OP-ED COLUMNIST
Life, Death and Deficits
By PAUL KRUGMAN November 23, 2012
专栏作者
减赤不是提高退休年龄的借口
保罗·克鲁格曼 2012年11月23日
America’s political landscape is infested with many zombie ideas — beliefs about policy that have been repeatedly refuted with evidence and analysis but refuse to die. The most prominent zombie is the insistence that low taxes on rich people are the key to prosperity. But there are others.
美国的政治领域遍布诸多僵尸想法，这些有关政策的种种论调早已经被各种证据和分析加以否定，但它们依然不肯死去。最著名的僵尸理论是，坚持富人低税是振兴的关键。但还有其它的理论。
And right now the most dangerous zombie is probably the claim that rising life expectancy justifies a rise in both the Social Security retirement age and the age of eligibility for Medicare. Even some Democrats — including, according to reports, the president — have seemed susceptible to this argument. But it’s a cruel, foolish idea — cruel in the case of Social Security, foolish in the case of Medicare — and we shouldn’t let it eat our brains.
而当前最危险的僵尸论调可能是这种说法，即号称由于人均预期寿命增长，我们应该提高社会安全福利(Social Security)规定的退休年龄，以及享受联邦医疗保险(Medicare)的年龄。据报道，包括我们总统在内的一些民主党人甚至都受到这一说法的影响。但这一说法既残酷又愚蠢，残酷在于社会安全福利一说，愚蠢在于联邦医疗保险一说。我们不应该让这个僵尸吃了我们的脑子。
First of all, you need to understand that while life expectancy at birth has gone up a lot, that’s not relevant to this issue; what matters is life expectancy for those at or near retirement age. When, to take one example, Alan Simpson — the co-chairman of President Obama’s deficit commission — declared that Social Security was “never intended as a retirement program” because life expectancy when it was founded was only 63, he was displaying his ignorance. Even in 1940, Americans who made it to age 65 generally had many years left.
首先，你应该明白，虽然人们出生时的预期寿命已大大提高，但这和我们这里所说的问题无关。有关的是那些已达或将至退休年龄的人们的预期寿命。这里有一个例子，当奥巴马总统成立的削减赤字委员会的联合主席艾伦·辛普森(Alan Simpson)宣布社会安全福利“从来都不是一个退休计划”，因为当社会安全福利初创时，人均预期寿命只有63岁，他只是显露了他的无知。即使在1940年，65岁的美国人也通常还能活很多年。
Now, life expectancy at age 65 has risen, too. But the rise has been very uneven since the 1970s, with only the relatively affluent and well-educated seeing large gains. Bear in mind, too, that the full retirement age has already gone up to 66 and is scheduled to rise to 67 under current law.
现在，65岁人的预期寿命也已增加。但自20世纪70年代起，这种增加一直不均衡，只有相对富裕、受教育程度良好的人群增寿较多。还要记住一点，我们的完全退休年龄已经提高到了66岁，并且根据现有法律还将再提高到67岁。
This means that any further rise in the retirement age would be a harsh blow to Americans in the bottom half of the income distribution, who aren’t living much longer, and who, in many cases, have jobs requiring physical effort that’s difficult even for healthy seniors. And these are precisely the people who depend most on Social Security.
这意味着，进一步提高退休年龄对于位于收入分配底层那一半人来说将是沉重的打击，这些人不会再活很久，在很多情况下，他们职业所需的体能付出甚至对健康的老年人都颇为不易。而这些人恰恰是最依赖于社会安全福利的人。
So any rise in the Social Security retirement age would, as I said, be cruel, hurting the most vulnerable Americans. And this cruelty would be gratuitous: While the United States does have a long-run budget problem, Social Security is not a major factor in that problem.
所以，如我所说，提高社会安全福利规定的退休年龄将是残酷的，会伤及这个国家最脆弱的人群。而且这种残酷没有必要。美国的确有一个长期的预算问题，但是社会安全福利并非这一问题中的主要因素。
Medicare, on the other hand, is a big budget problem. But raising the eligibility age, which means forcing seniors to seek private insurance, is no way to deal with that problem.
