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1、TheImpactofMedicalandNursingHomeExpensesandSocialInsurancePoliciesonSavingsandInequality∗KarenA.KopeckyTatyanaKoreshkovaUniversityofWesternOntarioConcordiaUniversityandCIREQkkopecky@uwo.catkoreshk@alcor.concordia.caFirstVersion:November2008ThisVersion:December2009Abs
2、tractWeconsideralife-cyclemodelwithidiosyncraticriskinlaborearnings,out-of-pocketmedicalandnursinghomeexpenses,andsurvival.Partialinsuranceisavailablethroughwelfare,Medicaid,andsocialsecurity.CalibratingthemodeltotheU.S.,wefindthat12percentofaggregatesavingsisaccumula
3、tedtofinanceandself-insureagainstold-agehealthexpensesgiventheabsenceofcompletepublichealthcarefortheelderly,andthatnursinghomeexpensesplayanimportantroleinthesavingsofthewealthyandonaggregate.Moreover,wefindthattheaggregateanddistributionaleffectsofpublichealthcareprov
4、isionarehighlydependentontheavailabilityofotherprogramscomprisingthesocialinsurancesystem.∗WethankArp´ad´Abrah´am,RuiCastro,EricFrench,JoaoGomes,JonathanHea´thcote,NarayanaKocherlakota,LeonardoMartinez,Jos´eVictorR´ıos-Rull,JuanSanchez,JohnKarlScholz,AnanthSeshadri,R
5、ichardSuen,andMotohiroYogoforhelpfulcommentsandKaiXuforexcellentresearchassistance.WealsothankseminarparticipantsattheMinneapolisFederalReserveBank,theUniversit´edeMontr´eal,UniversityofWisconsin-MadisonandtheWhartonSchool,andconferenceparticipantsatthe2008CanadianMa
6、croStudyGroup,the2007and2008WegmansConferencesattheUniversityofRochester,the2008ConferenceonIncomeDistributionandFamilyattheUniversityofKiel,the2009meetingoftheSocietyforEconomicDynamics,andthe2009ConferenceonHealthandtheMacroeconomyattheLaboratoryforAggregateEconomi
7、csandFinance,UCSB.11IntroductionWithagingpopulationsandsoaringmedicalcosts,healthcarehasneverbeenofgreaterconcerntopolicy-makersandindividuals.TheelderlyintheUnitedStatesinparticularfacelarge,volatileout-of-pockethealthexpensesthatincreasequicklywithageasMedicareonly
8、provideslimitedcoverageofsomehealthcarecosts.In2000,averageout-of-pocket(OOP)expenditureforhouseholdswithheadsaged65andoverwasappro
