Reassembling social security: a survey of pensions and health care reforms in Latin America
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| Main Author: | |
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| Format: | Book |
| Language: | English |
| Published: |
Oxford [u.a.]
Oxford Univ. Press
2008
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| Edition: | 1. publ. |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XXVI, 453 S. |
| ISBN: | 9780199233779 |
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Record in the Search Index
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| adam_text | CONTENTS LIST OF TABLES AND APPENDICES XX ABBREVIATIONS XXIII PART I.
INTRODUCTION: THE STATE OF PENSION AND HEALTH CARE IN THE REGION BEFORE
THE REFORMS 1 SOCIAL SECURITY PRINCIPLES, ENFORCEMENT IN LATIN AMERICA,
AND MODIFICATIONS BY THE REFORMS 3 1.1 INTRODUCTION 3 1.2 PRINCIPLES,
REGIONAL ENFORCEMENT, AND MODIFICATIONS BY THE REFORMS 5 1.2.1 UNIVERSAL
COVERAGE 5 1.2.2 EQUAL TREATMENT 8 1.2.3 SOLIDARITY AND INCOME
REDISTRIBUTION RO 1.2.4 COMPREHENSIVENESS AND SUFFICIENCY OF BENEFITS 12
1.2.5 UNITY, STATE RESPONSIBILITY, EFFICIENCY, AND SOCIAL PARTICIPATION
IN ADMINISTRATION 14 1.2.6 FINANCIAL SUSTAINABILITY 17 1.2.7 REFORM
ASSUMPTIONS/GOALS: PROMOTION OF NATIONAL SAVING AND CAPITAL MARKETS 21
1.2.8 REFORM ASSUMPTION: IMMUNITY TO STATE AND POLITICAL INTERFERENCE 21
1.2.9 CONCLUSIONS: ENFORCEMENT OF PRINCIPLES IN THE REGION BEFORE THE
REFORMS 21 PART II. PENSION REFORMS AND THEIR EFFECTS 2 PENSION REFORMS:
TAXONOMY, GOALS, AND ACTORS 27 2.1 PRIVATE AND PUBLIC SYSTEMS: TAXONOMY
IN LATIN AMERICA 27 2.2 TYPES OF REFORMS: STRUCTURAL AND PARAMETRIC 28
2.2.1 STRUCTURAL REFORMS 28 2.2.2 PARAMETRIC REFORMS OR LACK OF REFORMS
31 2.3 GOALS AND ASSUMPTIONS OF PENSION REFORMS 32 XIV CONTENTS 2.4
EXTERNAL INFLUENCES, INTERNAL ACTORS, AND POLITICO-ECONOMIC ENVIRONMENT
32 2.5 ONE SINGLE TYPE OF REFORM/MODEL OR SEVERAL TYPES/MODELS? 34 3
EFFECTS OF PENSION REFORMS ON UNIVERSAL COVERAGE 36 3.1 STATISTICAL
COVERAGE OF THE LABOR FORCE BY THE CONTRIBUTORY SYSTEM 36 3.1.1 PRIVATE
SYSTEMS - - . * . * 36 3.1.2 PUBLIC SYSTEMS 39 3.1.3 COMPARISON OF
PRIVATE AND PUBLIC SYSTEMS * ! COVERAGE * 39 3.2 LEGAL AND
STATISTICAL COVERAGE OF GROUPS DIFFICULT TO AFFILIATE . , * 40 3.2.1
URBAN INFORMAL SECTOR 41 3.2.2 RURAL SECTOR - 45 3.2.3 MEASURES TO
IMPROVE COVERAGE OF DIFFICULT GROUPS 46 3.3 SOCIAL ASSISTANCE PENSIONS
