HEALTH, MORTALITY, SOCIAL INSURANCE, AND SAVING

二十世纪的成就之一是扩展了 生活。自相矛盾的是，活得太长是老年人最关心的问题之一 老年人。“活得太久”是什么意思？对于老年人，两个 关键的担忧是健康状况和金融资产的充分性。 尽管平均预期寿命大幅增加，但对于任何 特定的人的未来仍然不确定--无论是在健康方面 以及生命本身的长度。从这个角度来看，活得太久了 意味着健康状况不佳和/或没有足够的资源来维持 先前的消费水平，最糟糕的情况是健康状况不佳的长寿 和贫穷。健康问题在很大程度上被忽略在关于 资产管理和不确定的生活。然而，健康对 在几个方面做出储蓄和消费决策。首先，它影响到 工作和赚取收入的能力。第二，它影响生活质量 以及所购商品的价值。第三，尽管医疗保险覆盖的范围很大 老年人的部分医疗费用，疾病仍然可能带来 大量自付支出，特别是用于长期护理的支出 年纪较大的。最后，当前健康状态的改变是一个信号， 携带有关未来健康和死亡率的信息。 我们关注的主要问题是： 1.在现有的社会保障和医疗保险制度下，有多严重 健康状况不佳或失去配偶的后果是什么？ 2.就退休年龄而言，老年人的准备情况如何 积累的财富以及私人和社会保险工具？ 3.私人保险和公共保险之间的权衡是什么？有没有 最近私人养老金的下降在福利方面得到了补偿， 社会保障方面的变化？ 4.社会保险是否有效提供，或者是否有可能增加 通过改变年金和医疗的组合来改善老年人的福利 在给定的政府预算内覆盖吗？ 拟议的研究重点是健康对储蓄和储蓄的影响 退休人员的消费决策。我们调查的决策单位 是一个夫妻家庭，将其幸存下来的资源集中在一起 会员。我们使用动态规划方法来模拟家庭的 规划问题。优化模型的主要组成部分是：i)A 人群不同健康生存状态的概率转移矩阵 配偶；2)描述货币成本和收益的支付矩阵 它们与每个转换相关联；3)状态相关的实用程序 对每个在世伴侣的函数，边际效用来自 消费因健康状况而异；4)基于资产定义的效用函数 在最后一位幸存者去世时作为遗赠留下。给定信息 在这些组件上，可以计算最优消耗 节约策略。但是，某些组件，如实用程序参数 是无法直接观察到的。我们通过直面来估计这些参数 有观察到的资产积累的最优计划，认识到财富 是有误差的。为此，我们使用了三个不同的样本-- 退休历史调查、健康和退休调查以及 收入动态的小组研究。恢复了偏好参数后 对于每个家庭，我们可以检查每个家庭资产的隐含路径 在退休后的几年里达到顶峰。然后我们就可以推断出预期的 以公共提供为条件的每户的效用(福利) 社会保障和医疗保险以及私人持有的工具 作为养老金和人寿保险，从而决定公共/私人 权衡取舍。

One of the triumphs of the twentieth century has been the extension of life. Paradoxically, living too long is one of the major concerns of the elderly. What does it mean to "live too long"? For the elderly, two critical concerns are health and the adequacy of financial assets. Although average life expectancy has increased dramatically, for any particular person the future remains uncertain -- both in terms of health and of the length of life itself. From this perspective, living too long means living in poor health and/or with inadequate resources to sustain prior consumption levels, the worst case being a long life of ill health and poverty. Health issues have been largely ignored in the literature on asset management and uncertain life. However, health is critical to saving and consumption decisions in several ways. First, it affects the capacity to work and earn income. Second, it affects the quality of life and the value of purchased goods. Third, although Medicare covers large portions of medical costs for the elderly, illness can still entail substantial out-of-pocket expenditures, especially for long term care at older ages. Finally, a change in current health status is a signal which carries information about future health and mortality. The main issues which concern us are: 1. Under the existing Social Security and Medicare systems, how severe are the consequences of falling into poor health or losing a spouse? 2. How well prepared are the elderly for their retirement years in terms of accumulated wealth and private and social insurance instruments? 3. What is the trade-off between private and public insurance? Has the recent decline in private pensions been compensated, in welfare terms, by changes in social security? 4. Is social insurance provided efficiently, or is it possible to increase the welfare of the elderly by changing the mix of annuities and medical coverage within a given government budget? The proposed research focuses on the impact of health on the saving and consumption decisions of retirees. The decision unit which we investigate is a husband-wife household which pools the resources of its surviving members. We use a dynamic programming approach to model the household's planning problem. The main components of the optimization model are: I) A probability transition matrix for different health survival states of the spouses; 2) A payments matrix which describes the monetary costs and gains which are associated with each transition; 3) A state dependent utility function for each living partner where the marginal utility from consumption varies with health; 4) A utility function defined over assets which are left as bequests when the last survivor dies. Given information on these components it is possible to calculate the optimal consumption saving strategy. However, some components, such as the utility parameters are not directly observable. We estimate these parameters by confronting the optimal plan with observed asset accumulation, recognizing that wealth is measured with error. For this purpose we use three different samples -- the Retirement History Survey, the Health and Retirement Survey, and the Panel Study of Income Dynamics. Having recovered the preference parameters of households, we can examine for each household the implied path of asset decumulation in the post retirement years. We can then infer the expected utility (welfare) of each household conditioned on publicly provided social security and medical insurance and privately held instruments such as pensions and life insurance and thus determine the public/private tradeoff.