National Social Security System Research Articles

Quality assurance in ENT tumor surgery

Quality control is of special importance in head and neck oncology since the quality of medical care constitutes a vital parameter for the diseased patient. In contrast to other medical specialties, no quality assurance program for head and neck cancer patients has yet been established in Germany. Therefore, a survey was conducted to assess the quality assurance instruments that are in use today in otorhinolaryngology-head and neck (ORL-HNS) centers. In a nationwide survey, questionnaires were sent out to 146 German ORL-HNS departments (the return rate was 75%). 56% of all departments apply dedicated quality assurance processes, and 38% have appointed a formal quality assurance officer. Interdisciplinary oncological conferences are held in the vast majority of all departments with the participation of radiation oncologists in 86 (78%), medical oncologists in 84 (76%), diagnostic radiologists in 82 (74%), and pathologists in 73 (66%). Morbidity-mortality conferences are held in seven departments (6%). A standardized follow-up of oncological patients is carried out in 95 units (86%), and 53 departments use computer-assisted data bases to organize their follow-up data (48%). A wide variety of documentation systems is in use throughout the country: 78 units (71%) offer formal follow-up to their oncological patients. This survey documents a wide-spread interest in quality assurance procedures. Many individual efforts are being undertaken. However, no uniform quality assurance or auditing system is currently in use in Germany nor is a commonly accepted data base available. The ability to offer oncological follow-up within the national social security system is generally considered indispensable for the maintenance of high-quality oncological care in ORL-HNS departments.

“An Ambitious Venture”: Commentary on “A Global Ranking of National Social Security Systems”

International Social Security ReviewVolume 53, Issue 4 p. 131-134 “An Ambitious Venture”: Commentary on “A Global Ranking of National Social Security Systems” Michel Voirin, Michel Voirin Social Security Department, International Labour OfficeSearch for more papers by this author Michel Voirin, Michel Voirin Social Security Department, International Labour OfficeSearch for more papers by this author First published: 19 December 2002 https://doi.org/10.1111/1468-246X.00108AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume53, Issue4December 2000Pages 131-134 RelatedInformation

Sistemas de seguridade social na América Latina: uma avaliação ordinal

Este artigo amplia a literatura comparativa de sistemas de seguridade na América Latina através da incorporação da dimensão avaliativa. Seu objetivo é a classificação dos sistemas de seguridade nos 36 países latino-americanos utilizando uma metodologia que possibilita uma avaliação do modelo estatutário do sistema de cada país. A conclusão mostra que a região com os melhores modelos é a América Central, marginalmente à frente da América do Sul. Os melhores sistemas nacionais de seguridade na América Latina estão na Bolívia, Uruguai, Brasil, Nicarágua e Argentina. Observam-se programas de nível mundial no Brasil, Argentina, Chile, Peru e Nicarágua.

The Consequences of European Monetary Union on Collective Bargaining and the National Social Security Systems

There is no indication that the European Monetary Union (EMU) will increase labour mobility within the euro area. Even if the social partners are still responsible for collective agreements on wages at national level, the introduction of a single currency has already compelled trade unions to coordinate national wage policies and will increasingly continue to do so. In certain Member States compliance with the convergence criteria for admission to monetary union entailed measures aimed at cutting excessive budget deficits. It was just as inevitable that such restructuring of public finances would have repercussions on the development of social costs, owing to their high proportion in relation to total budgetary expenditure in the Member States.

A Global Ranking of National Social Security Systems

There has been a very evident growth in descriptive and analytical comparative social security research over the past 40 years, but only Kaim‐Caudle has taken up the epistemological and methodological challenges of thecomparative evaluation of social security systems. The purpose of this paper is to rank social security systems in 172 countries using a comparative evaluation methodology that enables an assessment to be made of a country’s statutory social security intention. The conclusion drawn is that while seven of the ten best designed social security systems in the world can be found in western Europe, Australia has the best‐designed one.

How do retirement tests affect the labour supply of older men?

