Demography and Retirement: The Twenty-First Century

By Anna M. Rappaport; Sylvester J. Schieber | Go to book overview

Stephen C. Goss

Sam Preston's paper provides an excellent and insightful analysis of past demographic experience and his expectations for the future. Frank Bayo's discussion covers many of the reactions we share, both working at the Office of the Actuary, Social Security Administration. The comments below provide a few additional insights that I hope will be useful.


MORTALITY

In his paper, Dr. Preston suggests that future declines in mortality rates may be greater than those projected by the Social Security Administration (SSA). An extrapolation of long-term past rates of decline would support his position. However, a more careful look at past trends, and the reasons behind them, lead us at the SSA to believe that declines will not average as large in the future as in the past several decades.

Between 1900 and 1990, the age-sex-adjusted death rate in the United States population declined at an average annual rate of 1.2 percent. However, it is interesting to note that this period has been made up of several distinct periods with very different experience. From 1900 to 1936, mortality rates declined by only 0.8 percent per year. From 1936 to 1954, they declined by 2.3 percent per year. Little decline was experienced from 1954 to 1968, only 0.2 percent per year, followed by rapid decline from 1968 to 1982, at 2.0 percent per year. Since 1982, mortality rates have again been declining slowly, only 0.4 percent per year.

Precise explanation of this seemingly cyclic pattern of mortality is elusive. The rapid improvement between 1968 and 1982 would seem to be related to the introduction of Medicare, bringing more health care to those with the greatest probabilities of death. Slower declines since 1982 might be assumed to be associated with some of the Medicare reforms that decreased service. However, for these periods, the first rapid and then slow decline in mortality was experienced for all age groups, not just the elderly served by Medicare.

Frank Bayo suggests that future improvement will be harder because we have, in effect, already found the easiest cures and further medical cures will be more difficult. Two additional factors will also contribute to ultimately slower mortality improvement than experienced so far this century. Certainly much of the past improvement is due to our ability to make adequate nutrition and health care available to virtually the whole population. These changes can only be made once. They have contributed greatly to the health and thus the life expectancy of the population this century.

While we will continue to see declines in mortality from these changes, and from trends toward better eating habits by some and a reduction in smoking, for many years into the future, ultimate future gains will require new medical interventions and changes in life style that may be difficult to develop and harder to provide the population at large. Our ability as a nation to afford the new medical technologies for all the people is increasingly in question. Economics will likely restrict our ability to make them available. In fact, the level of current health costs suggests that we cannot even afford the current level of health

-53-

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Demography and Retirement: The Twenty-First Century
Table of contents

Table of contents

  • Title Page iii
  • MEMBERS OF THE PENSION RESEARCH COUNCIL v
  • Purpose of the Council vii
  • Contents ix
  • 1: Overview 1
  • Introduction 1
  • 2: Demographic Change in the United States, 1970-2050 19
  • ENDNOTES 47
  • Stephen C. Goss 53
  • Barry Edmonston 57
  • Introduction 57
  • 3: Expected Changes in the Workforce and Implications for Labor Markets 73
  • Introduction 73
  • Joseph F. Quinn 105
  • 4: Can Our Social Insurance Systems Survive the Demographic Shifts of the Twenty-First Century? 111
  • Introduction 112
  • ENDNOTES 148
  • 5: The Impact of the Demographic Transition on Capital Formation 163
  • Introduction 163
  • ENDNOTES 180
  • Alicia H. Munnell 183
  • 6: Implications of Demographic Change for Design of Retirement Programs 189
  • 7: Trends in Health Among the American Population 225
  • Introduction 225
  • ENDNOTES 242
  • Discussions 243
  • 8: Population Aging and Retirement Policy: An International Perspective 255
  • Introduction 255
  • ENDNOTES 284
  • Robert J. Myers 293
  • Bibliography 297
  • Index 315
  • Contributors 323
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