 1998) 29) : 1). 2) ( : GDP ). 3). 4) (, ) - 72 -
GDP 2%.. B. 1997 Golden Rule Sustainable Investment Rule. Golden Rule ( ). Sustainable Investment Rule GDP 40%. GDP 1996 52.5% 2001 41.1% 1996 GDP 4.2% 2001 0.7%. 2009 (2009~2015 ). C. 1990 (Budget Enforcement Act:BEA). Budget Enforcement Act of 1990(BEA) 3., () 5(1991~1995 ) 5,000 ( 1,500 + 3,500 ),, (CAP). - 73 -
3 CAP 3 1993 CAP 3 Cap. 1997 CAP 3 CAP, 2000 2 2001 CAP., PAYGO, ( )., () (420 /5 ), (150 /5 ),. PAYGO. 1999 BEA 1%. Spending Control Act of 2004. D. 1992 (Fiscal Spending Control Act) 1992~1996. E. 4.. - 74 -
F. Trend-Based Fiscal Policy,. G. New Zealand Superannuation Fund /GDP 30%. H. 1998. 1. I. 2009 2016 () 2020 ( ). J. 2008 2010 2. - 75 -
K. 2003 (the Law of Budget Stability).. < 27> OECD Golden Rule* : * : OECD Economic Outlook(2007) 26,, 11. 26,, 7. (Golden Rule) 30). - 76 -
31), 32),... OECD(2006)... Alesina and Ardagna(1998), Ahrend et al.(2006). OECD(2007)., 85 3 2 54. < 28>.. GDP.. 30) OECD Economic Outlook(2007) 31) 32) GDP. - 77 -
(-) (-) Gap (-) < 28> -0.046**** (-6.54) 0.01* 0.140*** (3.12) -0.567**** (-4.92) 0.199** (2.43) 0.113* (-1.66) 2.28**** (4.42) 1.493** (2.07) -0.594** (-1.78) 0.078*** (3.41) 0.061** (2.54) -0.19** (-2.23) 0.187**** (4.14) 0.079* (1.89) -0.758** (-2.56) -0.18** (-2.27) -1.001**** (-3.35) 0.195**** (3.47-0.127** (-2.37) 1.191*** (3.09) 0.586** (2.08) (1992~1997) 0.255**** (3.57) (1998~2005) 0.979* (1.84) 372 0.192 73 0.487 73 0.267 255.. 64 0.56 : 1) GDP GDP. 2) : * 10%, ** 5%, *** 1%, **** 0.1% ( ) t. : OECD Economic Outlook(2007) 2) 2006 8 2030- (2006) 2050 GDP 1.5~2.0%, /GDP 2011 31.43% 2050 43.55% - 78 -
..,. 33). Ⅵ. OECD,..,. 1980 ~1990., 33). 2009~2013 5.6%, 4.2%, 2~3%. 2014 (GDP) 33%. 2009~2013 2013 GDP 0.5% 35.9% 2010~2014. - 79 -
( ). 2060. ( ), (Built-in stabilzer).., (,,,, )...,,., ( )., (Generic), - 80 -
.. PAYGO(Pay-As-You-GO), Spending Cap. OECD(2006).. - 81 -
참고문헌, -, 2007. (NABO),, OECD, OECD FOCUS, 2004,,, 8 1, 2001.,,,, 2006,, 2010,,,, 2009,,, 2010.06, -,,,, 17 2, 2009.,, 23 2010., OECD, Issue & Focus, 6, 2009,,, 9, 2002.,,, 2010, 20,, 29 2, 2009, :,, 38, 2007., OECD,, 6, 1998, OECD, 9, 2004.,?,, 2010,, - 82 -
, 26 1, 2010. 2, 2012 -OECD,,, 2008. 3, OECD -,, 2006-17.,,, 2009 (NABO),, 2010,,, 2009 3,,, 2006.,, 2009.11, 2009~2013, 2009,,, 2007. 5, 2008,, 2008.,, (NABO), 2010 5,,,, 2009. 4,,, 2008.,, 2010,, 2008.02,, 2005,,, 97, 2010 4,,, 2005. - 83 -
5,,, 2009,,, 2005. OECD Core Study of Long-Term Care OECD Economic Surveys Alesina A., and S. Ardagna, "Tales of Fiscal Adjustments, Economic Policy", October 1998, 489-545. Ahrend R., Factors Behind Low Long Term Interest Rates, OECD Economics Department Working Paper No. 490, 2006. Casey., B. Policies for an Ageing Society, OECD WP 369, 2003 OECD, "Projecting OECD Health and Long-term Care Expenditures: What are the main drives? WP No. 477, 2006 Dang,T.T., P. Antolín and H. Oxley, Fiscal Implications of Ageing: Projections of Age-Related Spending, OECD, WP, No. 305, 2001. Health at a Glance 2009 RETIREMENT-INCOME SYSTEMS IN OECD COUNTRIES Jones, R. S., Public Social Spending in Korea in the Context of Rapid Population Ageing, Economics Department WP, No. 615, OECD, 2008 John P. Martin and Edward Whitehouse, "Reforming Retirement-Income Systems: Lessons from the Recent Experiences of OECD Countries" OECD, 2008 EUROPEAN ECONOMY, "The impact of ageing on public expenditure: projections for the EU25 Member States on pensions, health care, long term care, education and unemployment transfers (2004-2050)", 2006. World Economic Forum, "Transforming Pensions and Healthcare in a Rapidly Ageing World: Opportunities and Collaborative Strategies" - 84 -
Gruber, J. and Wise, D., "An International Perspective on Policies for an Ageing Society", NBER WP 8103. 2001. Aino Salomäki., "Public pension expenditure in the EPC and the European Commission projections: an analysis of the projection results", EU, ECONOMIC PAPERS Dec., 2006 OECD Economic Outlook, "Fiscal Consolidation: Lessions from Past Experience", 2007 Randall S. Jones., "Health-Care Reform in Korea Economics Department", Working Papers No. 797, 2010 Jones, R,, WP No.797 OECD, "Pension in France and aboard", 2010-85 -