Social Security Expenditure Research Articles

Japan: health cuts and outsourced supply chains left a health system under-prepared

36 | International Union Rights | 27/1-27/2 FOCUS | UNIONS, WORKERS’ RIGHTS, AND THE COVID-19 PANDEMIC Japan: health cuts and outsourced supply chains left a health system under-prepared The Japan Federation of Medical Workers’ Unions (JFMWU) represents 7 national unions and 47 prefectural unions in health and care sector in Japan. Since our formation in 1957, we have promoted campaigns and struggles for enough staffing and better working condition of medical doctors, nurses and care workers as well as for providing decent and better health care. Japanese health systems have been suffering from chronic understaffing, then we are working under the pandemic of COVID-19. Long working hours JFMWU has conducted a survey in every five years on working condition of nurses. The most recent one from 33,402 corresponded found that 71.7 percent says they have chronic fatigue, 67.5 percent says they have health concerns, 74.9 percent thinks to quite their job. These reasons are; 47.7 percent responded they have hard working condition due to understaffing, 30.0 percent responded their wage is low and difficult to take enough holidays. We also conducted nightshift work survey every year, and we found 39.3 percent nurses are working in 2-shift. And at 2-shift workplaces, 39.3 percent experience more than 16-hour work. Japanese nurses generally have more night-work than other countries, and 46.0 percent experiences less than 8-hour interval between shifts. To achieve safe and decent health and care, we have committed to promote strong campaign for better working condition and sufficient staffing. We demand ‘8-hour work day’, ‘more than 12-hour interval’ and ‘32-hour work week’, as well as more medical staff and better social security system. Reduction in designated medical institutions and community health offices Since the 1980s, the Japanese government has maintained its policy to reduce medical expenditure from the public budget, under the name of ‘administrative reform’ or ‘structural reform’. In recent years, Prime Minister Abe promoted so-called ‘Social Security System Reform’ in order to restore a balanced budget and to reduce social security expenditure. The number of beds for special infectious disease in 1998 was 9060 beds at 409 hospitals across Japan, but it is now only 1869 beds at 407 hospitals. It is important to note that 94 percent of these beds belong to public or government hospitals. The number of the public health offices was more than 850 in 1990s and now we have only 472 offices in 2019. Working conditions of medical workers under the pandemic When the Ministry of Health, Labour and Welfare issued a notice to request medical institutions to be ready for the COVID-19, JFMWU conducted an emergency survey for mostly public hospitals in March where we represent those workers. Even rather big and supposedly wellequipped institutions reported their concern and anxiety to respond to the outbreak, since they do not have sufficient medical staff and specialised facilities for dealing with infectious diseases. They have been forced to close loss-making sections such as TB sections, and do not have enough Personal Protective Equipment (PPE) and technical skills to treat infectious disease. Some hospitals say they accept COVID-19 patients while they stop certain surgery or outpatient department. In April, we experienced shortages of PPE at hospitals. According to the survey from 152 hospitals in 35 prefectures, we found some serious cases, both for safety and health of patients and health workers and sustainability of the hospitals. Some workers have only 1 mask per week. Another PPE and N95 mask are used repeatedly. Raincoat or garbage plastic bag are used for PPE. Sharp decrease of inpatients has huge impact for financial situation of hospitals and clinic, and there is a threat to cut wage and lump-sum payments in the coming months. Hospital workers have experienced discrimination and prejudice in community. JFMWU issued statements on these serious problems and demanded the governments to take immediate action. The Ministry reported 428 thousand COVID-19 inpatients, of which 222 thousand were hospitalised, The global supply chain system for PPE - based on neoliberal ideology - is clearly not working Shinobu Morita is President of the Japan...

Japan: health cuts and outsourced supply chains left a health system under-prepared