FOR THE UNINSURED AND IMPACT ON POVERTY 47 3.4 COVERAGE OF THE OLDER
POPULATION 51 3.5 IMPACT OF THE REFORMS ON COVERAGE 52 3.5.1 COVERAGE IN
PRIVATE AND PUBLIC SYSTEMS, AND REGIONAL TRENDS 52 3.5.2 GROUPS
DIFFICULT TO COVER 53 3.5.3 SOCIAL ASSISTANCE AND POVERTY 54 3.5.4
COVERAGE OF THE ELDERLY 55 4 EFFECTS ON EQUAL TREATMENT, SOLIDARITY, AND
COMPREHENSIVENESS-SUFFICIENCY 58 4.1 EQUAL TREATMENT 58 4.1.1 SURVIVAL
OF PRIVILEGED SCHEMES AND THEIR UNEQUAL ENTITLEMENT CONDITIONS. 5 8
4.1.2 GENDER INEQUALITY 59 4.2 SOLIDARITY AND INCOME DISTRIBUTION 63
4.2.1 SOLIDARITY VERSUS EQUIVALENCE 63 4.2.2 MECHANISMS FOR AND AGAINST
SOLIDARITY 64 4.3 COMPREHENSIVENESS AND SUFFICIENCY OF BENEFITS 67
4.3.1 RETIREMENT AGES AND SPANS, AND CONTRIBUTION YEARS IN ALL SYSTEMS
68 4.3.2 THE PENSION FORMULA IN PUBLIC PENSIONS 70 4.3.3 ADJUSTMENT OF
PRIVATE AND PUBLIC PENSIONS 72 4.3.4 LEVELS OF NONCONTRIBUTORY PENSIONS
IN PRIVATE AND PUBLIC SYSTEMS 73 4.3.5 ARE PRIVATE PENSIONS HIGHER THAN
PUBLIC PENSIONS? 74 CONTENTS XV 4.4ILMPACT OF THE REFORMS ON EQUAL
TREATMENT, SOLIDARITY, AND COMPREHENSIVENESS/SUFFICIENCY 76 4.4.1 EQUAL
TREATMENT 76 4.4.2 SOLIDARITY 77 4.4.3 COMPREHENSIVENESS AND SUFFICIENCY
78 5 EFFECTS ON UNITY, STATE RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL
PARTICIPATION, AND REFORM GOALS 83 5.1 UNIFICATION VERSUS SEGMENTATION
83 5.2 THE ROLE OF THE STATE 87 5.3 REFORM GOALS: FREEDOM OF CHOICE AND
PRIVATIZATION 89 5.4 REFORM GOAL: COMPETITION 93 5.5 INFORMATION 95 5.6
EFFICIENCY 97 5.7 ADMINISTRATIVE COSTS 98 5.8 SOCIAL PARTICIPATION IN
THE ADMINISTRATION 102 5.9 IMPACT OF THE REFORMS ON UNITY, STATE
RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL PARTICIPATION, AND REFORM
GOALS 105 5.9.1 MOST SYSTEMS ARE STILL SEGMENTED OR HIGHLY SEGMENTED 105
! 5.9.2 THE STATE ROLE CONTINUES TO BE FUNDAMENTAL RATHER THAN
SUBSIDIARY 106 5.9.3 REFORM GOALS: FREEDOM OF CHOICE AND PRIVATIZATION
106 5.9.4 REFORM GOAL: COMPETITION DOES NOT WORK PROPERLY OR DOES NOT
EXIST *. 107 5.9.5 THE INSURED LACK INFORMATION 107 5.9.6 UNEVEN GAINS
IN EFFICIENCY 108 5.9.7 HIGHER ADMINISTRATIVE COSTS IN PRIVATE THAN^ IN
PUBLIC SYSTEMS 108 5.9.8 ABSENCE OF SOCIAL PARTICIPATION IN PRIVATE
SYSTEMS 109 6 EFFECTS ON FINANCIAL SUSTAINABILITY AND REFORM GOALS 112
6.1 CONTRIBUTIONS 112 ,6.2 COMPLIANCE 116 6.3 COMPONENTS OF FISCAL COSTS
IN PRIVATE SYSTEMS IN THE TRANSITION AND BEYOND , 120 6.3.1 OPERATIONAL
