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特集 : アメリカの社会保障 21 世紀のアメリカ社会保障 渋谷博史 中浜隆 櫻井潤 1 2 3 1 2 1960 1980 1963 1980 Reaganomics 1960 1990 2000 1 21 1960 1980 4

21 1950 1 2 1 2 3 2 1 2 3 3 2 2-1 1 2006 1 GDP 8.9 2 tax expenditure GDP 0.7 0.8 4 3 GDP 4.1 3.0 4 GDP 4.1 5 2.4 TANF 5 2.7 GDP 20.8 6 2-2 1990 1990 2000 2 5

1990 1995 2000 2002 2003 2004 2005 2006 10 N/A 69 76 84 84 95 103 104 Summer 2010 No. 171 12006 A 415 575 800 930 997 1,052 1,125 1,171 102 142 192 219 236 251 267 287 36 50 70 91 102 112 123 133 136 191 270 309 320 332 352 361 129 176 251 293 320 339 363 370 12 16 17 18 19 18 20 20 B 408 572 690 816 850 881 933 1,025 OASDI 244 328 401 447 463 485 513 544 108 179 220 261 278 303 332 395 18 22 21 54 54 37 32 31 38 43 48 54 55 56 56 55 C 173 301 360 440 471 516 546 544 78 155 205 259 274 300 315 311 SSI 17 28 32 35 36 37 38 40 15 22 15 19 22 26 29 29 TANF 1 19 23 18 18 18 18 18 18 16 26 24 28 30 31 32 32 2 28 47 66 81 91 104 114 114 A B C 996 1,448 1,850 2,186 2,318 2,449 2,604 2,740 N/A 46 58 72 80 85 79 91 A 7.1 7.8 8.1 8.9 9.1 9.0 9.1 8.9 1.8 1.9 2.0 2.1 2.2 2.1 2.1 2.2 0.6 0.7 0.7 0.9 0.9 1.0 1.0 1.0 2.3 2.6 2.8 3.0 2.9 2.8 2.8 2.7 2.2 2.4 2.6 2.8 2.9 2.9 2.9 2.8 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 B 7.0 7.7 7.0 7.8 7.8 7.5 7.5 7.8 OASDI 4.2 4.4 4.1 4.3 4.2 4.2 4.1 4.1 1.9 2.4 2.2 2.5 2.5 2.6 2.7 3.0 0.3 0.3 0.2 0.5 0.5 0.3 0.3 0.2 0.7 0.6 0.5 0.5 0.5 0.5 0.5 0.4 C 3.0 4.1 3.7 4.2 4.3 4.4 4.4 4.1 1.3 2.1 2.1 2.5 2.5 2.6 2.5 2.4 SSI 0.3 0.4 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 TANF 1 0.3 0.3 0.2 0.2 0.2 0.2 0.1 0.1 0.3 0.4 0.2 0.3 0.3 0.3 0.3 0.2 2 0.5 0.6 0.7 0.8 0.8 0.9 0.9 0.9 A B C 17.2 19.6 18.8 20.9 21.1 21.0 21.0 20.8 N/A 0.6 0.6 0.7 0.7 0.7 0.6 0.7 N/A 0.9 0.8 0.8 0.8 0.8 0.8 0.8 1 1995 AFDC 2 direct relief EITC general assistance U. S. Census Bureau, Statistical Abstract of the United States, various issues; Centers for Medicare and Medicaid Services, Sponsors of Health Care Costs: Business, Households, and Governments, 1987-2008; Employer Benefit Research Institute(2009), EBRI Data Book 2009 Joint Committee on Taxation, Estimates of Federal Tax Expenditures, various issues 6

21 1990 1990 2000 10 GDP 17.2 18.8 1.6 1990 1995 2.4 1995 2000 0.8 1990 1990 1990 1997 GDP 1990 2000 1.3 2.1 0.7 1997 7 2000 2000 2006 GDP 18.8 20.8 1990 2.0 2000 2003 18.8 20.9 2.1 GDP 2000 2006 0.8 D 2004 2000 2-3 2001 1 2002 GDP 2-3-1 2-3-1-1 21 8 2004 2009 7

Summer 2010 No. 171 2016 2037 9 2-3-1-2 IRA 2001 IRA 401 k 2006 2001 1990 2000 10 11 2001 2-3-2 2-3-2-1 D A D 4 A B C A B A B D A B A 2009 A B D 70 C 20 2003 MMA D 2004 C D 2004 D 2004 2013 10 3950 12 8

