[The financing of Social Security. Social Security and the social budget of the Nation].
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Women age sixty-five and over now constitute about three fifths of the elderly population. They live longer than men and over time that longevity gap is increasing. Yet their income in later years is woefully inadequate. Poverty status is greater for elderly women than for elderly men; over half of aged women in poverty are widows. This paper describes the social security program, the cornerstone of our retirement income, and the lack of congruence of its provisions with contemporary social roles of women. It analyzes alternative proposals of two-tier, double decker and homemaker benefits, and earnings sharing, and their possible impact on women's economic status. It recommends improvements for this transition period while more basic structural reform is under discussion. Reform based on societal consensus could increase equity of treatment and adequacy of benefits for women. It is an essential prelude to consideration of long range financing needs of social security.
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Social Security's core protections must be maintained, according to this author. He believes that by creating universal savings accounts and investing a small portion of the Social Security trust fund in equities, it is possible to secure the long-term future of Social Security without subjecting workers to the risks of individual, private accounts.
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Social Security Disability Insurance is a federally created and regulated insurance plan. The definition of disability as it relates to work capacity is exclusively the purview of government administrators. The primary physician's opinion has little, it any, impact on decision. Administering this insurance scheme requires the quantification of illness as it relates to work capacity (disability). What has evolved is a program that insures for the amount of "disease." The assumption is that with more disease, there is a greater likelihood of illness, even illness manifest as work incapacity. Leaving this underlying assumption tacit is responsible for the adversary climate that envelops the physician, the patient-claimant, and the administrators. It is also responsible for the paucity of clinical investigations into the critical issue of the amount and form of illness a diseased person will have.
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The Social Security Amendments of 1977 resulted in substantial improvement in the current and projected financial condition of the OASDI program. This article reviews the causes of the recent operating deficits, describes the effects of the amendments that most influence the program's financial status, and gives projections of income and expenditures under the new law. The revised benefit formula eliminates the "over-indexing" expected to occur under the old provisions and results in stable earnings-replacement ratios under practically all future economic conditions. About one-half of the long-range actuarial deficit was resolved by this step alone. Increases in the contribution and benefit base, along with tax-rate reallocations and increases, prevent the imminent depletion of the OASI and DI trust funds. Increased income due to the higher wage bases is partially offset in later years, however, by greater benefit payments based on the increases in the coverage of total earnings. Overall, under the new law the OASDI program is projected to be financed adequately for about 50 years but significant operating deficits are expected after that. The financial condition of the hospital insurance program was substantially unchanged by the amendments, however, and the HI trust fund is expected to be exhausted in 1988.
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The present study, fourth in the national literature about general psychiatric epidemiology, refers the experience of a social security system through the study of a sample obtained in a year of work of an important neurologic and psychiatric clinic of this system, studying relevant characteristics of 1 054 subjects in a total 7 102 acute and chronic psychiatric patients, showing a prevalence of 180 per 100 000 habitants. We found 36 different psychiatric disorders, most of them psychoneurotic in ambulatory patients and psychotic forms in hospitalized. The last ones made the 0.022% of the total sample. The biggest frecuency is made by young adults with moderate predominance of females than males. The sample is formed near the 10% by patients of 26 states of Mexican Republic. The period of major frecuency are the months of vacations of government workers, most of them of Public Education Secretary (Secretaría de Educación Pública). We comment some epidemiological articles of Mexican medical literature concerning psychiatric disorders and some socioeconomic and cultural characteristics of mental pathology in our country.
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