We analyze the sequential elimination of retirement/earnings tests from Canada's public pension plans. Our empirical framework potentially overcomes the obstacles encountered analyzing the tests within the context of a national social security system. Our results indicate that the removal of the tests were associated with relatively large shifts from part year full time to full year full time work. We are unable to reconcile these results within the context of a traditional labour supply model. Instead, they are consistent with a model which incorporates fixed costs of work, or labour market rigidities which preclude continuous reductions in labour supply around retirement.

La lente construction des systèmes de retraite en France de 1750 à 1945

The slow building up process of retirement pension systems in France from 1750 to 1945 Little research work has been done on retirement pension issues before 1945, date on which the French Social Security system was implemented. This article aims at tracing back from 1750 to 1945 the way which has led to the establishment of the National Social Security System. Over those hundred and fifty years, French retirement pension systems have been characterised by a strong diversity and been exclusively oriented towards a contributory pension system approach.

Public Insurance and Mobility: An Exploratory Analysis in the Context of European Economic Unification

Many studies on the future of social security systems in a unified Europe treat the issue as merely a particular aspect of the broader question of redistribution within a federation with mobile agents. As a result, such studies typically recommend their gradual centralisation. This paper which is based on the model of Rothschild, Stiglitz and Wilson adopts a much less categorical approach, emphasising the need to clarify whether social security systems principally seek insurance or redistribution. In this analytical framework competition between public insurance systems can generate efficiency. It can also remain compatible with cross-subsidisation if the proportion of low risks is sufficiently large. The result depends on the relative proportion of high risks, on the goals of the national social security systems, and on their behaviour when competing with each over.

Health indicators and the organization of health care systems in western Europe.

This study investigated the association between health care systems and health indicators in developed countries. Cross-national comparisons were conducted with regression analysis between 17 Western European countries with two types of health care systems: national health services and social security systems. Health care expenditures were inversely correlated to potential years of life lost to females and to infant mortality rates; they were positively correlated to life expectancy for females. Regression models predicted that countries with national health services systems would have lower infant mortality rates at similar levels of gross domestic product (GDP) and health care expenditures. Finally, increases in health care expenditures would decrease the ratio of observed to predicted infant mortality rates according to GDP; this decrease would be greater in countries with national health services than in those with social security systems. The model predicted this difference to be about 13% at average levels of health expenditures. National health services seem to be more efficient at producing lower infant mortality rates than social security systems in Western European countries.

Principles and practice of social security payments for care

This article examines the dimensions which determine whether national social security systems make payments towards the costs of long‐term care needs and whether they do so where these needs are met within the family; what kinds of payments are made and to whom; and what levels these payments are set at. The article is based on empirical material from five European Union countries (the United Kingdom, Ireland, France, Italy and Germany). We argue that differences between countries along three dimensions account for most of the diversity between national systems in this field. These dimensions are the allocation of responsibilities and powers to local versus central levels of government; assumptions of to whom long‐term care represents a “risk”; national principles of subsidiarity and the relationship between the family and the State. This is, however, a field undergoing change (albeit mostly incrementalist and ad hoc) in the face of the demands placed on social welfare systems by growing levels of disability (related to the growth of elderly populations) and demands from women's movements and disability movements for recognition of their needs within social welfare systems.

Towards A Professional Rationalization.

