This paper presents simulations of the impact of age-related public expenditures on overall government budget positions and on national savings for 20 countries. Using demographic projections prepared by the World Bank, models have been constructed for the evolution of public pension expenditures and contributions, on the assumption that present policies continue. Sensitivity analysis and some illustrative scenarios of possible reform options are also presented. Scenarios for the evolution of public health-care expenditures are also presented with sensitivity analysis of the assumptions linking age and health-care costs and the evolution of treatment costs. These scenarios for pensions and health care are set within the wider framework of general government balances to capture the effects of public debt accumulation and debt servicing costs ...