36 | International Union Rights | 27/1-27/2 FOCUS | UNIONS, WORKERS’ RIGHTS, AND THE COVID-19 PANDEMIC Japan: health cuts and outsourced supply chains left a health system under-prepared The Japan Federation of Medical Workers’ Unions (JFMWU) represents 7 national unions and 47 prefectural unions in health and care sector in Japan. Since our formation in 1957, we have promoted campaigns and struggles for enough staffing and better working condition of medical doctors, nurses and care workers as well as for providing decent and better health care. Japanese health systems have been suffering from chronic understaffing, then we are working under the pandemic of COVID-19. Long working hours JFMWU has conducted a survey in every five years on working condition of nurses. The most recent one from 33,402 corresponded found that 71.7 percent says they have chronic fatigue, 67.5 percent says they have health concerns, 74.9 percent thinks to quite their job. These reasons are; 47.7 percent responded they have hard working condition due to understaffing, 30.0 percent responded their wage is low and difficult to take enough holidays. We also conducted nightshift work survey every year, and we found 39.3 percent nurses are working in 2-shift. And at 2-shift workplaces, 39.3 percent experience more than 16-hour work. Japanese nurses generally have more night-work than other countries, and 46.0 percent experiences less than 8-hour interval between shifts. To achieve safe and decent health and care, we have committed to promote strong campaign for better working condition and sufficient staffing. We demand ‘8-hour work day’, ‘more than 12-hour interval’ and ‘32-hour work week’, as well as more medical staff and better social security system. Reduction in designated medical institutions and community health offices Since the 1980s, the Japanese government has maintained its policy to reduce medical expenditure from the public budget, under the name of ‘administrative reform’ or ‘structural reform’. In recent years, Prime Minister Abe promoted so-called ‘Social Security System Reform’ in order to restore a balanced budget and to reduce social security expenditure. The number of beds for special infectious disease in 1998 was 9060 beds at 409 hospitals across Japan, but it is now only 1869 beds at 407 hospitals. It is important to note that 94 percent of these beds belong to public or government hospitals. The number of the public health offices was more than 850 in 1990s and now we have only 472 offices in 2019. Working conditions of medical workers under the pandemic When the Ministry of Health, Labour and Welfare issued a notice to request medical institutions to be ready for the COVID-19, JFMWU conducted an emergency survey for mostly public hospitals in March where we represent those workers. Even rather big and supposedly wellequipped institutions reported their concern and anxiety to respond to the outbreak, since they do not have sufficient medical staff and specialised facilities for dealing with infectious diseases. They have been forced to close loss-making sections such as TB sections, and do not have enough Personal Protective Equipment (PPE) and technical skills to treat infectious disease. Some hospitals say they accept COVID-19 patients while they stop certain surgery or outpatient department. In April, we experienced shortages of PPE at hospitals. According to the survey from 152 hospitals in 35 prefectures, we found some serious cases, both for safety and health of patients and health workers and sustainability of the hospitals. Some workers have only 1 mask per week. Another PPE and N95 mask are used repeatedly. Raincoat or garbage plastic bag are used for PPE. Sharp decrease of inpatients has huge impact for financial situation of hospitals and clinic, and there is a threat to cut wage and lump-sum payments in the coming months. Hospital workers have experienced discrimination and prejudice in community. JFMWU issued statements on these serious problems and demanded the governments to take immediate action. The Ministry reported 428 thousand COVID-19 inpatients, of which 222 thousand were hospitalised, The global supply chain system for PPE - based on neoliberal ideology - is clearly not working Shinobu Morita is President of the Japan...

How to reform China’s fiscal system?

ABSTRACTAs the population aging, China’s government expenditures, including general fiscal expenditure, healthcare and social security expenditure, will grow more rapidly than government revenues, tending to elevate government debt. Local governments undertake overwhelming 85% of total general fiscal revenue and are responsible for healthcare and social security, and their debt has been growing. Fiscal reforms are imperative, including tax reforms, the structure of government spending reforms, social security reforms, healthcare reforms, local public finance reforms, and central and local government’s fiscal relationship reforms. This paper will explore the fiscal challenges China faces and discuss how to reform the fiscal system to cope with these challenges.

The collapse of Brazilian Social Security: Macroeconomic impacts of the increase of the minimum age of PEC nº 287/2016 reform

This paper presents a simulation of the economic impacts of the increase of the minimum age contained in the Proposal for Constitutional Amendment (PEC) nº 287/2016. For that, an overlapping generations (OLG) model with 57 generations was built, including the transition rule. The results suggest that not increasing the minimum age for retirement is a very bad choice for society. The fiscal situation becomes unsustainable, and the expansion of social security expenditures, in combination with the reduction of the labor supply, leads the country to a scenario of a sharp fall in consumption and output per capita. The simulation with the new minimum retirement age of PEC nº 287/2016 indicates that, although it is not the definitive solution to the Brazilian pension issue. The results of the model indicate that raising the minimum age avoids a very bad scenario, but does not seem to be even able to maintain the current level of output per capita. As a policy suggestion, although PEC nº 287/2016 has not even been voted, the recommendation is that it represents a minimum level for the next pension reform.

