Generational Aspects of Medicare
Generational Aspects of Medicare
复制标题
医疗保险的代际方面
DOI：
10.1257/aer.90.2.303
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Louise M. Sheiner
中科院分区：
文献类型：
--
作者：
David M. Cutler;Louise M. Sheiner
本文考察了代际方面的现行医疗保险制度和一些程式化的改革。我们发现，今天工人的医疗保险回报率高于社会保障，医疗保险制度正在将更大份额的负担转移给未来的工人，而不是社会保障。尽管如此，按照医疗保险受托人（Medicare Trustees）的假设，联邦医疗保险（Medicare）的回报率仍然不是那么高——对于今天最年轻的工人来说，回报率大约为2%。但是预测未来的医疗保险支出是相当困难的。在另一种我们认为合理的更高成本基准下，今天最年轻工人的回报率将超过3%。通过提高工资税或减少福利，使医疗保险建立在可持续的基础上，将大大降低当今工人的回报率。例如，在受托人的假设下，工资税必须增加工资的2.0%，才能使医疗保险系统永久保持平衡。这一政策将使当今最年轻工人的回报率降至1.3%左右。
This paper examines the generational aspect of the current Medicare system and some stylized reforms. We find that the rates of return on Medicare for today's workers are higher than those for Social Security and that the Medicare system is shifting a greater share of the burden on future workers than is Social Security. Nonetheless, the rates of return on Medicare, using the Medicare Trustees assumptions, are still not that high--roughly 2 percent for today's youngest workers. But forecasting future Medicare expenditures is quite difficult. Under an alternative higher-cost baseline, which we consider plausible, rates of return for today's youngest workers will exceed 3 percent. Putting Medicare on a sustainable basis by raising the payroll tax or reducing benefits would greatly reduce the rate of return for today's workers. Under the Trustees assumptions, for example, the payroll tax would have to be increased by 2.0 percent of payroll to put the Medicare system in balance in perpetuity. This policy would reduce the rate of return on today's youngest workers to about 1.3 percent.