Romania

2021 ◽  
pp. 879-900
Author(s):  
Diana Burlacu ◽  
Alexandru Daniel Moise
Keyword(s):  
Social Insurance ◽  
Social Health Insurance ◽  
Social Insurance System ◽  
Health Politics ◽  
Insurance System ◽  
The Social ◽  
Out Of Pocket Payments ◽  
Containment Measures ◽  
Centralized System

This chapter examines health politics and the social health insurance system in Romania. It traces the development of the Romanian healthcare system, characterized by chronic underfunding, political neglect, and low public satisfaction. Since the regime change in 1989, Romanian health policy has focused on the transformation from a Semashko-style tax-based centralized system into a more decentralized Bismarckian social insurance system. Other healthcare issues have been rising out-of-pocket payments, a failed privatization attempt starting in 2007, and cost-containment measures following the 2008 recession. As the chapter argues, political instability, especially the frequent changes of health ministers, is partly responsible for a lack of long-term planning and a patchwork style of reforms.

Bosnia And Herzegovina

2021 ◽  
pp. 948-957
Author(s):  
Jasmin Hasić
Keyword(s):  
Bosnia And Herzegovina ◽  
Social Insurance ◽  
Social Health Insurance ◽  
Political Agenda ◽  
Social Insurance System ◽  
Health Politics ◽  
Insurance System ◽  
Building Process ◽  
The Social ◽  
Republika Srpska

This chapter offers an in-depth look at health politics and the social health insurance system in the separate entities that make up Bosnia and Herzegovina. It traces the development of the healthcare system in Bosnia and Herzegovina, marked by the introduction of self-managed insurance system during communism. After Bosnia and Herzegovina declared independence in 1992 following the breakup of the SFRY, the health system deteriorated during the devastating Bosnian War, and the nation-building process dominated the political agenda. Since 1996, facilitated by international organizations, health politics has focused on remodeling the socialist self-managed insurance system towards a more standard social insurance system with market elements. While the Republika Srpska entity has a centralized social insurance system, in the Federacija Bosne i Hercegovine entity the social insurance is decentralized, governed independently by ten cantons. As described in the chapter, the main healthcare issues have been the significant portion of uninsured, inequalities in health access both across and within regions, the high cost of private health services, and difficulties with collecting sufficient insurance contributions due to high rates of unemployment and informal employment.

Estonia

2021 ◽  
pp. 401-433
Author(s):  
Mare Ainsaar ◽  
Ave Roots ◽  
Jüri Kõre
Keyword(s):  
Social Insurance ◽  
Waiting Times ◽  
Social Health Insurance ◽  
Social Insurance System ◽  
Health Politics ◽  
Insurance System ◽  
Regime Changes ◽  
Single Payer ◽  
The Social ◽  
The 2008 Financial Crisis

This chapter provides an extended look at health politics and the social health insurance system in Estonia. The chapter traces the historical development of the Estonian healthcare system through a series of regime changes, all of which affected healthcare. The post-1991 transformation of Estonia’s health system went rapidly and was marked by relatively high consensus and professionalism. Consequently, stable financing and a large tax component allowed Estonia’s national health fund to avoid the heavy dependence on out-of-pocket payments characteristic of many other transition countries. Despite plans for decentralized social insurance, by 2000 the decision was made to centralize the social insurance system, which has become essentially a single-payer system. This has allowed quite a bit of leverage for setting healthcare priorities. But, as the chapter argues, given the pressure for austerity after the 2008 financial crisis, reduced capacity has led to longer waiting times.

Familiengerechtigkeit in der sozialen Pflegeversicherung

2020 ◽  
Vol 69 (8-9) ◽  
pp. 627-641
Keyword(s):  
Social Insurance ◽  
Long Term Care ◽  
Term Care ◽  
Social Insurance System ◽  
Insurance System ◽  
The Social ◽  
The Family ◽  
Long Term Care Insurance

Zusammenfassung Ausgehend von Beiträgen des Wissenschaftlichen Beirats für Familienfragen zum Verhältnis Familie und Sozialversicherung beleuchten wir in diesem Aufsatz die Frage der Familiengerechtigkeit in der sozialen Pflegeversicherung. Ein Großteil der Pflegearbeit in Deutschland wird innerhalb der Familie erbracht, gleichzeitig gewährleisten Familien die nachhaltige Finanzierung der Pflegeversicherung. Demographische Entwicklungen und veränderte Verantwortungskonzepte stellen diese Leistungserbringung vor Herausforderungen. Wir argumentieren, dass Familien auf der Beitrags- wie auf der Leistungsseite mehr ­Unterstützung benötigen, z. B. bei der arbeitsrechtlichen und finanziellen Absicherung pflegender Angehöriger, um die bestehende Schieflage zwischen stationärer und häuslicher Versorgung zu mildern. Abstract: The Role of Families in the Social Insurance System Based on previous reports of the Scientific Advisory Board for Family Affairs on the role of families in the social insurance system, this essay examines the aspect of family fairness in long-term care insurance. The majority of care work in Germany is provided within the family, while at the same time families ensure sustainable financing of long-term care insurance. Demographic change and changing concepts of responsibility challenge these modes of care provision. We argue that families need more support on the contribution as well as the benefit side, e. g. by securing labour rights and financial protection of caring relatives to alleviate the existing imbalances between institutional and home care.

scholarly journals Institutional Design and Incentives for Migrant Workers to Participate in Social Insurance in China: Evidence from a Policy Experiment in Chengdu City

