随着美国人口的老龄化,社会保障和医疗保险是否仍然可行?

Henning Bohn
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引用次数: 124

摘要

是的,这取决于对医疗保险成本的担忧和潜在的自我确认的怀疑。由于人口老龄化,美国的社会保障体系(广义上包括医疗保险)面临着重大的财政问题。但人口结构的变化也可能增加储蓄,提高工资,降低利率。在这种背景下,退休保险的财政问题似乎被高估了。更为严重的问题是医疗保险支出的快速增长。在某种程度上,医疗支出在gdp中所占份额的增长是对人口老龄化的有效回应。但由于道德风险问题,医疗保险的增长可能会过度。除了这个警告,社会保障在经济上几乎肯定是可行的。为了检验社会保障的政治可行性,我将重点放在中间选民环境下的跨期成本效益权衡上。对于各种假设,我发现社会保障将保留大多数人的支持。我还讨论了利他主义、再分配和多维投票的作用,并发现它们为社会保障提供了额外的选民支持。
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Will social security and Medicare remain viable as the U.S. population is aging?

Yes, subject to concerns about Medicare cost and potentially self-confirming skepticism. The U.S. social security system (broadly defined, including Medicare) faces significant financial problems as the result of an aging population. But demographic change is also likely to raise savings, increase wages, and reduce interest rates. Viewed in this context, the fiscal problems of retirement insurance seem over-rated. A more serious issue is the rapid growth of Medicare spending. Up to a point, a growing GDP-share of medical spending is an efficient response to an aging population. But Medicare growth might be excessive due to moral hazard problems. Except for this caveat, social security is almost certainly economically viable. To examine the political viability of social security, I focus on intertemporal cost-benefit tradeoffs in a median-voter setting. For a variety of assumptions, I find that social security will retain majority support. I also discuss the role of altruism, redistribution, and multi-dimensional voting and find that they provide additional voter support for social security.

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