First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
While public expenditure on health care and long‐term care (LTC) has been monitored for many years in European countries, far less attention has been paid to the financial consequences for older people of private out‐of‐pocket (OOP) expenditure necessary to access such care. Employing representative cross‐sectional data on the elderly populations of 11 European countries in 2004 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we find that OOP payments for health care and LTC are very common among the elderly across European countries and such expenditures impact significantly on disposable income: up to 95 per cent of the elderly make OOP payments for health care and 5 per cent for LTC, resulting in income reductions of between 5 and 10 per cent, respectively. Failure to prevent financial ruin, as a consequence of excessive OOP payments, is evident in 0.7 per cent of elderly households utilizing health care and 0.5 per cent of elderly households utilizing LTC. Those particularly concerned are the poor, women and the very old.
This article takes a critical view of the United Kingdom government's design for the delivery of the Universal Credit (UC) benefit reforms. It is argued that the UC is destined to fail because of the policy's extension into specifying the means (“digital by default”) of delivery for such services. The authors argue that an unseen but ubiquitous set of “scale” management assumptions has been allowed to infiltrate the means by which the government intends to enact its headline policy objective to “make work pay”. Following Seddon's “Vanguard Method”, a practical example of how a better service was designed in a local authority housing benefits service is then examined. Results from this service include being able to deal with up to 50 per cent more demand, with fewer resources, in half the official target time. Finally, the article will conclude with a call for more evidence‐based policy.
This article assesses the effectiveness of pension provision and health insurance in preventing ill health among older people in developing countries. It argues that, until recently, social protection agendas devoted insufficient attention to health risk prevention, instead focusing on the reduction of income poverty through cash transfers. The article shows that there is little reliable evidence to indicate that providing older people with pension benefits enhances their health status and that these effects should not be taken for granted by policy‐makers. The article then focuses on the effect of inclusion in health insurance schemes on health outcomes for older people, with specific reference to outcomes related to hypertension. Drawing on newly‐available data from the World Health Organization for Ghana, Mexico and South Africa, it shows that older people with health insurance are marginally more likely to be aware of health conditions such as hypertension and more likely to have them under control. Nevertheless, the great majority of hypertensive older people, insured or uninsured, are not effectively treated. The chief barriers to treatment are shown to be mainly related to awareness and service provision, rather than financial ones. Consequently, the capacity of pensions or health insurance to enhance health outcomes for older people in such countries, including in rural areas, is heavily contingent upon health education, health screening and adequate health service provision. These interventions should be viewed as an integral element of mainstream social protection strategies, rather than adjuncts to them. Yet, in practice, social protection and health promotion continue to be treated as almost entirely separate spheres, thus presenting substantial institutional barriers to developing combined interventions.
An important contribution to preventing social insecurity can be made by strong social security programmes that promote collective as well as personal security: in particular, they act as built‐in automatic stabilizers with social and political as well as economic benefits for the whole society. By contrast, weaker systems have a destabilizing effect built in that reduces their preventive effectiveness. The ways in which social security systems can contribute to preventing social and economic insecurity have become less effective in many countries. Reasons for the relative neglect of prevention are considered together with the changes that have weakened systems' preventive elements specifically. The structural context within which social security policies have to work, particularly the quality and quantity of employment as well as the interaction with other public programmes, has of course a major effect on their ability to prevent. There is still much that can be achieved by schemes with closer attention directed to what is needed to prevent insecurity. Proposals to strengthen the preventive contribution in social security programmes are offered to promote greater debate of these issues and to restore the goal of prevention as a central objective.
