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Across the OECD, healthcare spending has typically outpaced economic growth in recent decades. While such spending has improved health outcomes, there are concerns about the financial sustainability of this upward trend, particularly as healthcare systems are predominantly funded from public resources in most OECD countries. To better explore this financial sustainability challenge, many countries and international institutions have developed forecasting models to project growth in future healthcare expenditure.

Despite methodological differences between forecasting approaches, a common set of healthcare spending drivers can be identified. Demographic factors, rising incomes, technological progress, productivity in the healthcare sector compared to the general economy (Baumol’s cost disease) and associated healthcare policies have all been shown to be key determinants of healthcare spending.

In the coming years, labour markets will face significant challenges. In this context, re- and upskilling of adults is an urgent priority for all at national, regional and local levels. To turn challenges into opportunities and to ensure that the supply of local skills matches constantly changing skills demands, there is a need to create strong adult learning systems for a more resilient and empowered society and productive economy. To support local governments in their efforts to future-proof adult learning systems, this policy manual presents a range of policy options and concrete actions that can inspire and guide work at the local level. It is designed for both policy makers and practitioners at the local and regional level, but also for national policy makers to support their efforts in supporting the diversity of local needs.