Design of Social Insurance for the Elderly: Public Pensions & Health Insurance

描述（由申请人提供）：本研究的目标是提供洞察公共医疗保险和养老金计划的最佳设计为老年人。医疗保险和社会保障目前占联邦政府的三分之一以上，预计随着婴儿潮一代的年龄增长，寿命延长和医疗费用继续上升，这两项支出将大幅增长。因此，通过仔细和知情地设计这些方案，老年人福祉的潜在改善是巨大的。拟议的研究涉及几个补充项目，旨在了解私人市场的性质，为健康保险和年金，以及医疗保险和社会保障的替代设计对老年人福祉的可能影响。为此，它将开始调查私人健康保险市场的市场失灵的性质，以及私人健康保险和年金市场的市场失灵的效率成本。然后，它将解决公共医疗保险和公共养老金优化设计的两个核心问题。首先，它将调查最佳的福利水平。为了做到这一点，拟议的研究将估计风险厌恶者对这些社会保险计划所承保的每一种风险的态度，从而计算出每个计划所提供的增加的财务安全带来的幸福感的增加。它还将估计医疗保险对医疗支出的影响，从而估计公共医疗保险对政府支出的影响。第二，它将探讨在社会保险制度中为个人提供保险合同选择的成本和收益。具体而言，它将比较允许个人选择不同的保险金额的潜在好处，与个人对自己的健康状况的私人信息造成不利选择的潜在成本;它将评估特定社会保险设计的效率和分配后果。为了实现这些目标，拟议的研究将利用两个丰富的专有微观数据集，其中包含有关个人保险选择、401 k缴款和资产分配以及健康和死亡率的详细信息。它将开发两种不同的分析框架，分别用于估计年金和健康保险的需求，并开发模拟模型，使用需求估计数来计算替代公共政策下的福祉。研究结果将揭示公共医疗保险和公共养老金的替代设计对老年人福祉以及政府支出的可能后果。公共卫生相关性：本研究的目的是为老年人的公共健康保险和养老金计划的最佳设计提供见解。医疗保险和社会保障支出目前占联邦政府的三分之一以上，预计随着婴儿潮一代的老龄化、寿命的延长和医疗成本的持续上升，这两项支出将大幅增长。因此，通过仔细和知情地设计这些方案，老年人福祉的潜在改善是巨大的。

DESCRIPTION (provided by applicant): The goal of this research is to provide insight into the optimal design of public health insurance and pension programs for the elderly. Medicare and Social Security currently account for over one-third of the federal government, and are projected to grow dramatically as the baby boomers age, longevity increases, and medical costs continue to rise. The potential improvement in elderly well-being from careful and informed design of these programs is therefore enormous. The proposed research involves several complementary projects design to understand the nature of the private market for health insurance and for annuities, and the likely impact of alternative designs of Medicare and Social Security for the well-being of the elderly. To this end, it will begin by investigating the nature of market failures in private health insurance markets, and the efficiency cost of market failures in both private health insurance and annuity markets. It will then tackle two questions central to the optimal design of public health insurance and public pensions. First, it will investigate the optimal level of benefits. To do so, the proposed research will estimate how risk averse individuals are over each of the risks insured by these social insurance programs, and hence calculate the increase in well-being from the increased financial security provided by each program. It will also estimate the effect of health insurance on health spending, and hence the impact of public health insurance on government expenditures. Second, it will explore the costs and benefits of offering individuals choice over insurance contracts within a social insurance system. Specifically, it will compare the potential benefits from allowing individuals who differ in their preferences to select different amounts of coverage, with the potential cost of creating adverse selection by individuals with private information about their health; it will evaluate both the efficiency and distributional consequences of specific social insurance designs. To accomplish these aims, the proposed research will utilize two rich, proprietary micro data sets containing detailed information on individuals' insurance choices, 401k contributions and asset allocations, and health and mortality. It will develop two different analytical frameworks for estimating demand for annuities and for health insurance respectively, and simulation models that use the demand estimates to calculate well-being under alternative public policies. The results from the research will shed light on the likely consequences of alternative designs of public health insurance and public pensions for elderly well being as well as for government expenditures. PUBLIC HEALTH RELEVANCE: The goal of the proposed research is to provide insight into the optimal design of public health insurance and pension programs for the elderly. Expenditures for Medicare and Social Security currently account for over one-third of the federal government, and are projected to grow dramatically as the baby boomers age, longevity increases, and medical costs continue to rise. The potential improvement in elderly well-being from careful and informed design of these programs is therefore enormous.