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SAGE Publications
Social Insurance: America's Neglected Heritage and Contested Future / Edition 1

Social Insurance: America's Neglected Heritage and Contested Future / Edition 1

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What has America done to protect its citizens from life-changing but common risks such as death of a family breadwinner, ill health, disability, involuntary unemployment, outliving retirement savings, and birth into a poor family? Each, in its own way, burdens—and possibly devastates—unlucky individuals and families both emotionally and financially. It is the rare life that is untouched by one or more of these six threats. How do our current policies affect taxation, spending, and the economy, as well as prospects for individual lives? What more might these policies do to protect Americans? Rich in stories, data, and analysis, Social Insurance by Theodore R. Marmor, Jerry L. Mashaw, and John Pakutka provides a strong intellectual foundation for understanding the history, economics, politics, and philosophy of America’s most important social insurance programs. This insightful work provides a unifying vision of these programs’ purposes and reminds us, amidst the confusing and often apocalyptic rhetoric, why we have the programs and policies we do, while arguing for reforms that preserve and enhance the protections in place.

Product Details

ISBN-13: 9781452240008
Publisher: SAGE Publications
Publication date: 10/11/2013
Pages: 328
Sales rank: 1,223,679
Product dimensions: 7.70(w) x 11.40(h) x 0.90(d)

About the Author

Theodore (Ted) Marmor is professor emeritus of public policy and management and professor emeritus of political science at Yale University. Marmor is an accomplished author and co-author of eleven books, and has published over a hundred articles in a wide range of scholarly journals. Additionally, he is a frequent Op-Ed contributor to U.S. and Canadian newspapers. Marmor began his career as a special assistant to Wilbur Cohen (Secretary of HEW) in the mid-1960s. He has served as associate dean of Minnesota's School of Public Affairs, a faculty member at the University of Chicago, the head of Yale's Center for Health Services, a member of President Carter's Commission on the National Agenda for the 1980s, and a senior social policy advisor to Walter Mondale in the presidential campaign of 1984. He has testified before Congress about medical care reform, social security, and welfare issues, as well as being a consultant to government and non-profit agencies.

Jerry L. Mashaw, Sterling Professor of Law at Yale Law School, teaches courses on administrative law, social welfare policy, regulation, legislation, and the design of public institutions. His books include Administrative Law: Introduction to the American Public Law System, Sixth Edition (with Richard Merrill and Peter Shane, 2009); Bureaucratic Justice (1983), awarded Harvard University’s Gerard Henderson Memorial Prize in 1993; The Struggle for Auto Safety (with David Harfst, 1990), awarded the Sixth Annual Scholarship Prize of the ABA’s Section on Administrative Law and Regulatory Policy in 1992; and Greed, Chaos, and Governance: Using Public Choice to Improve Public Law (1997), awarded the ABA’s Section’s Twelfth Annual Scholarship Prize in 1998 and the Order of the Coif Triennial Book Award in 2002. He is a frequent contributor to legal and public policy journals, newspapers, and news magazines. Professor Mashaw is a founding member and past President of the National Academy of Social Insurance.

John Pakutka is managing director of The Crescent Group, an advisory services firm with expertise in healthcare management, policy, and litigation. Firm clients have included Fortune 500 companies, Global 100 law firms, health systems, investment banks, state governments, and the United States Department of Justice. Prior to founding The Crescent Group, he worked for Exxon/Reliance Electric, the United States Government Accountability Office, Yale University, and APM/Computer Sciences Corporation. He has served on numerous public and non-profit boards and commissions, most recently the Connecticut State Legislature’s Task Force on Small Business Health Costs and the Citizenship Fund of the Connecticut Secretary of the State. He holds a BS in electrical engineering from Cornell and a MA in public and private management from Yale, where he lectures annually in the Product Planning class at the School of Management.

Table of Contents

Figures and Tables ix

Series Foreword Donald F. Kettl xv

Preface xix

About the Authors xxiii

Part I American Social Insurance 1

1 Economic Risks and Social Insurance Realities 3

Three Stories 3

Risks and Social Insurance 6

Social Insurance versus Private Insurance 9

Plan of the Book 12

2 Assessment of the Six Threats to Family Income 14

Family Income and Assets 14

The Nature of the Threats 17

3 Philosophies, Policies, and Public Budgets 34

Philosophies of Social Welfare 34

The American Expression of Social Welfare Philosophy 40

Appendix: Public Expenditure in the United States 42

4 The Historical Development of American Social Insurance and Its Associated Programs 47

The Formative Years 49

The New Deal Arrives 52

Early Expansion 55

Consolidation and Conflict 56

The Battle for Universal Health Insurance 59

Accomplishments and Challenges 64

Part II Threats and Protections 69

5 The Threat of Birth into a Poor Family 71

Measuring Poverty in America: A Brief Discussion 74

Cash Assistance 76

Food Assistance 82

Access to Health Care for Poor Children 85

Access to Child Care and Education for Children of Poor Families 86

Access to Shelter 89

Programmatic Summary: Assistance to Poor Families 90

Reform Directions 92

6 The Threat of Early Death of a Family Breadwinner 95

Private Life Insurance 97

Social Security Survivors Benefits 101

International Comparisons 103

7 The Threat of Ill Health 106

American Health Care Reform: Making Sense of the Affordable Care Act's Origins, Fate, and Future 109

The Nature of the Threat and Its Cost 110

The Protective Arrangements in Place 113

Employer-Sponsored Coverage 115

Medicaid 119

Medicare 121

The Affordable Care Act 124

Basic Health Care Economics 126

International Experience 129

Conclusion 134

8 The Threat of Involuntary Unemployment 135

Point of Departure 137

Measuring Unemployment 138

How Unemployment Insurance Works 139

Why Unemployment Insurance Is Failing So Many 143

Does Unemployment Insurance Encourage Unemployment 147

Recent Reforms and Possible Models 149

9 The Threat of Disability 153

The Market for Commercial Disability Insurance 155

A Century of Workers' Compensation 156

Social Security Disability Insurance 159

Potential Benefits and Application Process 161

Continuing Disability Reviews and Returns to Work 163

The SSDI Trust Fund 164

Understanding the Growth in SSDI Beneficiaries and Expenditures 166

Supplemental Security Income 168

Additional Protections 170

International Experience and Reform Possibilities 173

10 The Threat of Outliving One's Savings 178

The Difficulty of Retirement Planning 179

The Three- (or Four-)Legged Stool 180

The International Context 196

Solutions to the Social Security Trust Fund Seventy-Five-Year Imbalance 198

Part III Thinking about the Design of Income Security Programs and Their Reform 203

11 Accomplishments and Limitations 205

Variations in Program Design 206

Political Compromise and Programmatic Dysfunction 210

12 Social Insurance, Markets, and "Modernization" 216

The Durability and Desirability of Social Insurance 217

Clouds over Camelot 220

Social Security: Fairness, Affordability, and Modernization 220

Medicare: Fairness, Affordability, and Modernization 227

Enter the Affordable Care Act 236

Epilogue 239

Notes 242

Index 267

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