Does government spend too little or too much on child care? How can education dollars be spent more efficiently? Should government's role in medical care increase or decrease? In this volume, social scientists, lawyers, and a physician explore the political, social, and economic forces that shape policies affecting human services.

Four in-depth studies of human-service sectors - child care, education, medical care, and long-term care for the elderly - are followed by six cross-sector studies that stimulate new ways of thinking about human services through the application of economic theory, institutional analysis, and the history of social policy.

This timely study sheds important light on the tension between individual and social responsibility, and will appeal to economists and other social scientists and policymakers concerned with social policy issues.

"Defensive medicine" is a potentially serious social problem: if fear of liability drives health care providers to administer treatments that do not have worthwhile medical benefits, then the current liability system may generate inefficiencies many times greater than the costs of compensating malpractice claimants. To obtain direct empirical evidence on this question, we analyze the effects of malpractice liability reforms using data on all elderly Medicare beneficiaries treated for serious heart disease in 1984, 1987, and 1990. We find that malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications. We conclude that liability reforms can reduce defensive medical practices.

Studies in the Economics of Aging is the fourth book in a series from the National Bureau of Economic Research that addresses economic issues in aging and retirement. Building on the research in The Economics of Aging (1989) , Issues in the Economics of Aging (1990), and Topics in the Economics of Aging (1992), this volume examines elderly population growth and government spending, life expectancy and health, saving for retirement and housing values, aging in Germany and Taiwan, and the utilization of nursing home and other long-term care.

Japanese and American economists assess the present economic status of the elderly in the United States and Japan, and consider the impact of an aging population on the economies of the two countries.

With essays on labor force participation and retirement, housing equity and the economic status of the elderly, budget implications of an aging population, and financing social security and health care in the 1990s, this volume covers a broad spectrum of issues related to the economics of aging. Among the book's findings are that workers are retiring at an increasingly earlier age in both countries and that, as the populations age, baby boomers in the United States will face diminishing financial resources as the ratio of retirees to workers sharply increases.