DEFICIT OF THE PUBLIC SYSTEM 120 6.3.2 RECOGNITION BOND 122 6.3.3
MINIMUM PENSION 122 6.3.4 OTHER STATE GUARANTEES 123 6.4 ESTIMATES AND
PROJECTIONS OF FISCAL COSTS IN PRIVATE SYSTEMS 123 6.5 FINANCIAL AND
ACTUARIAL EQUILIBRIUM IN PUBLIC SYSTEMS 126 6.6 POPULATION AGING 131 XVI
CONTENTS 6.7 REFORM GOALS/ASSUMPTIONS: PRIVATE SYSTEMS PROMOTION OF
NATIONAL SAVING, CAPITAL MARKETS AND RETURNS, AND IMMUNITY AGAINST
POLITICAL INTERFERENCE 132 6.7.1 CAPITAL ACCUMULATION 133 6.7.2 INCREASE
IN NATIONAL SAVING 134 6.7.3 DEVELOPMENT OF THE CAPITAL MARKETS AND
PORTFOLIO DIVERSIFICATION 136 6.7.4 CAPITAL RETURNS 140 6.7.5 IMMUNITY
AGAINST STATE AND POLITICAL INTERFERENCE 143 6.8 IMPACT OF THE REFORMS
ON FINANCIAL SUSTAINABILITY AND REFORM GOALS/ASSUMPTIONS 145 6.8.1
PRIVATE SYSTEMS IMPOSE HIGHER CONTRIBUTIONS ON WORKERS 145 6.8.2
COMPLIANCE DETERIORATION 145 6.8.3 PROJECTION OF FISCAL COSTS JN PRIVATE
SYSTEMS 146 6.8.4 FINANCIAL AND ACTUARIAL EQUILIBRIUM IN PUBLIC SYSTEMS
146 6.8.5 POPULATION AGING 147 6.8.6 REFORM GOALS/ASSUMPTIONS: PROMOTION
OF NATIONAL SAVING, CAPITAL MARKETS AND CAPITAL RETURNS, AND IMMUNITY
AGAINST STATE-POLITICAL INTERFERENCE 147 PART III. HEALTH CARE REFORMS
AND THEIR EFFECTS 7 HEALTH CARE REFORMS: TAXONOMY, OBJECTIVES, AND
ACTORS RSS 7.1 HEALTH CARE AND PENSION REFORMS COMPARED 155 7.2
DEFINITION OF HEALTH CARE REFORM 158 7.3 HISTORICAL SUMMARY OF THE
REFORMS 159 7.4 REFORM GOALS 159 7.5 TAXONOMY OF HEALTH CARE SYSTEMS AND
THEIR REFORMS 160 7.6 EXTERNAL INFLUENCES, INTERNAL ACTORS, AND
POLITICAL ENVIRONMENT 161 7.7 MEASURING THE EFFECTS OF HEALTH CARE
REFORMS 163 8 EFFECTS OF HEALTH CARE REFORMS ON UNIVERSAL COVERAGE 167
8.1 LEGAL COVERAGE AND TARGETS 168 8.1.1 COVERAGE BY THE THREE SECTORS
168 8.1.2 FULFILLMENT OF REFORM COVERAGE TARGETS 173 8.2 ESTIMATES OF
POPULATION COVERAGE 173 8.2.1 PROBLEMS TO ESTIMATE COVERAGE 176 8.2.2
ANALYSIS OF THE AVAILABLE DATA ON COVERAGE: CURRENTLY AND BEFORE THE
REFORM CONTENTS XVII 8.2.3 ROUGH ESTIMATE OF REGIONAL COVERAGE 179 8.2.4
TRENDS IN COVERAGE BY SECTOR 179 8.3 COVERAGE BY LOCATION, URBAN-RURAL
ZONES, AND ETHNIC GROUPS 180 8.4 COVERAGE BY INCOME LEVEL 181 8.5
COVERAGE OF THE SELF-EMPLOYED AND OTHER GROUPS DIFFICULT TO INCORPORATE
184 8.6 ACCESS AND UTILIZATION 186 8.7 CAUSES OF POOR COVERAGE AND
NONFULFILLMENT OF TARGETS 189 8.8 IMPACT OF THE REFORMS ON COVERAGE AND
FULFILLMENT OF TARGETS 193 8.8.1 LEGAL COVERAGE, GROUPS DIFFICULT TO
