I guess my comment was specific to the US, but pay in the medical field is vastly lower in Europe than in the US. Regardless, Europe is still subject to the biggest factor, which are demographic changes and they will have an impact on the availability of future benefits. I would say these past 20 years and maybe next 10 will have been the peak, and then there will be visible cuts in services or quality of services due to lack of people (and/or taxes) to service the debt.