Impact Of Social Security Expenditures On Income Distribution: Case Of Turkey

Income inequality is a significant hindrance to the growth and expansion of social welfare. Modern societies use many tools to overcome this hindrance. Social security system is one of the most known tools. The fact that social security spending improves the income distribution differently in each country, originating from the diversity of social security methods. In this study, the influence of social security expenditure on income distribution in Turkey is examined by Johansen and Juselius (JJ) Cointegration test for the period 1975-2010. The findings of the unit root tests show that all the variables are stationary at first difference and the findings of the cointegration test display that variables have a long run relationship. In addition, it is found that social security expenditure has a negative effect on income distribution in Turkey in the studied period, while economic growth has a positive effect on it.

Managing shocks in Singapore's ageing and retirement arrangements

ABSTRACT Asia is rapidly ageing and there is a need for governments to adjust social security expenditures accordingly to facilitate better management of socioeconomic shocks by the individual/household and society as a whole. This article examines the ageing and retirement arrangements in Singapore and argues that they provide a very limited ability for the individual/household to mitigate the effects of an adverse socioeconomic shock. A major contributor to this is the limited social risk pooling resulting from a continued focus on mandatory savings to a defined-contribution scheme for ageing and retirement-financing needs, age and gender biases in existing policy designs, and low real rates of return to mandatory savings balances. More fundamental reforms are needed if Singapore is to be able to better manage the impact of adverse socioeconomic shocks. This includes introducing a budget-financed universal social pension, and a realignment of the mandated returns to the contributions and balances under existing retirement financing arrangements. Otherwise, there is potential for socially-destabilizing and -detrimental outcomes to emerge in the medium- to longer-term.

An Economic Analysis of Intra-governmental Account Transfers: Social Security and Public Infrastructure in Japan

In the context of limited local government resources, it is often targeted to secure financial resources for social security expenditures for the aging society and upkeep expenditures against the aging of public infrastructure facilities. This paper examines whether transfers from general accounts to special accounts and public enterprise accounts have a significant impact on the financial burden of local governments, using panel data from Japanese local governments. We find that transfer to special accounts and public enterprise can inflate the net liabilities.

Social Security and Sustainable Economic Growth: Based on the Perspective of Human Capital

China’s social security expenditure has rapidly grown during the past decade, and concerns about the impact of social security on productivity and sustained economic growth have attracted attention. Based on Chinese provincial panel data over the period 2007–2016, a threshold model analysis found that the impact of social security on productivity has a “double threshold” on human capital. Using dynamic panel data models and system General Moment Method estimators also found the existence of this threshold effect: When the human capital level is low or high, social security is favorable for sustained economic growth. However, if the human capital level is at the intermediate level, the function of social security is weak. The main conclusions were still valid after we examined the robustness of our results with several methods.

Social security expenses with patients with back pain by the National Institute of Social Security of Brazil from 2008 to 2014

Objective: To analyze all social security expenditures paid by Brazilian Institute of Social Security (INSS) of lower back pain, from 2008 to 2014. Methods: Consultation to Social Security database in order to obtain information about the main benefits offered individuals by the INSS, in the period between 2008 and 2014. Based on the Social Security database and the ICDs M51 and M54, the INSS expenditures were assessed for low-income retirement, sickness and to accidental retirement, between men and women from urban and rural areas from 2008 to 2014. Results: In this period, the most prevalent benefit was Disease Aid, with an average annual cost of R$ 88.458.511,10. The total cost of benefit was: Accidental Sickness Insurance-R$ 116.076.692,00;Accidental Retirement-R$ 6.740.052,84; Illness Assistance-R$ 373.547.294,00; Retirement Due to Disability-R$ 75.883.844,00. Among all the above mentioned beneficiaries, there was a predominance of males and individuals living in the urban area. Conclusions: Lower back pain leads to suffering for workers, costs to companies, as well as burdening the public coffers regarding the social security system and health care.

Short and long-term correlation of social security expenditure and human development: Turkish model

The aim of this study is to analyse the relationship between social security expenditures (SSE) and human development in Turkey between 1990 and 2014. The main variables of the analysis include the proportion of social security expenditures in gross domestic product (GDP) for social security expenditures and the re-calculated real Human Development Index (HDI) values, with data from the Turkish Statistical Institute (TUIK) for human development. In doing so, the auto-regressive distributed lag (ARDL) bounds test for co-integration is employed. It has been seen upon conclusion of the analysis that social security expenditures are positively affecting human development on a significant level, in both the short- and long-term.

