First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
In an effort to establish universal health coverage (UHC), Senegal set up two departmental health insurance units (UDAM) to scale-up health insurance to rural communities. Part of this innovation meant that health insurance was longer managed by volunteers, but by professionals. Several years after the conclusion of the project in 2017 that supported their initial development, both UDAMs still operate successfully. This mixed methods research aims to understand the factors that have contributed to the sustainability of both UDAMs, as well as discuss the remaining challenges. The factors deemed favourable to sustainability are actions undertaken to ensure financial stability and organizational risk taking. However, the mobilization of the population, relationships with health professionals and the role of the State have been more difficult to organize. Challenges concern the payment of subsidies and the supply of medicines by the State and partnership with the health care system, the maintenance of contributions, the digitalization of administration, as well as fraud and abuse.
This special issue selectively addresses the relationship linking social security systems, inclusive growth and social cohesion. Inclusive growth and social cohesion are viewed as political expedient and necessary goals for national economies. The desirability of their attainment reflects political pragmatism, the “social contract”, as much as it does a commitment to the wider emancipative goal of social justice. The International Social Security Association (ISSA) has often paraphrased these assertions to argue that there can be “no social justice without social security”. Of course, progress achieved towards the realization of the goals of inclusive growth and social cohesion should be equally beneficial for the adequacy, sustainability and coverage of social security systems. The aim of this special issue is to unpack and better understand the nature of this relationship.
Social protection and revenue collection are often regarded as potential drivers of social cohesion. The article joins this debate, providing three main contributions. First, we carefully discuss the concept of social cohesion and endorse one specific definition. Second, we propose using the concept of the “fiscal contract” as the key theoretical lens to understand the often neglected potential joint effects of social protection and revenue collection policies on social cohesion. Third, we illustrate three main mechanisms through which these policies can have positive or negative impacts on the different components of social cohesion and highlight how relevant it is for policy-makers to carefully think about these.
China has adopted an array of special social security measures in response to the spread of the COVID-19 virus, to mitigate the downside social and economic impacts caused by the pandemic. Measures include the reduction, exemption and deferral of social security contributions by employers, the extension of benefits coverage for employees, and the provision of more accessible e-services by social insurance agencies. The article points out that a preliminary assessment of those measures would suggest that they have played a key role in supporting social cohesion and in stabilising the economy. In a critical manner, the article compares the measures adopted in China with those of other countries, and identifies how China could learn from international practice and experience. Finally, and based on recent Chinese experience, the article presents proposals that seek to improve the longer-term contribution made by the Chinese social security system to realise the goals of social cohesion and inclusive economic development. As set out in China’s Social Insurance Law of 2010, the social security system should not only support a fair sharing of benefits of development, but also promote social harmony and stability.
The expansion of social assistance in low- and middle-income countries raises important issues for inclusive growth. Labour is by far the principal asset of low-income groups. Changes in the quantity, quality, and allocation of labour associated with social assistance will impact on the productive capacity of low-income groups and therefore on inclusive growth. The article re-assesses the findings reported by impact evaluations of social assistance in low- and middle-income countries to address this issue. Most studies have tested for potentially adverse labour supply incentive effects from transfers but have failed to find supportive evidence. The article highlights findings from this literature on the effects of social assistance on human capital accumulation and labour reallocation. They point to the conclusion that well-designed and well-implemented social assistance contributes to inclusive growth.
Mongolia achieved high population coverage under mandatory health insurance relatively quickly. This fact was viewed by policy- and decision-makers as a central issue for health financing reform in Mongolia. Health insurance brought many new features for health service planning, provision, funding and resource management. Based on initial achievements, health insurance came to be strategically considered as the vehicle for achieving universal coverage. The article analyses developments in Mongolia's health insurance over the last decade along with the core policy dimensions of Universal Health Coverage. It examines various reform approaches and the numerous amendments to laws that have been implemented during this period and discusses new opportunities as well as challenges. The analytical review and findings discussed suggest that Mongolia has a need for evidence-based policy decisions and informed political support, with health insurance backed by robust institutional and administrative capacities. More generally, it also emphasizes that health policy goals and objectives can be attained by strengthening and making transparent and publicly-accountable all health system financing functions and arrangements. The policy analysis, experiences, lessons and proposed strategies presented with regard to Mongolia intend to stimulate wider discussions on health insurance development as well as promote continuing focused research on specific aspects of health insurance and public financing reform.