另一方面，联邦医疗保险则是一个不小的预算问题。但是提高享受保险的年龄必将迫使老年人购买私人保险，这丝毫解决不了问题。
It’s true that thanks to Obamacare, seniors should actually be able to get insurance even without Medicare. (Although, what happens if a number of states block the expansion of Medicaid that’s a crucial piece of the program?) But let’s be clear: Government insurance via Medicare is better and more cost-effective than private insurance.
的确，多亏了奥巴马医改(Obamacare)，老年人即使没有联邦医疗保险也能享受医保。（然而，如果多个州阻止此计划的核心：联邦医疗补助[Medicaid]，那怎么办？）但是必须说明：通过联邦医疗保险计划提供的政府保险要优于私人保险且花费更少。
You might ask why, in that case, health reform didn’t just extend Medicare to everyone, as opposed to setting up a system that continues to rely on private insurers. The answer, of course, is political realism. Given the power of the insurance industry, the Obama administration had to keep that industry in the loop. But the fact that Medicare for all may have been politically out of reach is no reason to push millions of Americans out of a good system into a worse one.
在那种情况下，你可能会问，为什么医改不将联邦医疗保险的范围扩大到每一个人，而是建立一个依赖于私营保险机构的机制。答案当然是政治现实主义。鉴于保险行业的雄厚实力，奥巴马政府必须让他们参与医改。但事实是普及联邦医疗保险到每一个人在政治上不可行，因此没有道理让数以百万计的美国人退出一个好的体系，而加入一个更糟糕的体系。
What would happen if we raised the Medicare eligibility age? The federal government would save only a small amount of money, because younger seniors are relatively healthy and hence low-cost. Meanwhile, however, those seniors would face sharply higher out-of-pocket costs. How could this trade-off be considered good policy?
如果我们提高享受联邦医疗保险的年龄，情况会怎样？因为较低龄的老年人相对更健康，花费不多，因此，联邦政府只能省一笔小钱。然而同时，这些老人会面对剧增的现金支出。这样的权衡结果能算是良策吗？
The bottom line is that raising the age of eligibility for either Social Security benefits or Medicare would be destructive, making Americans’ lives worse without contributing in any significant way to deficit reduction. Democrats, in particular, who even consider either alternative need to ask themselves what on earth they think they’re doing.
根本问题是，不论是提高享受社会安全福利的年龄还是提高联邦医疗保险的年龄都具有破坏性，使美国人生活更糟的同时却对于减赤没有太大助益。民主党人，特别是那些考虑其中任何一项举措的民主党人，都需要问问自己，他们到底在做什么？
But what, ask the deficit scolds, do people like me propose doing about rising spending? The answer is to do what every other advanced country does, and make a serious effort to rein in health care costs. Give Medicare the ability to bargain over drug prices. Let the Independent Payment Advisory Board, created as part of Obamacare to help Medicare control costs, do its job instead of crying “death panels.” (And isn’t it odd that the same people who demagogue attempts to help Medicare save money are eager to throw millions of people out of the program altogether?) We know that we have a health care system with skewed incentives and bloated costs, so why don’t we try to fix it?
但是反赤字派人士会问，像我这样的人将对增加的支出做何建议？答案是其它发达国家怎么做，我们就怎么做，同时努力控制医疗支出。应赋予联邦医疗保险对药价的议价能力。让独立支付顾问委员会(Independent Payment Advisory Board)行使职责，而不是挂着“死亡陪审团”(death panels)的名声。独立支付顾问委员会是奥巴马医改的一部分，意在帮助联邦医疗保险控制开支。（那些鼓吹采取措施为联邦医疗保险节省开支的人，同时却要将数以百万计的人踢出这一计划，这难道不奇怪吗？）我们知道，我们的医疗保障体系有着扭曲的激励体制和臃肿的开支，那么我们为什么不想办法改进它呢？
What we know for sure is that there is no good case for denying older Americans access to the programs they count on. This should be a red line in any budget negotiations, and we can only hope that Mr. Obama doesn’t betray his supporters by crossing it.
我们可以确信的是，拒绝老龄美国人享受他们所依靠的社会安全福利和联邦医疗保险不是好事。这在任何预算讨论中都应该视为红线禁区，我们只能寄希望于奥巴马不会背叛他的支持者而越过这条红线。
翻译：曹莉
