The number of people dying annually in the European Union is set to increase by almost 20% over the next 30 years. Set that forecast against estimates that 60% of a person's health costs are concentrated in the year preceding death, and the scale of the challenge facing public health authorities starts to emerge. The European Commission estimates that demographic aging will increase the annual death rate in the 15 member states from 3 725000 in 1994 to 4 375000 by the year 2025. This calculation, says the commission, indicates the amount by which “health costs will be multiplied over the next 30 years solely as a result of the demographic effect.”

The scenario is set out in the commission's second examination of the demographic situation in the …