老龄化对我国社会保障支出的影响

老龄化对我国社会保障支出的影响

Females, the Elderly, and also Males: Demographic Aging and Macroeconomy in Japan

The speed and magnitude of ongoing demographic aging in Japan are unprecedented. A rapid decline in the labor force and a rising fiscal burden to finance social security expenditures could hamper growth over a prolonged period. We build a dynamic general equilibrium model populated by overlapping generations of males and females who differ in employment type and labor productivity as well as life expectancy. We study how changes in the labor market over the coming decades will affect the transition path of the economy and fiscal situation of Japan. We find that a rise in the labor supply of females and the elderly of both genders in an extensive margin and in labor productivity can significantly mitigate effects of demographic aging on the macroeconomy and reduce fiscal pressures, despite a decline in wage during the transition. We also quantify effects of alternative demographic scenarios and fiscal policies. The study suggests that a combination of policies that remove obstacles hindering labor supply and that enhance a more efficient allocation of male and female workers of all age groups will be critical to keeping government deficit under control and raising income across the nation.

Análise de fatores influentes na relação entre constribuições e benefícios previdenciários

Este estudo procurou identificar fatores que podem corroborar com as diferenças entre as arrecadações e despesas previdenciárias (RGPS) no que tange aos municípios de Minas Gerais. Na revisão de literatura, discutiu-se as clientelas previdenciárias, a influência dos cenários trabalhistas e demográficos e socioeconômicos na previdência social, o debate sobre o déficit previdenciário e a conexão entre a previdência social, as finanças públicas e o Estado de bem-estar social. Quanto a metodologia, foi utilizada a Análise Exploratória de Dados, Análise Fatorial, e o Teste de Independência de Qui-Quadrado, visando associar entre os fatores encontrados e o Indicador de Resultado Previdenciário Primário (IRPP) criado. Os resultados demonstraram a conexão do IRPP às condições socioeconômicas municipais, confirmando a hipótese testada. Ademais, verificou-se relação entre aspectos de localidade populacional, demográficos, trabalhistas e de desenvolvimento humano com o mesmo indicador. Concluiu-se os desequilíbrios financeiros no RGPS podem ser retratados por cenários socioeconômicos negativos

Activation against absenteeism – Evidence from a sickness insurance reform in Norway

I evaluate a program aimed at strictly enforcing a requirement that people on long-term sick leave be partly back at work unless explicitly defined as an exception. Employing the synthetic control method, I find that the reform reduced work-hours lost due to sickness absenteeism by 12% in the reform region compared to a comparison unit created by a weighted average of similar regions. The effect is driven by both increased part-time presence of temporary disabled workers and accelerated recovery. Musculoskeletal disorders was the diagnosis group declining the most. The findings imply large savings in social security expenditures.

Determinants of Public Indebtedness in European Union Countries

Abstract The paper strives to determine the impact of fiscal variables on factors determining the dynamics of public debt in European Union countries. Based on the literature, the dynamics of public debt are determined by changes of three elements: the primary balance, interest-rate-growth-differential and the change of government assets. Therefore, it seems reasonable to estimate the dynamics of these three values to find the variables crucial for limiting the growth of public debt. Three groups of dynamic panel regressions were estimated based on the one-step Generalized Method of Moments. The data was collected for the 1995-2015 period for 27 EU countries. Dependent variables included: primary balance, interest-rate-growth-differential and change of government assets. Independent variables consisted of: interest payable to GDP ratio, unemployment rate, squared unemployment rate, FDI stock to GDP, net FDI inflow to GDP, general government expenditures to GDP, share of social security expenditures and openness of the economy measured by the ratio of export and import to GDP. On the basis of statistical data, three components of debt changes were distinguished, and estimations of the dynamic panel regressions were applied to find the impact of independent variables. According to the basic models, the primary balance is lower for: countries with higher unemployment, greater FDI stock and higher general government expenditures. The interest-rate-growth-differential is lower in the case of: high subsidies and for a more open economy. However, unemployment and FDI remain the most important determinants of this variable. The change of government’s assets ratio decreases as FDI net inflows or the share of expenditures to GDP increase as well as in the case of very high unemployment.

Public social security burden of musculoskeletal diseases in Brasil-Descriptive study.

