On the Contribution of Economics to the Evaluation and Formation of Social Insurance Policy
展示经济学如何帮助理解社会保险的需求、规模及其经济影响，通过分析社会保障、医疗保险等案例，为政策制定提供依据。
If one had to choose a single policy that best characterizes the postwar behavior of governments, it might well be their expansion of social insurance. Today's citizen of a typical developed country is insured through government programs against unemployment, disability, medical expenses, impoverishment in youth and middle age (through welfare systems), impoverishment in old age (through old-age pensions), loss of spousal support due to divorce (through Social Security dependent benefits), fluctuating earnings (through progressive tax systems), early death of a spouse (via survivor's insurance), and late death (via annuity insurance). The remarkable growth of social insurance has occurred against a backdrop of increased geographic mobility, dramatic changes in demographics, and, at least in the United States, a dissolution of the family. The extent to which social insurance has been the cause of family decline and demographic change or its result is one of many complex questions that economics or any other social science is unlikely to ever fully answer. Economic analysis, while not being able to discover the precise recipe leading to our social insurance institutions, has, at least, been able to taste many of the key ingredients. Economics has and can provide real insight into a) the need for social insurance programs, b) the appropriate size of such programs, and c) how social insurance programs affect the economy. This paper seeks to illustrate each of these three kinds of economic contributions to the evaluation and formation of social insurance policy. Section I (drawing on my 1987 article) presents an efficiency argument for compulsory saving through a progressive Social Security system. Section II (drawing on my paper with Avia Spivak and Laurence Summers, 1982, and on Alan Auerbach's and my 1987b paper) illustrates an analysis of the appropriate size of social insurance programs, examining in turn the questions of whether households save enough and buy enough life insurance or whether more government intervention in these matters is appropriate. Section III (drawing on my 1989 book) illustrates how social insurance programs can affect the economy by discussing potential savings effects of health insurance, particularly an asset-tested Medicaid scheme. Section IV concludes the paper with suggestions for future research and policy options. As indicated, the paper draws on my own and coauthored research, and it provides only limited references for no better reason than easing my task and saving space. In so doing I do not pretend to suggest that this is more than a very small subset of a huge volume of research sparked in the 1970s, in large part, by Martin Feldstein.