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The Birth and Growth of the Social Insurance State: Explaining Old-Age and Medical Insurance Across Countries

  • Cutler, David
  • Johnson, Richard
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    We seek to explain why countries have adopted national Old-Age Insurance and Health Insurance programs. Theoretical work has posited several factors that could lead to this adoption: the strain from expanding capitalism; the need for political legitimacy; the desire to transfer to similar people; increased wealth; and the outcome of leviathan government. We relate the probability of a country's creating social insurance to proxies for each of these theories. We find weak evidence that the probability of adopting a system declines with increases in wealth and with greater ethnic heterogeneity. Still, none of the theories is very strongly related to system adoption. We conclude that social insurance can be politically expedient for many different reasons.

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    File URL: http://dash.harvard.edu/bitstream/handle/1/2643658/cutler_birthandgrowth.pdf
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    Paper provided by Harvard University Department of Economics in its series Scholarly Articles with number 2643658.

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    Date of creation: 2004
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    Publication status: Published in Public Choice
    Handle: RePEc:hrv:faseco:2643658
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    Web page: http://www.economics.harvard.edu/

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    1. Browning, Edgar K, 1975. "Why the Social Insurance Budget Is Too Large in a Democracy," Economic Inquiry, Western Economic Association International, vol. 13(3), pages 373-88, September.
    2. Alberto Alesina & Reza Baqir & William Easterly, 1997. "Public Goods and Ethnic Divisions," NBER Working Papers 6009, National Bureau of Economic Research, Inc.
    3. Roubini, Nouriel & Sachs, Jeffrey D., 1989. "Political and economic determinants of budget deficits in the industrial democracies," European Economic Review, Elsevier, vol. 33(5), pages 903-933, May.
    4. Willem Adema & Marcel Einerhand & Bengt Eklind & Jorgen Lotz & Mark Pearson, 1996. "Net Public Social Expenditure," OECD Labour Market and Social Policy Occasional Papers 19, OECD Publishing.
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