Actuarial status of the HI (hospital insurance) and SMI (supplementary medical insurance) Trust Funds

This article is adapted from the 1987 Annual Reports of the Medicare Board of Trustees. It presents a summary of the current financial and actuarial status of the Hospital Insurance (HI) and Supplementary Medical Insurance (SMI) Trust Funds. The Board found that the present financing schedule for the HI program is sufficient to ensure the payment of benefits over the next 12-14 years if the intermediate (II-A and II-B) assumptions underlying the estimates are realized. Although steps have been undertaken to reduce the rate of growth in payments to hospitals, the Board urges Congress to take remedial measures to bring future HI program costs and financing into balance. The Board found the SMI program to be actuarially sound but recommends that Congress take action to curtail the rapid growth in that part of Medicare.     

Income of new disabled-worker beneficiaries and their families: findings from the New Beneficiary Survey

In 1982, disabled workers who came on the social security disability insurance rolls from mid-1980 to mid-1981 had median monthly incomes of less than $500 if they were unmarried and less than $1,300 if they were married. These median monthly income levels, which include the income of a spouse and minor children if present, are roughly half those of the noninstitutionalized population aged 25-64. Social security benefits are the most important source of income for disabled workers and their families: They account for 40 percent of the total family income of married disabled workers and 65 percent of the total income of unmarried disabled workers. Social security benefits provide at least half of all income for more than 80 percent of unmarried disabled-worker beneficiaries and for 50 percent of the married beneficiaries. For married disabled-worker beneficiaries, earnings of the spouse are the second most important income source. Spousal earnings account for 28 percent of total income. Pensions and asset income each account for about 10 percent of total income for these married beneficiaries. Earnings are not an important source of income for unmarried disabled-worker beneficiaries for whom they amount to only about 3 percent of total income. Pensions, asset income, and public transfers each account for about 10 percent of total income of the unmarried beneficiaries.     

The distribution of income in a despotic society

A distribution of income between rulers and subjects can be derived as an equilibrium of violence, rather than from considerations of marginal products of owned factors of production. Society is organized in ranks, and the occupants of each rank are provided with incomes just sufficient that obedience is preferable to rebellion. To incorporate such considerations into a model, it is necessary to recognize phenomena that are normally excluded from economic analysis: combat, the mortality rate (from natural causes and from violence) as a component of the utility function, and a rudimentary technology of control.     

Decentralized planning in Kenya

In 1983 the Government of Kenya embarked on an accelerated programme of decentralization known as ‘District Focus’. This exercise in devolution is aimed at promoting more effective and efficient use of scarce domestic resources through efforts to strengthen planning capacity at the district level, improve horizontal integration among operating ministry field agents, and expand authority to district heads of operating ministries for managing financial and procurement aspects of local project implementation. Given the importance of this initiative to the economic growth of Kenya and the current search for administrative reforms that could help accelerate rural development in Africa, District Focus merits close attention by development experts. This article reviews the historical background, content, and implementation progress of District Focus.