Preventing social exclusion has become a critical issue in the European Union (EU) as a result of cutbacks in social expenditure imposed by Member States’ exploding debt. This issue sits at the intersection of employment and training policies and of reforms seeking to adapt social protection systems to the new realities of the present socio‐economic context (population ageing, family instability, massive unemployment, employment insecurity, in‐work poverty and persistent and increasing social inequality). This article will show that promoting social protection as part of a social investment approach is an excellent means of reconciling the objectives of equal opportunity over the life cycle, sustained economic performance (improved structural competitiveness) and strengthened social cohesion in the interest of collective well‐being. Particular emphasis is given to the need to promote universal and individual rights to mobility and lifelong training, which would constitute new social guarantees, offsetting requirements linked to labour market flexibility. The article also emphasizes the importance of incorporating these rights throughout the EU as part of a wider social protection floor. This would offer permanent protection against the risk of exclusion in the Union, promote the economic and social integration sought since the revised Lisbon Strategy (2003‐2005), and create confidence and hope among Europe's citizens.
Nigeria has a predominantly youthful population and limited job opportunities in the formal labour market, which makes the search for formal employment difficult and can be conducive to the growth of exploitative working conditions. As one response to address the vulnerability of Nigerian workers, the Employee's Compensation Act was passed into law in December 2010. Of note, the Act includes provisions for compensation for mental health injuries, or “mental stress”, suffered in the course of employment. The article examines the strengths and weaknesses of the provisions, in particular the premise for mental health injury claims made in the Act. The wider policy implications of the Act as regards the development of compensation for mental health injuries in sub‐Saharan Africa are discussed and suggestions for the future review of the Act offered.
The informal workforce is growing worldwide, and changes in the global structure of employment and in places of employment mean that work is a source of hazard and ill‐health for many poorer workers. Yet informal workers do not have access to work‐related social security. They face high work‐related risks, but have little or no access to reliable formal or informal social protection. Citizen‐focused social security programmes, such as cash transfers, do not give enough attention to the needs of able‐bodied adults who work. Further, informal workplaces are not covered by the traditional discipline and practice of occupational health and safety (OHS), which is a necessary component of overall work‐related social security. In particular, poorer informal workers are ill‐placed to make use of possible preventive interventions, as they may lead to loss of income in the short term. A more inclusive approach will require changes in the institutional arrangements governing OHS, and should involve especially local authorities and informal worker organizations, who are developing influential international sectoral networks. In this regard, promising examples of negotiated and inclusive OHS policy reforms are presented. The broader challenge is to develop an expanded OHS that specifically includes informal workers as “workers”, rather than as “vulnerable citizens” who qualify only for poverty‐oriented social protection programmes, and that explicitly addresses preventive measures.
Early retirement schemes and disability insurance in the Netherlands have undergone several reforms in recent decades. The reforms have increased incentives for older workers to continue working and have decreased the roles of “substitute pathways” into retirement. This article gives an overview of the reforms and, using administrative data for workers in the health care sector, tests a number of hypotheses about the labour market participation of older workers. The results offer two main findings: i) that the Dutch reforms have indeed been effective, as the labour force participation rate of older workers has increased; and ii) the concept of “substitute pathways” has become less relevant as the use of disability insurance has been closed off as an exit route to early retirement. Nevertheless, caution is required before generalizing the implications of these Dutch findings to other OECD countries.
Using an inventory of local and/or non‐statutory transfers (droits connexes) in 13 French towns and cities, the article first measures the gains from returning to work for recipients of national, statutory means‐tested benefits (Revenu minimum d'insertion— RMI, and Allocation parent isolé— API) by type of household before 2009. The reforms of national, statutory benefits carried out during the 2000s, especially those affecting the working tax credit (Prime pour l'emploi— PPE), failed to ensure that the recipients of means‐tested benefits always stood to gain financially from returning to work. The effects of the reforms were offset by the effects of other measures. The article then simulates the effects of the introduction of the Revenu de solidarité active (RSA) in place of the RMI in 2009, and takes into account the way that local and/or non‐statutory transfers are modified by increases in national, statutory transfers. We observe that the RSA eliminates the financial disincentives to returning to work for almost all localities and types of household. The article shows that the marginal tax rate of 38 per cent chosen by the government is very close to the upper limit compatible with a back‐to‐work incentive.
