Moody H R
Brookdale Center on Aging of Hunter College, New York, NY 10010.
J Med Philos. 1988 Feb;13(1):31-56. doi: 10.1093/jmp/13.1.31.
In recent years, critics have argued that, when inter-generational transfer programs such as Medicare are judged by the standard of "generational equity", these programs are seen to be unfair. It is argued that, under a pay-as-you-go system, future generations are committed to burdens without their consent; that claims are not contractually guaranteed; that early entrants reap windfalls gains; that successive cohorts are tempted to provide insupportably high benefit levels; and, finally, that fluctuations leave future generations at unacceptable risk. Attempts have been made to defend social insurance programs by means of a "lifespan prudential model" of age-group resource allocation, but this defense does not adequately take account of uncertainties and inequities faced by historical birth cohorts. A deeper defense must acknowledge an element of risk-sharing and solidarity while trying to limit inequities within reasonable bounds.
近年来，批评者认为，当诸如医疗保险这样的代际转移项目以“代际公平”标准来评判时，这些项目被视为不公平。有人认为，在现收现付制下，后代在未经其同意的情况下承担负担；权益没有合同保障；早期参与者获得意外之财；后续各代人倾向于提供高得难以承受的福利水平；最后，波动使后代面临不可接受的风险。人们试图通过年龄组资源分配的“生命周期审慎模型”来为社会保险项目辩护，但这种辩护没有充分考虑历史出生队列所面临的不确定性和不公平性。更深入的辩护必须承认风险分担和团结的因素，同时试图将不公平限制在合理范围内。
