Social Insurance: America’s Neglected Heritage and Contested Future (Public Affairs and Policy Administration)

"Social Insurance: America's Neglected Heritage and Contested Future" is an extraordinary book. As one of the blurbs on the back cover claims, quite correctly, “This may be the best one-volume introduction to the American welfare state ever written.” The authors, Theodore Marmor, Jerry Mashaw, and John Pakutka are experienced and extremely capable social scientists and public policy and health systems analysts who have published numerous important works on American and international social insurance programs.Social insurance programs, including Social Security, Unemployment Insurance, Medicare, and Medicaid, are intended to protect individuals and families against financial threats such as being born into a poor family, the early death of a family breadwinner, involuntary unemployment, disability or outliving one’s savings in old age, and unaffordably high medical expenditures. All of us face such risks in developed economies, risks that can easily outrun the capacities of individual planning or commercial insurance to provide adequate protections.Social insurance programs, as the authors note, “typically condition benefits on some level of prior contributions toward the support of the programs. The more universal both contributions and benefits are, the closer the program is to the social insurance model.” (p. 37) Usually social insurance offers earned benefits “for which all similarly situated persons are eligible because of their financial contribution,” whether in the form of payroll or income taxes.”All too often we forget the nature of these programs and their vast importance to individuals, families, and the wider economy. This volume seeks to help us understand what they do, how they do it, and why they are so valuable. It is written for the general reader as well as the experienced analyst. Numerous detailed examples of individual risks addressed by social insurance programs and well-written analyses of each program make this book a delight to read in a field studded with difficult and (for most of us who are not experts) virtually unreadable works.I cannot recommend this book too highly. It is particularly important in the context of current political discussions, in which powerful, but ignorant attacks on social insurance programs are launched continually and most of us, although we support individual programs strongly, have forgotten or never knew why they exist, why they have had bipartisan support over many decades, and why we should continue to defend them.

Terrific book. I wish Congress would read it.Marmour et al leads with an anecdote about a fire that occurred in Rhode Island (many will know of the 2003 Station fire) and the costs incurred on those who lost loved ones, or faces medical bills as a result. Why? Illness is like a fire in some ways: it is costly, catastrophic and (often, not always) not the fault of the person suffering. Governments choose to create insurance for such instances, which is possible given the economic benefits of having a nation-wide risk pool. Strong insurance programs that provide EVERY person with insurance/protection -- funded mostly by taxes -- against misfortune (being born poor, unemployment, sickness, displaced etc...are the norm in the industrialized world. In the United States what plans we do have are means tested, not universal and the people who rely on them are often decried as lazy. The people not eligible for them (notable health insurance programs) can suffer greatly, and even die. It is well within the means of wealthy nations to provide these programs and those who use them pay into them as taxpayers.This book will have you look at government programs in new and important ways and does a terrific job of showing the US approach to social insurance, vs that of other nations. The authors do not hide that they see social insurance policies as rational. I suspect critics of things like Medicare, or the prospects for Medicare for All, may find them to be rational if they gave this book a careful read and with an open mind.Especially relevant today as Congress is mulling a bill that would reduce one of our primary social insurance programs (Medicaid) to ashes and the most popular Senator is pushing for public financing of a universal health system that would include a nation-wide risk pool and provide universal care. Many have been told such a thing is unaffordable, but as the book shows, these policies often save money and lives

In short, easily read chapters and sections, these distinguished authors revive the concept of Social Insurance and outline 5 philosophies of social welfare that inform current debate as well as past eras of reform. They describe six threats in America to a stable income and opportunities to thrive - especially for our youth: being born into a poor family, the early death of a breadwinner, involuntary unemployment, ill health, disability, and outliving one's savings. Marmor, Mashaw and Pakutka explain what has been done to address each one and how much threat remains. Balanced passages are paired with clear charts and graphs. A balanced history explains how each current program, such an unemployment insurance or Social Security or Medicare came to be, and the book ends by assessing what has been accomplished and what has not. Short comparisons with other advanced capitalist countries provide an international context and interesting ideas. The production, printing, and quality of the book are outstanding.Every chapter of the League of Women Voters, AARP, and other civic groups who discuss America's social dilemmas should read the relevant chapters to what they are discussing in this book no thicker than a pack of cards. Remarkably compact and informative. Students in courses about American social policy will greatly benefit too. Those planning retirement will find an overview of where they and their family members stand in terms of national and state policy. The chapter on saving for retirement begins, "Want to make God laugh? Tell him your plans!"

Excellent overview of a critically important and poorly understood topic.

“Social Insurance” is not afraid to tackle difficult issues that underpin American attitudes towards the risk of suffering catastrophic, unavoidable economic loss, eg, as a result of serious illness or injury. These events have dramatic consequences for individuals and their families, and the extent to which federal or state agencies can and should intervene has long been the subject of social and political discourse. However, the literature is often coloured (overtly or covertly) by partisan thinking and ideology, but not here. This book is filled with quality data, insightful analysis and exposition of the facts and surrounding issues, done in a way that will inform students and other interested readers who come to the subject with an open mind. As Marmor et al state in the Preface, “American social insurance is little understood and … contemporary discussions of discrete programs suffer from persistent myths and serious misunderstandings.” The authors set about debunking some of these myths and trying to fill this gap in understanding, and as they comment in the Epilogue, their intent “is to inform, not to argue”. I agree, and they do it well.