Social Insurance Issues for the Nineties

The American system of social insurance faces significant challenges in the 1990s. Parts of the system - Social Security and unemployment insurance - are more than fifty years old, and even the newest part - Medicare - has passed its twenty-fifth anniversary. During these years there have been mahor changes in labor force behavior and patterns of compensation, in longevity and family life, and in the scope and structure of our health and social service systems. The third annual conference of the National Academy of Social Insurance examined where and how social insurance should be adapted to take account of these changes and to better reflect the circumstances of the 1990s.

The Social Security retirement program, which was the focus of the Academy's first and second conferences, has been relatively successful in alleviating poverty and maintaining living standards among the aged. In other areas, however, the system of social protection is inadequate. The costs of health care are gobbling up an increasing share of our national output, yet 15 percent of Americans under sixty-five have no health insurance. More and more Americans are living to an advanced age, yet the United States lacksa a satisfactory system for helpinf people anticipate and pay for long-term care. The 1990s are beginning with a recession, yet only about 40 percent of the unemployed are collecting unemployment insurance benefits. The Americans with Disabilities Act of 1990 aims to bring people with disabilities into the economic and social mainstream, yet the Social Security disability insurance program continues to assume a clear division between those who can work and those who cannot.

The Academy's 1991 conference looked at the current state of insurance protection in four areas:

• health care for accute illness
• long-term care
• unemployment
• disability

and it set out options for improving coverage. Twenty experts from various diciplines presented papers. Over 200 other social insurance professionals, policy and budget analysts, and teachers and students of public affairs gathered to participate.

Chair:

Lawrence H. Thompson
The Urban Institute

A book of published proceedings, Social Insurance Issues for the Nineties, edited by Paul N. Van de Water, is available.