INCORPORATE AND FULFILLMENT OF TARGETS 193 8.8.2 POPULATION COVERAGE AND
COMPARISONS BEFORE AND AFTER THE REFORM 195 8.8.3 GEOGRAPHICAL, ETHNIC
AND INCOME DISPARITIES IN COVERAGE 196 8.8.4 ACCESS AND UTILIZATION 197
8.8.5 CAUSES FOR LOW COVERAGE AND NONFULFILLMENT OF TARGETS 198 9
EFFECTS ON EQUAL TREATMENT, SOLIDARITY, AND
COMPREHENSIVENESS/SUFFICIENCY 203 9.1 EQUAL TREATMENT 203 9.1.1
STANDARDIZATION OF BENEFITS AND SUBSISTING DISPARITIES 204 9.1.2
FINANCIAL EQUITY BY INCOME LEVELS AND GEOGRAPHIC AREAS 206 9.1.3
INEQUALITIES IN HUMAN AND PHYSICAL RESOURCES AND IN HEALTH INDICATORS:
GEOGRAPHIC AREAS, HEALTH SECTORS, AND ETHNIC GROUPS 209 9.1.4 GENDER
INEQUALITIES IN ACCESS AND CARE 211 9.2 SOLIDARITY AND INCOME
DISTRIBUTION 212 9.2.1 SOLIDARITY VIS-A-VIS EQUIVALENCE 213 9.2.2
MECHANISMS IN FAVOR AND AGAINST SOLIDARITY 214 9.3 COMPREHENSIVENESS AND
SUFFICIENCY OF BENEFITS 217 9.3.1 BASIC PACKAGE OF BENEFITS 217 9.3.2
CATASTROPHIC ILLNESSES AND HIGH-COMPLEX PROCEDURES 224 9.3.3 PERCEIVED
QUALITY OF BENEFITS 225 9.4 IMPACT OF THE REFORMS ON EQUAL TREATMENT,
SOLIDARITY, AND COMPREHENSIVENESS/SUFFICIENCY 227 9.4.1 EQUAL TREATMENT
AND EQUITY 227 9.4.2 SOLIDARITY 229 9.4.3 COMPREHENSIVENESS/SUFFICIENCY
230 XVIII CONTENTS 10 EFFECTS ON UNITY, STATE RESPONSIBILITY,
EFFICIENCY, COSTS, SOCIAL PARTICIPATION, AND REFORM NEW GOALS 235 - 10.1
UNITY OR INTEGRATION OF THE SYSTEM 236 10.1.1 INTEGRATION AND
COORDINATION IN PUBLIC SECTOR A N D SOCIAL I N S U R A N C E -{***- 236
10.1.2 MULTIPLICITY IN THE PRIVATE SECTOR - 240 10.2 REFORM GOAL:
SEPARATION OF FUNCTIONS 241 10.3 ROLE OF THE STATE: REGULATION AND
SUPERVISION- 246 10.4 REFORM GOAL: DECENTRALIZATION 248 10.4.1 DEGREE OF
DECENTRALIZATION ACHIEVED 249 10.4.2 DECENTRALIZATION OF FUNCTIONS 252
10.4.3 EVALUATION OF DECENTRALIZATION RESULTS 253 10.5 REFORM GOAL:
COMPETITION 257 10.6 REFORM GOAL: PRIVATIZATION 261 10.7 REFORM GOAL:
FREEDOM OF CHOICE 264 10.8 EFFICIENCY 266 10.8.1 GENERAL INDICATORS OF
EFFICIENCY 267 10.8.2 MAJOR PROBLEMS OF EFFICIENCY 270 10.8.3 MEASURES
TO IMPROVE EFFICIENCY 271 10.9 ADMINISTRATIVE COSTS 273 10.10 SOCIAL
PARTICIPATION IN THE ADMINISTRATION 276 10.10.1 SOCIAL PARTICIPATION IN
THE REFORM PROCESS 277 10.10.2 GENERAL EVALUATIONS OF SOCIAL
PARTICIPATION 278 10.10.3 PARTICIPATORY BODIES, REPRESENTATION,
FUNCTIONS, AND EFFECTIVENESS 279 10.11 IMPACT OF THE REFORMS ON UNITY,