2021 ◽  
Author(s):  
Yihao Tian ◽  
Yuxiao Chen ◽  
Mei Zhou ◽  
Shaoyang Zhao
Keyword(s):  
Social Security ◽  
Migrant Workers ◽  
Security Policy ◽  
Social Insurance ◽  
Participation Rate ◽  
National Bureau ◽  
Social Insurance System ◽  
Insurance System ◽  
The Social ◽  
Social Security Policy

Abstract Background: Rural-to-urban migration has increased rapidly in China since the early 1980s, with the number of migrants reaching 376 million in 2020 (National Bureau of Statistics [NBS], 2020). Despite this sharp trend and the significant contributions that the migrants have made to urban development, migrant workers have had very limited access to the social insurance that the majority of urban workers have enjoyed. Methods: Based on the background of the social insurance system adjustment in Chengdu in 2011, we establish a difference-in-differences (DID) model to empirically test the impacts of change in social insurance policy contribution rates on migrant workers' social insurance participation rates, using the China Migrants Dynamic Survey (CMDS) data from 2009-2016.Results: The social insurance participation rate of migrant workers was significantly reduced after they are incorporated into the urban worker insurance system. Meanwhile, there is no significant change in the wages of migrant workers, but the working hours became longer and the consumption level turned lower. That is to say, simply changing the social insurance model of migrant workers from "comprehensive social insurance" to "urban employee insurance" reduces the incentives for migrant workers to participate in the insurance and harm the overall welfares of migrant workers.Conclusion: The design of the social security policy is an important reason for lower participation rate of migrants. Therefore, it is necessary to solve the problem of insufficient incentives through targeted social security policies. Specifically, the first is to formulate a social security policy contribution rate suitable for the migrants. The second is to establish a comprehensive social security policy and gradually integrate the social security system.

scholarly journals Institutional Design and Incentives for Migrant Workers to Participate in Social Insurance in China: Evidence From a Policy Experiment in Chengdu City

2021 ◽  
Vol 9 ◽  
Author(s):  
Yihao Tian ◽  
Yuxiao Chen ◽  
Mei Zhou ◽  
Shaoyang Zhao
Keyword(s):  
Social Security ◽  
Migrant Workers ◽  
Security Policy ◽  
Social Insurance ◽  
Institutional Design ◽  
Participation Rate ◽  
Social Insurance System ◽  
Insurance System ◽  
The Social ◽  
Social Security Policy

Rural-to-urban migration has increased rapidly in China since the early 1980s, with the number of migrants has reached 376 million by 2020. Despite this sharp trend and the significant contributions that migrants have made to urban development, the migrant workers have had very limited access to the social insurance that the majority of urban workers enjoy. Against the background of the social insurance system adjustment in Chengdu in 2011, this study uses a difference-in-differences (DID) model to empirically test the impacts of changes in the social insurance policy contribution rates on the social insurance participation rates of migrant workers, using the China Migrants Dynamic Survey (CMDS) data for 2009–2016. We find that the social insurance participation rate of migrant workers was significantly reduced after they were incorporated into the urban worker insurance system. There was no significant change in the wages of migrant workers, but the working hours were increased and their consumption level decreased. In other words, simply changing the social insurance model of migrant workers from “comprehensive social insurance” to “urban employee insurance” reduces the incentives for migrant workers to participate in insurance and harms the overall welfare of migrant workers. Our study indicates that the design of the social security policy is an important reason for the lower participation rate of migrants. It is necessary to solve the problem of insufficient incentives through the targeted social security policies; primarily, the formulation of a social security policy contribution rate suitable for the migrants, and the establishment of a comprehensive social security policy and the gradual integration of the social security system.

Pensions at the Time of Recession. The Case of Lithuania

2011 ◽  
Vol 57 (3) ◽  
pp. 251-266 ◽  
Author(s):  
Teodoras Medaiskis
Keyword(s):  
Private Sector ◽  
Social Insurance ◽  
Pension System ◽  
Social Insurance System ◽  
High Unemployment ◽  
Insurance System ◽  
The Social ◽  
Reserve Fund ◽  
The Government ◽  
Deep Recession

In 2009, Lithuania suffered very deep recession. The fall in GDP by 15 %, high unemployment, and decreased population earnings all affected the pensions system. Before the recession struck, social insurance expenditures had increased considerably and the reserve fund had been exhausted. The recession resulted in the decreased income of the social insurance system and state. While in 2009, the government attempted to maintain the level of pensions, by 2010, it was forced to cut benefits. This shocking decision raised awareness about some theoretical problems concerning the nature of pensions. Is the social insurance payg pension the property of the retiree, or it is only a part of the working generation income shared via the social insurance system with the retired generation? How should the protection against poverty and income replacement components be combined in the pension system and how should they be financed? How should the payg and funded components be united and what are the roles of the private sector and the government? In this article, Lithuania’s attempts to cope with the recession’s consequences and to respond to these newly posed questions are presented.

Economic burden of multiple sclerosis to the social insurance system in Germany

2017 ◽  
Vol 26 (3) ◽  
pp. 271-278
Author(s):  
Silke Neusser ◽  
Janine Biermann ◽  
Gerald Lux ◽  
Jürgen Wasem ◽  
Volker Reissner ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Economic Burden ◽  
Social Insurance ◽  
Social Insurance System ◽  
Insurance System ◽  
The Social
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