21 2009 A 2017 B D 13 2-3-2-2 1990 HDHP HDHP HDHP HDHP MSA 14 HSA 2003 MMA HSA HSA HDHP 15 16 9

Summer 2010 No. 171 2-3-3 1996 17 1990 1996 2002 10 18 2005 TANF 2010 1995 2005 19 3 3-1 NAIC NAIC 1871 20 NAIC NAIC 1 3-2 1980 1990 10

21 3-2-1 1 2 1 1 1980 90 1 1 1930 1970 1980 1 1970 1980 21 22 3-2-2 NAIC 1990 1996 11

Summer 2010 No. 171 12 3-2-3 2 2010 1

21 2 NAIC NAIC NAIC 1 1 20 2005 2 2006 2007 2010 3 Social Security Welfare AFDC TANF Social Welfare 1 4 2005 4 5 2009 Children s Health Insurance Program Reauthorization Act of 2009 State Children s Health Insurance Program SCHIP CHIP 2009 2000 CHIP 13

Summer 2010 No. 171 2009 6 Adema 2001 OECD 7 1990 2006a, 2006b 8 Economic Report of the President, various issues. Wise and Woodbury 2009 9 Board of Trustees, Federal Old-age and Survivors Insurance and Federal Disability Insurance Trust Funds 2009, pp. 2-4. 10 2010 11 VanDerhei 2009 12 Congressional Budget Office 2004 pp. 9-10. 13 Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds 2009 pp. 2-4. 14 2010 15 HSA HDHP Fronstin 2004 Congressional Budget Office 2006 16 Hoffman and Tolbert 2006. 17 2006 2007 18 Chairman of the Council of Economic Advisors, Economic Report of the President, various issues. 19 Boiman 2008. 20 21 50 22 2010 2007 2006a 2006b 2005 20 3 2010 I 2010 I 2006 2009 71 3 2006 2010 2008 G. W. 2010 2006 II Adema, W. (1999), Net Social Expenditure, Labour Market and Social Policy Occasional Papers No. 39, OECD. Board of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (2009), 2009 Annual Report of the Board of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. Board of Trustees, Federal Old-age and Survivors Insurance and Federal Disability Insurance Trust Funds (2009), 2009 Annual Report of the Board of Trustees of the Federal Old-age and Survivors Insurance and Federal Disability Insurance Trust Funds. Boiman, Tiffany (2008), Entering the Next Phase of Welfare Reform: State Responses to Changes in Federal TANF Law and Regulations, NGA Centers for Best Practices Issue Brief. Centers for Medicare and Medicaid Services, Sponsors of Health Care Costs: Business, Households, and Governments, 1987-2008 (http://www.cms.hhs.gov/nationalhealthexpenddata/ downloads/bhg08.pdf). Chairman of the Council of Economic Advisors, Economic Report of the President, various issues. Congressional Budget Office (2004), A Detailed Description of CBO s Cost Estimate for the Medicare Prescription Drug Benefit. Congressional Budget Office (2006), Consumer-Directed Health Plans: Potential Effects on Health Care Spending and Outcomes. 14

21 Employee Benefit Research Institute, EBRI Data Book on Employee Benefits (http://www.ebri.org/publications/books/index.cfm?fa =databook). Fronstin, Paul (2004), Health Savings Accounts and Other Account-Based Health Plans, EBRI Issue Brief No.273. Hacker, Jacob S. (2002), The Divided Welfare State: The Battle over Public and Private Social Benefits in the United States, Cambridge University Press. Hoffman, Catherine & Tolbert, Jennifer (2006), Health Savings Accounts and High Deductible Health Plans: Are They An Option for Low-Income Families?, Kaiser Commission on Medicaid and the Uninsured Issue Paper. Howard, Christopher (1997), The Hidden Welfare State: Tax Expenditure and Social Policy in the United States, Princeton University Press. Howard, Christopher (2007), The Welfare State Nobody Knows: Debunking Myths about U. S. Social Policy, Princeton University Press. Social Security Administration, Social Security Bulletin Annual Statistical Supplements, various issues. VanDerhei, Jack (2009), The Impact of the Resent Financial Crisis on 401(k) Account Balances, EBRI Issue Brief. Wise, David A. & Woodbury, Richard G. (2009), Social Security in a Changing Environment: Findings from the Retirement Research Center at the National Bureau of Economic Research, Social Security Bulletin, Vol. 69, No. 4, pp.65-81. U. S., House Committee on Ways and Means (2004), 2004 Green book. 15