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

描述(申请人提供)：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优化设计提供洞察力。医疗保险和社会保障目前占联邦政府的三分之一以上，随着婴儿潮一代年龄的增长、寿命的延长和医疗费用的持续上升，预计这一比例将大幅增长。因此，通过仔细和知情地设计这些计划，对老年人福祉的潜在改善是巨大的。拟议的研究涉及几个互为补充的项目，旨在了解医疗保险和年金私人市场的性质，以及医疗保险和社会保障对老年人福祉的替代设计可能产生的影响。为此，它将首先调查私人健康保险市场失灵的性质，以及私人健康保险和年金市场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，它将调查最优福利水平。为此，拟议的研究将估计风险厌恶个人对这些社会保险计划承保的每个风险的厌恶程度，从而计算每个计划提供的更多财务保障带来的幸福感增加。它还将评估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。其次，它将探讨在社会保险体系内为个人提供保险合同选择的成本和收益。具体地说，它将比较允许偏好不同的个人选择不同承保金额的潜在好处，与利用有关其健康的私人信息造成个人逆向选择的潜在成本；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、专有的微观数据集，其中包含关于个人保险选择、401K缴费和资产分配以及健康和死亡率的详细信息。它将开发两个不同的分析框架，分别用于估计年金和医疗保险的需求，以及使用需求估计来计算替代公共政策下的幸福感的模拟模型。这项研究的结果将阐明公共健康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。

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.