Owing to a favourable economic situation and to national labour market and social protection policy reforms, Latin America has witnessed significant progress in social protection coverage extension. Some countries, however, have seen weaker progress, with stagnant coverage levels. Several factors underlie the extension of pensions and health care coverage and the increased formalization of the labour market: substantial improvements in the quality of employment, more flexible eligibility criteria for contributory coverage, and the strengthening of the supervisory and regulatory roles of the State. This article first addresses the link between social protection and informality in Latin America to show the relationship between informal labour markets, the lack of social protection and the scale of unpaid contributions. Also highlighted is regional progress in extending social protection as a result of labour market formalization. Countries in the region have used various policies to encourage formalization and these have also helped to reduce wage inequalities, since formalization has had especially beneficial effects on low-income sectors. Finally, we discuss controversial and diverging views on social protection financing in the region. These views tend to favour non-contributory over contributory financing mechanisms and support proposals for limited coverage, but do not address the stratification of access to social protection. The move towards the alignment of benefits is deemed essential: strategies to universalize social protection in the region should not focus exclusively on increasing resources, but must address their form given that institutional change is a crucial part of the locus of innovation
In writing the overture to an issue on contribution financed social security one cannot but speak of Bismarck; it must also address Beveridge who saw contributions, although in their design and role clearly differently from Bismarck, as one core revenue tool to finance his vision. Beveridge attributed to the private financial sector a prominent role in securing people against the negative effects on income of shocks and crises, while Bismarck did not. Beveridge's concept, when first published, had, and still has today, the most attractive charm of rigorously satisfying peoples' striving for equitable and inclusive societal solutions. Bismarck's concept intrinsically offers income security only to those who contribute, while the level of protection depends on the level of contributions paid (with the exception of health insurance). In reality, both concepts, where implemented, had to face the realities of socio-economic and political developments: Beveridge's vision was achieved in respect of access to health services where his proposal, in its predominantly tax-financed version, has since turned into a worldwide blueprint for health schemes; in its other components, it was not resilient enough to achieve the intended standards and now is replete with means-tested (poor relief) elements. Bismarck's scheme has proven its potential to achieve "universality", not necessarily by theoretical design but as a matter of fact, i.e. covering people from cradle to grave (like Beveridgean schemes). With globalization, schemes of both origins have had to face massive neoliberal attacks over the last three decades. Which of the approaches is best able to survive must be left an open question: in the current worldwide context of rapid change, both have weak and strong points, and whether a symbiosis of the two offers the answer to future challenges remains to be seen.
This article addresses the link between pensions and occupational earnings using the example of social security contributions in selected OECD countries. The rules of the pension schemes studied point towards a very strong link between occupational earnings and pension level. However, certain pension calculation methods, through pension calculation parameters or through the existence of tools to compensate for certain career discontinuities, may distort this link in the majority of the countries studied. Therefore, the examination of pension calculation parameters and of solidarity measures attached to retirement is necessary to provide a more finely-tuned evaluation of the link between occupational earnings and pension level. Ultimately, comparison of pension systems across countries remains challenging given their specificities.
Social security contributions make up around a fourth of total tax revenue in OECD countries. However, there are concerns on the economic effects of high levies on labour. Recent studies suggest that at least a third of taxes on labour are shifted onto employers, leading to higher wage costs. We find substantial evidence in the literature that the nature of social security contributions matters. With a clear connection between contributions and rights, the employee will perceive this contribution as a price and not as a tax. As a consequence, these contributions will be less distortive in terms of labour supply, wage costs and private savings.