I The French Health Care Financing And Delivery System FINANCING and provisions are a mixture of public, private and contracts mainly between professionals and the State or its representatives. National Health Insurance is one element of a large National Social Security System (N.S.S.) which is also responsible for retirement pensions and family allowances. In the health care field, the financial crisis of the welfare state is accompanied by relative consistent growth of the for profit sector (Huard, et al.). But, at the same time, the control of the State is stronger than it ever was. As is well known, French health care is financed by a National Social Security system which is compulsory and financed by the workers and their employers. After having been constantly extended over the years, today almost 100% of the population is covered by this national system. Unemployed and certain groups of workers (such as Miners or Craftsmen) still remain covered either by the State or by special insurance plans which predated the complete integrated system of today. These special insurance plans are facing chronic deficits because of the disequilibrium between the numbers of working and retired members of these declining professions. However, the plans are still maintained for historical reasons and because they give their members certain advantages, they are likely to lose by joining the general insurance system. From an institutional point of view, the, N.S.S. is an independent and non profit organization managed by representatives of the employers and the labor unions. Currently, however the State plays a great part in its regulation. By coveting the annual so-called deficit, determining along with the professionals the main unitary health care prices, regulating the financial compensation between several health funds, etc., the State supports the framework of the whole system. Membership of the public health insurance system is compulsory for all working people and the premium, the major part of which is paid by the employers, is a fixed percentage of the wages. The share of such a charge in overall manpower costs is 2.3 times higher in France than in the U.S or even in some other European countries (Concialdi, et al.). At a time and, under circumstances when, as a result of the enormous growth of international trade, a firm's and a nation's competitiveness are of universal concern, this phenomenon plays against the increasing of health care expenditure. As a result, there is increasing suspicion of the idea that growing expenditure has to be balanced by growing worker contributions. Also, there is a growing concern about what is called the fiscalization of the Social Security System, the aim of which will be to shift gradually the financing basis from wage earners to taxpayers. The advantage of this new procedure will be to insulate, at least in the short term, the flow of the N.S.S. revenue from the increasing amount of unemployment and from wage stagnation. Economists have computed that, ceteris paribus, a 0.3% decrease in the wages paid in France would result in a 3 billion FF loss in N.S.S. receipts. Thus, the introduction, in 1990, of the Contribution Sociale Generalisee (General Social Contribution) has to be considered as a real innovation. For the first time, N.S.S. funds are directly and formally provided by means of a new tax, instead of by an increased rate of contribution. From an equitable point of view, such a tax will be seen as closing the gap between costs and taxes related to work or consumption. Another and more classical way of decreasing social charges is to encourage workers and households to contract for private health insurance on a voluntary basis. Since the national health insurance has always worked with a co-payment mechanism (around 20%, depending on the type of care), there has always existed private and essentially non profit-making insurance companies offering to reimburse the co-payment. …

The Forensic Economist in the International Setting: Applying Purchasing Power Parities to Nicaraguan Damage Claims

Abstract No abstract available.

Protection of Atypical Work and Family Benefits: Comparison of the Australian, German and British Social Security Systems

In defining atypical work, this paper encompasses part‐time work, casual and temporary work, outwork/homework/telework and small self‐employment. All three national social security systems are very selective and inflexible in protecting these forms of work as they are modeled according to the dominant pattern of full‐time, continuous employment. As atypical work is women's work, it is also regulated by social security benefits for the other part of women's work—domestic work. Family benefits have a very ambiguous function. They provide some means to escape from private dependency and they sometimes even recognize domestic work as insured normal labor market work. On the other side, they were also intended to subsidize the low wages of marginal work and allow only for a small amount of paid work, especially atypical work, while on benefit. Thus, they also structured and sustained the segmentation of labor market work and domestic work.

The Implementation of European Community Equality Legislation on Social Security: International Experiences*

Abstract. The article evaluates the EC Equality Directives in matters of social security adopted by the Council in 1978 and 1986. We ask whether these EC Directives are appropriate instruments to reduce manifest disadvantages women face in the national social security systems. In the first part, some features are singled out in the European pension systems which are particularly disadvantageous to women. In the second, the EC Directives are analysed with respect to their material scope and the underlying normative concepts. Thirdly, some problems with respect to the legislative implementation of the Social Security Directives in the UK, the Netherlands and Germany are discussed. It is argued that the Directives, in prescribing equal treatment, do not lead to substantial improvement for women.

Adult Equivalence Scales: A Life‐Cycle Perspective

In any policy-orientated study of family welfare, it is inevitable that some comparison of welfare between households with different compositions will be required, and the theory of (adult) equivalence scales aims to formalise the way in which these comparisons may be made. An adult equivalence scale is defined as the proportionate increase in income per adult necessary to maintain a certain level of household living standard given some change in demographic circumstances (typically, the introduction of children). Values for such scales might be obtained in any of a number of ways. It is clear, for instance, that any national social security system can be interpreted as embodying one such set of scales; in the UK this is given by those reported in Table 1.