To present data on the social security burden of diseases of the musculoskeletal system and connective tissue (DSOTC) in Brasil in 2014, and evolution of these social security expenditures between 2009 and 2014. Compilation and analysis of data on the granting of disability pensions and sickness benefits in the year 2014, available on the official website of Social Security, classified according to ICD 10. It was evaluated the evolution between 2009 and 2014, using the F test to compare the curves with the growth of the active age population (PIA). Among the 22 disease groups classified according to ICD-10, the DSOTC group led benefits grants in 2014, with 19% of the sickness benefits and 13.5% of the disability pensions. The main causes of sickness benefit and disability retirement were, respectively: dorsopathies (43.3% and 41.2%), soft tissue diseases (27.3% and 19.7%), osteoarthritis (7.6% % And 27.8%) and chronic inflammatory arthropathies (2.8% and 7.9%). In the evolution of the number of sickness benefits granted between 2009 and 2014, both INSS and DSOTC totals showed an increasing tendency (35.9 and 35.3%, respectively, with p = 0.000 for both). As for disability retirement, there was a 5.9% increase in the INSS total (p = 0.039), while for the DSOTC there was a decrease of 7.6% (p = 0.005). These data point to a progressive increase in the granting of sickness pensions and disability benefits in the country, superior to the growth of the PIA, as well as a high participation of DSOTC in these benefits.

How do social security expenditures vary by state? The surprising impact of unemployment

AbstractWe examine state-level variation in the flow of benefits under the largest Social Security programme – the Old-Age (OA) programme. OA pensions remain a robust and growing component of the American social safety net. Although OA pensions are entirely administered by the federal government, state-level demographic features can imply different aggregate levels of programme expenditures across states. We describe high levels of variation in the resources flowing into states from the OA programme and we find relationships between state features that might seem only remotely related to income support for the elderly: current unemployment rates, previous income levels, poverty rates and minority populations. We find a particularly strong link between current unemployment rates, OA coverage and OA average benefits. The number of recipients and the level of average OA payments increase when unemployment increases. This is a poorly understood but important feature of the OA programme.

The Influence of China Demographic Structure on Social Security Expenditure—Based on Panel Data Model

Based on the panel data of 31 provinces and municipalities inChinafrom 1998 to 2016, this paper studies the effect of demographic structure on social security expenditure inChinaby using entity fixed effect regression model. The results show that there is a long-term co-integration relationship between population aging and social security expenditure in the demographic structure, and there is a positive correlation between population aging and social security expenditure. And the different cross-sectional effects in 31 regions of China reflect the difference between population aging and social security expenditure in different regions of China.

The effect of public pensions on women's labor market participation over a full life cycle

Spousal and survivor pensions are two important provisions of the US Social Security pension system. In this paper, we assess the impact of these benefits on the female employment rate in the context of a full life‐cycle model in which households decide on female labor supply and savings. One important aspect of our model is that we allow for returns to labor market experience so that participation decisions affect not only current earnings and Social Security pension eligibility but also future earnings. We quantify the effect on female labor supply and on household inequality of (i) removing spousal benefit, (ii) removing both spousal and survivor pension benefits, and (iii) extending from 35 to 40 the number of periods of the working career that are considered when calculating the retired worker's pension. We find that reforms (i) and (ii) significantly increase female employment throughout the life cycle, whereas reform (iii) has a very mild effect. The effect of (ii) on income inequality in older household is large, whereas the effect on consumption inequality is small. All three reforms have substantial effects on Social Security expenditure and fiscal revenues. Social Security Spousal and Survivor Benefits Women's Labor Market Participation D15 H55 J22 J24

The Impact of Per-Capita Transfer Payment on the Stabilization of Local Fiscal Expenditure

The transfer payment should exert the economic and social stability effect. However, the empirical data show that the total amount of transfer payment varies greatly in different regions and deviates from the goal of the transfer payment system to a certain degree. If per-capita transfer payment is adopted as the analysis variable, from 1998 to 2015, 31 provincial government financial data were used to empirically test the impact of per-capita transfer payment on the stability of provincial fiscal expenditures. Based on the analysis of the influence of fiscal self-sufficiency and the 5 types of fiscal expenditures closely related to economic and livelihood stability, we can find that the per-capita transfer payment has a significant negative correlation with the stable effect of fiscal expenditure, while the effect of fiscal self-sufficiency on the provincial financial expenditure has no significant effect. Science and Technology Expenditure, Medical Expenditure on the stability of local fiscal expenditure has a more significant negative effect. The influence of Educational Expenses on the stabilizing effect of local fiscal expenditure is not significant. Social Security Expenditure has the same effect as Cultural Expenditure, and has a significant positive impact on the stability of local fiscal expenditure. In order to further enhance the stabilizing effect of transfer payment on local fiscal expenditure, we should improve the current transfer payment system and improve the fiscal expenditure structure of local governments.