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.
Georgia’s national social security system offers almost complete non-contributory basic pension coverage. The basic pension has, to date, proved effective in dealing with poverty. But Georgia’s fiscal constraints and ageing population also highlight the importance of improving the pension system, in order to ensure its sustainability. This article presents policy reform choices, which suggest that, in Georgia, pension reform might include increasing the statutory retirement ages and reducing the generosity of benefits through means testing. The case of the Georgian non-contributory basic pension might hold value for some low- and middle-income countries that are considering the implementation of, or expanding coverage under, a non-contributory pension programme.
In the first decade of transition, the Georgian social protection system experienced a major retrenchment as the government struggled to finance welfare provision in the face of massive economic contraction and the near collapse of public institutions. Since 2004, this trend has been reversed, with the economy returning to a fast growth path and public administration improving considerably. Recent reforms, including the notable introduction of universal public health insurance, are welcome steps towards building a modern welfare state. Major challenges still remain, however, especially in relation to the system’s limited effect on widespread poverty. Decelerating growth, the lack of strong pro-welfare actors, and the absence of positive external pull factors may stall or prevent future growth, but the changing nature of the social contract between the people and government, as well as Georgian politicians’ growing recognition of the importance of the welfare system for inclusive growth, leaves ample space for optimism.
In many countries the regulations governing survivors’ pensions were established in periods when female labour market participation was lower than at present. However, the current trend in many Latin American countries is for growing levels of female labour participation. In Brazil, where there are no restrictions on the concurrent receipt of retirement and survivors’ pensions, and where until recently lifelong pensions could be obtained without any conditionality, not only has the accumulation of such benefits grown, but there are indications that these rules have had a negative impact on women’s labour market participation. Analysis of the case of Brazil shows the need for social security regulations to adapt to labour market changes, and underlines the need to acknowledge that social security regulations can actually have an impact on the labour market.
The possession and use of a personal social security number helps to structure people’s daily lives. However, despite its fundamental normative importance, the social security number remains a little-known entity. Increasingly universal and yet diverse in form, it is a legal and technical norm which is as much a mechanism for surveillance and monitoring as it is a necessary instrument for giving effect to social rights. Analysis of this constituent element of social security systems permits as assessment of some of the technical difficulties presented by the ever-increasing movement of people and data. Overcoming these technical difficulties should permit to envisage a first technical step towards realizing a universal and global social security system.
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.