“Like the ecological transition, the demographic transition requires planning,” said Solidarity Minister Aurore Bergé last Friday to justify her strategy regarding old age. Because France is aging and the bill for assistance to elderly people promises to increase. By 2040, the cost of allowances paid to those over 60 under the Personalized Autonomy Allowance (APA) could almost double and reach 12.4 billion euros compared to 5.9 billion in 2020, according to the Institute of Public Policy (IPP). Currently, 1.3 million people benefit from this aid paid by the department to those over 60 with a recognized loss of autonomy and calculated according to their level of income. It allows you to pay part of the nursing home or home support costs.
In a note published very recently, economist Pauline Mendras provides an overview of future public spending in view of the future increase in the number of dependent elderly people and beneficiaries of APA. Given the increase in average lifespan and the “arrival of the baby boomer generation at high ages”, estimates are based on 1.7 million APA beneficiaries in 20240, or 350,000 new beneficiaries. or 29% more than in 2020. Hence a mechanical increase in the bill. This is why “with unchanged public care policy, the increase in the number of APA beneficiaries would lead to a 30% increase in total APA expenditure between 2020 and 2040,” specifies the note. A base scenario where APA expenditure would then reach 7.7 billion euros.
But to get closer to reality, the economist takes into account the hypothesis of the “residential shift” in his projections, i.e. the potential freeze on the creation of places for residents in nursing homes. Which implies that “people with greater needs will live at home than today”. Hence a necessary increase in salaries to allow the recruitment of professionals, increases that are “inevitable” to meet recruitment needs in a sector whose attractiveness is low and which will experience job strain by 2023. artwork”. But “these salary increases will also increase the cost of care” for the elderly, therefore implying a need to strengthen benefits.
Results: “By integrating these changes, total APA expenditure would increase by 4.8 billion euros by 2040, or 80% compared to 2020,” estimates the Institute of Public Policy. In this more complex scenario where the State would adapt the means on the table, APA expenditure would exceed the 10 billion euros mark to reach 10.7 billion euros. Allowances for elderly people supported at home would increase the most, of the order of 50%, reflecting the logic of the domiciliary shift, “where more resources would be necessary to allow dependent elderly people to be kept at home today welcomed in nursing homes.”
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But other expenses could well add to the bill. Part of the hours of help are currently provided by a “helper”, that is to say a relative. However, the IPP is counting on “a lesser presence of informal caregivers among people supported at home” in the future. Given this probable greater social isolation of recipients kept at home, professional help should replace informal help. In this scenario, annual APA expenditure in 2040 would reach 12.4 billion euros. The results of this final scenario, more credible in the eyes of Pauline Mendras, diverge by 4.6 billion from those of the basic scenario. Thus, by 2040, a gap of 60% “is observed by 2040 between a scenario without measures to support the change in housing and this scenario”.