This article considers the implementation of a universal basic income, a neglected area in basic income research. We identify and examine three important practical bottlenecks that may prevent a basic income scheme from attaining the universal reach desired and proclaimed by its advocates: i) maintaining a population‐wide cadaster of eligible claimants ensuring full takeup; ii) instituting robust modalities of payment that reach all intended beneficiaries; and iii) designing an effective oversight mechanism in a policy context that actively opposes client monitoring. We argue that the implementation of universal basic income faces unique challenges that its proponents must consider carefully.
Most countries have separate pension plans for public‐sector employees. The future fiscal burden of these plans can be substantial as the government usually is the largest employer, pension promises in the public sector tend to be relatively generous, and future payments have to be paid out directly from government revenues (pay‐as‐you‐go) or by funded plans (pension funds) which tend to be underfunded. The valuation and disclosure of these promises in some countries lacks transparency, which may hide potentially huge fiscal liabilities to be passed on to future generations of workers. In order to arrive at a fair comparison between countries regarding the fiscal burden of their public‐sector pension plans, this article recommends that unfunded pension liabilities should be measured and reported according to a standard approach for reasons of fiscal transparency and better policy‐making. From a sample of Member countries of the Organisation for Economic Co‐operation and Development, the size of the net unfunded liabilities as of the end of 2008 is estimated in fair value terms. This fiscal burden can also be interpreted as the implicit pension debt in fair value terms.
Japan and the Republic of Korea achieved universal health insurance coverage for their populations in 1961 and 1989, respectively. At present, Japan continues to operate a multiple‐payer social health insurance system, while the Republic of Korea has moved to an integrated single‐payer national health insurance structure. This article analyzes the influence of political economy in shaping the policy divergence found between these two Bismarckian health insurance systems. Issues addressed include differences in political power, the policy influence of business, the extent to which regional autonomy has developed and regional traits have been preserved, the level of political democratization, the form of political leadership, and the scale of development of the health insurance system. The article offers policy lessons derived from the two countries' experiences.
One of the main challenges facing social policy in Latin American is to guarantee social security coverage for the entire population in the presence of a large informal sector. In Argentina, a regional pioneer in terms of the development of its pension system, more than one third of those of retirement age were without benefits in 2005. Since then, considerable progress has been made in extending coverage thanks to the introduction of a programme that has reduced contribution requirements and allocated benefits to a large number of seniors previously excluded from the system. This article analyzes the impact of this process in Argentina on the level and distribution of coverage, identifies changes in socio‐demographic factors which affect inclusion/exclusion in the social security system, and discusses remaining obstacles to the provision of universal coverage in the medium and long term.
The aim of this article is to establish basic guidelines to support the possible design of an information letter to be sent to individuals who contribute to the Spanish state pension system, should a decision ever be taken to adopt such an instrument. Basing our work on international experience and published research in the field, we look into the concept of “individual pension information” and identify its most relevant features. We then give detailed descriptions of two models for the provision of individual pension information (the United States and Sweden), looking in particular at how these are structured, what aspects could be improved and their limitations. Finally, we offer recommendations for the design of a model for Spain.
The COVID-19 pandemic has exposed the vulnerability of those who are inadequately covered by social protection in more and less developed countries alike, and has exacerbated the fragility of a social contract that was already under strain in many countries. A weak social contract in the context of an exceptional crisis poses a very real risk to social cohesion. Nevertheless, many States have reasserted themselves as the guarantor of rights by protecting public health and incomes. By sustaining these measures, economic recovery will be supported which will help minimize risks that may weaken social cohesion. However, this is a fast-moving, inherently unstable and protracted crisis. Social protection stands at a critical juncture. Decisive policy action will be required to strengthen social protection systems, including floors, as one of the cornerstones of a reinvigorated social contract.