Retirement, Pensions, and Social Security

American workers are retiring earlier, living longer, and receiving greater retirement benefits for each year out of the labor force than ever before, which has created serious financial pressures on the nation's Social Security system and generated an intense and often heated debate. This book places retirement in an economic context, calculating the income opportunities facing older workers at alternate retirement ages, and estimating how responsive retirement ages are to changes in income opportunities. It is the first book length study to combine evidence on private pension and Social Security institutions with econometric evidence on the determinants of retirement behavior, providing new empirical results that shed light on current policy issues. Retirement, Pensions, and Social Security reveals the importance of earnings, private pensions, and Social Security benefits compared to health, mandatory retirement, and other noneconomic factors in determining retirement patterns; the amounts of private pension and Social Security benefits that workers would receive at alternate retirement ages; the prospective budget sets facing potential retirees from ages 60 to 68; and variation across pension plans in the gains or losses from deferring retirement. It describes regression models showing that retirement patterns can be explained in part by the retirement income streams available at age 60 and by the gain in retirement income if retirement is postponed to age 65, and multinomial logit and ordered logit models which formulate the retirement decision in a utility-based framework while accounting for unmeasured preferences of individuals and nonlinearities in income opportunities. The book predicts the responsiveness of retirement ages and retirement incomes to reductions in Social Security benefits, using several different prediction methods including a new one published here for the first time. And it explains the differences in average retirement ages among workers in different pension plans in terms of differences in the economic rewards for deferring retirement and differences in workers' taste for income and leisure.

A goal-focusing approach to analysis of intergenerational transfers of income

In place of classical utility conceptions, policy discussions for intergenerational transfers of income involve the balancing of several desirable social goals: maintaining or improving the standard of living of (i) the working popuuion, (ii) the retired population, and (iii) maintaining a stable intergenerational transfer system. The new method of goal focusing achieves both the trade-off analyses of utility function methods at Pareto-efficient points and due accounting for the effects of multiple objectives. A goal-focusing approach is herein developed for the detailed quantitative analysis of intergenerational income transfers of a national social security system.

Social Security Reform in Japan

The United States is not alone in trying to make its social security system financially viable. Japan's social security program is also facing a potential crisis. Its financial difficulties can be measured by the fact that it has the fastest growing proportion of elderly in the world. The Japanese Ministry of Health and Welfare recently proposed a comprehensive plan to reform the nation's social security system. This article discusses problems surrounding that system, briefly presents the double-decker plan recommended by the ministry, and discusses and evaluates some issues especially relevant to the United States.

Population waves and fertility fluctuations: Social security implications

The demographic consequences of periodic movements in fertility rates are explored. Different types of periodic fluctuations are examined and incorporated into long range population projections. In some cases the resulting population waves can have a profound impact on a national social security system. These impacts are illustrated numerically in the context of the Canadian situation.

Public Policies in Conflict: Land Reform and Family Planning in Costa Rica

Family planning policies and land reform are in conflict in Costa Rica because land-reform programs based upon individual ownership incentives stimulate attitudes conducive to population growth. Although the communal-enterprise variety of land reform stimulates more positive attitudes toward smaller family size and contraception the use of contraceptives has not been found to be significantly greater among communal peasants than among private owners. This leads the author to analyze problems and obstacles which stand in the way of greater contraceptive acceptance among potentially receptive rural peasants. The investigation points to lack of availability and access to services as the greatest obstacles to increased contraceptive usage. 4 reasons for such limited access and availability are presented: (1) Modern birth control devices are difficult to obtain in rural areas pharmacies being found only in larger towns and rural stores rarely stocking contraceptives. (2) Regular medical care in rural areas is more difficult to obtain than in urban areas despite government-supported rural health programs. Fear and misinformation are widespread among rural women. 3) Many medical personnel do not support the use of contraceptives. 4) Religious leaders in rural communities are more outspoken in their opposition to artificial methods of birth control than their urban counterparts. The report also points out that although Costa Rica does have a law which requires a year of social service for all physicians it is difficult to attract more doctors to remain in the rural communities given the lower standard of living. One solution proposed is the incorporation of communal peasants into the National Social Security System. If this population could be included in the coverage of the System and receive regular medical attention it would then be possible to stimulate attitudinal change and contraceptive acceptance. The paper concludes that Costa Rican policy makers should consider the implications of these findings which link increased contraceptive practice to communal land-reform policies and a broader and more educational scope for Social Security health coverage.