The future economic needs of the health care system vary from country to country, and depend, among other things, on demographics. In many wealthy countries, the key issue in health care financing has to do with the aging of populations. In most wealthy countries, two phenomena are creating this demographic shift. First, people are living longer and second, they are having fewer children. As the chronic health issues of the elderly are not only expensive but are fundamentally different from those of younger people, this demographic evolution means that health care systems will experience increasing need to find funding for such things as home care and hospice care for aging populations.
Another future economic issue is the way medicine is becoming increasingly tailored to small populations, an effect that will increase with the development of targeted gene therapies. For new therapies to pay back the cost of development with a smaller customer base, they become more expensive. As medical care involves more extremely expensive treatments, one is confronted with the need to either let de facto rationing based on patients' ability to pay limit access, establish price controls, restrict access to treatment, or have health care become an increasing percentage of GDP.