This article analyses the risk of disability facing workers who contribute to the Argentinian Integrated Social Security System (Sistema Integrado Previsional Argentino— SIPA). Using administrative records as our source of data for the period 2000‐2006, the results indicate that 1.46 workers per 1,000 became disabled annually during that period. The risk of disability rates were higher for men than for women, but increased with age for both sexes. The risk of disability rates have also been broken down by pathology and social security scheme, taking the effects of age and sex into account. To conclude, international comparisons are presented.
The aim of this article is to offer detailed information of the redistributive impact of social transfer programmes and taxes in 28 Member countries of the Organisation for Economic Co‐operation and Development, employing data that have been computed from the Luxembourg Income Study's micro‐level database. We find that welfare states on average reduce inequality by 35 per cent. Social benefits have a much stronger redistributive impact than taxes. As far as social programmes are concerned, public pensions account for the largest reduction in income inequality, although the pattern is diverse across countries. To a lesser extent, social assistance, disability and family benefits also contribute to smaller income disparities.
In 1997, Hungary and Poland led Central Europe in partially privatizing their national pension systems, diverting a portion of public pension contributions to privately‐managed individual investment accounts. In the aftermath of the global economic crisis, both governments retrenched these second‐tier schemes: Hungary (December 2010), by ceasing to fund the accounts and recouping most workers' existing balances; and Poland (April 2011), by reducing the diversion of contributions to the second tier. The factors that drove these retrenchments are traced to the original 1997 second‐tier designs, which omitted key specifications related to financing the accounts, private benefit design, and the regulation of private management fees. While both governments tried to compensate for the missing design specifications during implementation, the results were limited. By reducing investment returns and raising borrowing costs, the global economic crisis brought the problems to a head. The conclusion highlights some outstanding issues whose resolution will shape the retrenchments' long‐term impacts.
Using micro‐data for the year 2007, this article analyzes the effectiveness of Luxembourg's minimum guaranteed income (revenu minimum garanti — RMG) social assistance programme. First, we examine the effectiveness of the RMG by comparing the proportion of eligible households based on the different criteria for the years 2007 and 1986, and find that, in 2007, 5.5 per cent of households were eligible versus 3.75 per cent in 1986. A relaxation of the RMG's eligibility criteria implies that more low‐income households should have access to the RMG. As a second measure of programme effectiveness, the article estimates the extent of non‐takeup behaviour among those eligible for the RMG in 2007. It is found that just over 65 per cent of all households potentially entitled to the RMG do not claim. Regression analysis of the potential determinants of non‐takeup behaviour confirms the hypotheses derived from theoretical models in the literature, i.e. that rational motivation, such as the expected net utility from claiming, and stigma, play a major role in explaining levels of non‐takeup.
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.
This article examines the timing of the introduction of four major social security programmes — work accident insurance, sickness benefits, pensions, and family allowances — in 43 African countries. Further, it explores whether legislative structure, dominant religion or the colonial past of the country is of importance when we control for year of independence, prosperity, degree of democracy, government stability, industrialization and the size and ethnic homogeneity of the population. On the basis of Cox hazard rate modelling it is concluded that industrialized, homogeneous and rather populous countries that were under French rule tend to be pioneers in African social security legislation.
In 2009, Argentina introduced a new transfer programme for children and adolescents younger than age 18 (Universal Child Allowance) that extended coverage under the contributory programme for family allowances to include families in the informal economy and families of unemployed persons. This article describes this innovative programme, compares it with similar programmes in Latin America and analyses its impact on coverage and its possible effects on the welfare of the population. The results indicate that the extension of access to this type of benefit has reduced considerably the coverage gap for the poor and indigent and supports efforts to consolidate the operations of different and poorly coordinated transfer programmes.