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Longevity Differences and the Redistributive Effects of Social Security

Title
Longevity Differences and the Redistributive Effects of Social Security
Alternative Author(s)

Ha, SolleepRyu, JaerinKim, Hee-Nyun ; Cho, Yongchan

Keyword
National Health Insurance ; Life Expectancy ; Microsimulation ; MSM ; Social Security
Publication Year
2024
Publisher
Korea Institute for Health and Social Affairs
Abstract
This study aims to project the distributional outcomes of social security, taking into account the performance of national health insurance. Using KIHASA Microsimulation model (‘KIHASA SIM’), we analyzed the redistributive effects of the national pension and health insurance systems.
The findings are as follows. First, The government's pension reform proposal, which increases both the contribution rate and the income replacement rate, with a relatively larger increase in the income replacement rate, is expected to worsen income redistribution.
Second, increasing efficiency of the public healthcare system is slightly more favorable to high-income earners, whereas enhancing equity is relatively more advantageous for low-income groups. However, the increase in net pension benefits resulting from improved equity in health insurance was slightly larger for high-income groups. This could be attributed to the lower pension receipt rates among low-income individuals or suggest that, superficial changes in cost-sharing and benefit design alone may have limited effects in redistribution if health disparities by income level are not mitigated at earlier stages of disease onset.
Third, efficiency of public health spending is a key factor influencing net benefits. Differences in efficiency between public and private expenditures act as a mediating factor in determining net benefits through the national healthcare system, thereby creating disparities across income groups. It is important to note that when both equity and efficiency are improved simultaneously, the total net benefits tend to increase, contributing significantly to reducing disparities.
Table Of Contents
요 약 1

제1장 서론 5

제2장 국민건강에 대한 의료비 지출의 영향 11
제1절 의료비 지출과 국민 건강수준의 관계 13
제2절 의료비 지출의 국민 건강수준에 대한 영향 분석 25

제3장 기대수명과 사회보험을 통한 소득재분배 효과 41
제1절 노후소득보장제도체계에서 기대수명의 영향 43
제2절 기대수명을 고려한 사회보험의 순혜택 변화 57

제4장 기대수명을 고려한 사회보험의 소득재분배 효과 분석 65
제1절 미시모의실험모형의 구축 67
제2절 정책 시뮬레이션 107

제5장 결론 및 제언 123
제1절 결과 요약 및 함의 125
제2절 제언 130

참고문헌 133

부록 143
[부록 1] 소득수준별 사망확률 차이 143
[부록 2] 시뮬레이션 모형의 의료비 지출 분포 145

Abstract 147
Local ID
Research Monographs 2024-44
ISBN
9791172520618
DOI
10.23060/kihasa.a.2024.44
KIHASA Research
Subject Classification
Population and family > Population changes
Population and family > Responses to population aging
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