The Economics of an Aging Society

Written by leading thinkers in the field, this text provides an in-depth analysis of the economic and policy issues associated with the aging of individuals and populations. With a strong policy focus based on demographic and economic study, this book focuses on "who gets what" from current and proposed government programs that impact on older persons, and how these affect individual behaviour. It does so in a straightforward manner that is accessible to readers with a range of mathematical backgrounds. The discussion concentrates on: bull; bull;the effects of aging populations on the United States and other nations; bull;the economic wellbeing of the elderly, highlighting women and minorities; bull;public and private programs providing income for the elderly; bull;Medicare, Medicaid, and private health insurance; bull;Social Security and Medicare reform options; bull;employer-based retirement programs and pensions; bull;retirement patterns and factors influencing retirement decisions. The authors draw from the experiences of other countries in evaluating the US experience and options. Additionally, each chapter engages the reader through practical examples and stimulates further investigation by providing practice questions with relevant website addresses.

Robert L. Clark is Professor of Economics at North Carolina State University.

Richard V. Burkhauser is the Sarah Gibson Blanding Professor of Policy Analysis and Chair of the Department of Policy Analysis and Management in the College of Human Ecology, Cornell University.

Marilyn Moon is Vice President and Director of Health at the American Institutes for Research.

Joseph F. Quinn is Dean of the College of Arts and Sciences at Boston College.Timothy M. Smeeding is Maxwell Professor of Public Policy and Professor of Economics and Public Policy at Syracuse University.

List of figures

ix

List of tables

xi

Acknowledgments

xiii

Introduction

1

(8)

Why Write a Book on the Economics of Aging?

1

(2)

How This Book Can Help You

3

(2)

The Range of Issues Covered

5

(4)

PART I POPULATION AGING AND THE INCOME OF THE ELDERLY

9

(76)

The Graying of America and the World

11

(23)

Introduction

12

(1)

Population Mathematics

13

(5)

Improving Life Expectancy in America

18

(11)

International Aging

29

(1)

Population Aging: Good News or Bad?

30

(1)

Discussion Questions

31

(1)

References

32

(2)

The Economic Well-Being of Older Americans

34

(51)

Introduction

36

(1)

The Measurement of Economic Well-Being

37

(1)

Sources and Shares of Income of the Elderly

38

(6)

Income of the Elderly

44

(5)

Poverty among the Elderly

49

(2)

Diversity among the Elderly

51

(3)

The Sensitivity of Income and Poverty Measures to Alternative Measurement Assumptions

54

(3)

The Sensitivity of Policy Outcomes to Poverty Measurement Assumptions

57

(6)

Inclusion of In-Kind Benefits

63

(5)

A Policy Comparison: How Older People Fared During the Growth Years of the 1980s

68

(3)

Wealth among the Elderly

71

(7)

A Population at Risk?

78

(2)

Conclusion

80

(1)

Discussion Questions

81

(1)

Notes

82

(1)

References

83

(2)

PART II RETIREMENT PLANNING AND POLICIES

85

(82)

Economics of Retirement and Old Age

87

(24)

Introduction

89

(1)

Basic Economics and Retirement Savings Economics

89

(4)

Economic Models

93

(5)

Life Cycle Model

98

(6)

Role of the Public Sector

104

(4)

Program Interactions, Societal Aging, and the Limits of Public Versus Private Responsibility

108

(1)

Discussion Questions

109

(1)

Notes

109

(1)

References

110

(1)

Work and Retirement

111

(24)

Introduction

112

(1)

Determinants of Retirement

112

(5)

Trends in Labor Force Participation among Older Americans

117

(8)

Why the Change in Retirement Patterns?

125

(3)

How do Older Americans Leave the Labor Force?

128

(1)

International Patterns of Retirement

129

(3)

Conclusion

132

(1)

Discussion Questions

132

(1)

Note

133

(1)

References

133

(2)

Retirement Policies and Pension Plans

135

(32)

Introduction

137

(1)

Pension Economics

137

(1)

Types of Pension Plans

138

(7)

Benefit Accruals

145

(3)

Pensions and Worker Behavior: Empirical Evidence

148

(1)

Development of Pensions in the United States

148

(3)

Changing Universe of Pension Plans

151

(3)

Government Regulation of Private Pensions

154

(2)

Other Retirement Policies

156

(4)

Discussion Questions

160

(1)

Notes

160

(4)

References

164

(3)

PART III SOCIAL SECURITY PROGRAMS AND REFORMS

167

(102)

Social Security Benefits and Program Objectives: An Individual Perspective

169

(34)

Introduction

171

(1)

How Old-Age, Survivors, and Disability Insurance Works

171

(7)

What are the Policy Objectives of the OASDI Tax and Benefit Structure?

178

(3)

Trends in Social Welfare Spending in the United States

181

(2)

Disentangling the Insurance and Redistributive Components of Social Security

183

(7)

Evaluating Social Security Policies

190

(9)

Conclusion

199

(1)

Discussion Questions

199

(2)

Notes

201

(1)

References

201

(2)

Social Security Financing and Reform Issues

203

(34)

Introduction

205

(1)

Fully Funded vs. Pay-As-You-Go Systems

205

(3)

Social Security Finances

208

(3)

Proposed Solutions to the Long-Term Financing of OASI

211

(4)

Some Specific Reform Proposals

215

(8)

Criteria for Social Security Reform

223

(5)

Conclusion

228

(3)

Discussion Questions

231

(1)

Notes

231

(4)

References

235

(2)

Disability Policy

237

(32)

Introduction

239

(1)

How Social Security Disability Insurance (SSDI) Works

240

(4)

A Brief History of SSDI Policy

244

(3)

How Supplemental Security Income (SSI) Works

247

(2)

A Brief History of SSI Policy

249

(2)

Program Participation and Work Incentives of SSI and SSDI

251

(6)

Trends in Employment Rates and Benefit Caseloads for People with Disabilities

257

(3)

Disability Policy Trade-Offs

260

(2)

Conclusion

262

(3)

Discussion Questions

265

(1)

Notes

266

(1)

References

267

(2)

PART IV HEALTH AND LONG-TERM CARE FOR OLDER PERSONS

269

(75)

The Financing and Delivery of Acute Health Care Services

271

(45)

Introduction

273

(1)

Special Concerns Regarding Health Care and the Elderly

273

(7)

The Basics of Medicare

280

(4)

Supplemental Coverage for Acute Care

284

(4)

Problems with and Strengths of the Medicare System

288

(12)

Reform Options to Improve Beneficiary Protections

300

(1)

Reform Options to Reduce Medicare Costs

301

(7)

Prospects for the Future

308

(1)

Conclusion

308

(1)

Discussion Questions

309

(1)

Notes

309

(1)

References

310

(6)

Additional Health Issues: Long-Term Care

316

(28)

Introduction

318

(1)

Defining Long-term Care

319

(4)

The Current Long-term Care ``System''

323

(6)

Problems with the Current System

329

(5)

Approaches to Improve Coverage and Meet Other Needs

334

(6)

Conclusion

340

(1)

Discussion Questions

341

(1)

Notes

341

(1)

References

342

(2)

Index

344

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The Economics of an Aging Society

Summary

Author Biography

Table of Contents

Supplemental Materials