What are the main challenges which sickness and disability policy makers in Denmark, Finland, Ireland and the Netherlands will need to address in the future? This chapter highlights the key outcomes and trends in these countries during the past 10-15 years in four areas: labour market integration of people with disability and workers with reduced work capacity; financial resources of those people; costs of sickness and disability benefits schemes; and exclusion and inclusion errors of those schemes. In addition, it addresses two macroeconomic challenges: population ageing and future labour supply shortages, and the impact of changing labour market requirements on workers’ health. These external challenges need to be taken into account if sickness and disability policy systems are to be reformed successfully.