STATE RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL PARTICIPATION, AND
REFORM GOALS 284 10.11.1 INTEGRATION AND COORDINATION 284 10.11.2 REFORM
GOAL: SEPARATION OF FUNCTIONS 284 10.11.3 STATE ROLE: REGULATION AND
SUPERVISION 285 10.11.4 REFORM GOAL: DECENTRALIZATION 285 10.11.5 REFORM
GOALS: COMPETITION, PRIVATIZATION, AND FREEDOM OF CHOICE 287 10.11.6
EFFICIENCY AND ADMINISTRATIVE COSTS 288 10.11.7 SOCIAL PARTICIPATION 289
11 EFFECTS ON FINANCIAL SUSTAINABILITY AND EFFICACY 293 11.1 FINANCIAL
SUSTAINABILITY 293 11.1.1 HEALTH EXPENDITURE TRENDS, DISTRIBUTION BY
SECTORS AND PER CAPITA ( ,. 294 11.1.2 SOURCES OF FINANCING 299 11.1.3
COMPLIANCE 308 11.1.4 REFORM GOAL: SHIFT FROM SUPPLY TO DEMAND SUBSIDIES
* 313 CONTENTS XIX 11.I.5 FINANCIAL AND ACTUARIAL BALANCE 315 11.1.6
IMPACTS OF THE REFORMS ON FINANCIAL SUSTAINABILITY . . . .. 32O 11.2
EFFICACY 324 11.2.1 UNFEASIBILITY TO MEASURE THE REFORM IMPACT ON
EFFICACY 324 11.2.2 EVOLUTION OF HEALTH INDICATORS BETWEEN 1990 AND 2002
325 PART IV. TOWARD S A BETTER SOCIAL SECURITY IN THE FUTURE 12 POLICIES
ON PENSIONS AND HEALTH CARE 335 12.1 PENSIONS 335 12.1.1 COVERAGE 336
12.1.2 EQUAL TREATMENT , , 341 12.1.3 SOLIDARITY AND INCOME
REDISTRIBUTION 342 12.1.4 COMPREHENSIVENESS AND SUFFICIENCY OF BENEFITS
343 12.1.5 UNITY, STATE RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL
PARTICIPATION, AND REFORM GOALS 345 12.1.6 FINANCIAL SUSTAINABILITY 349
12.1.7 REFORM GOALS: PROMOTION OF NATIONAL SAVING, CAPITAL MARKETS, AND
CAPITAL RETURNS 352 12.1.8 REFORM ASSUMPTION: IMMUNITY AGAINST STATE
INTERFERENCE 355 12.2 HEALTH CARE, 355 12.2.1 COVERAGE 357 12.2.2 EQUAL
TREATMENT 362 12.2.3 SOLIDARITY AND INCOME REDISTRIBUTION 364 12.2.4
COMPREHENSIVENESS AND SUFFICIENCY OF BENEFITS 365 12.2.5 UNITY, STATE
RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL PARTICIPATION, AND REFORM
GOALS 367 12.2.6 FINANCIAL SUSTAINABILITY 376 12.2.7 IMPACT ON HEALTH
INDICATORS (EFFICACY) 381 APPENDICES 383 BIBLIOGRAPHY 387 INDEX 412
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| adam_txt |
CONTENTS LIST OF TABLES AND APPENDICES XX ABBREVIATIONS XXIII PART I.
INTRODUCTION: THE STATE OF PENSION AND HEALTH CARE IN THE REGION BEFORE
THE REFORMS 1 SOCIAL SECURITY PRINCIPLES, ENFORCEMENT IN LATIN AMERICA,
AND MODIFICATIONS BY THE REFORMS 3 1.1 INTRODUCTION 3 1.2 PRINCIPLES,
REGIONAL ENFORCEMENT, AND MODIFICATIONS BY THE REFORMS 5 1.2.1 UNIVERSAL
COVERAGE 5 1.2.2 EQUAL TREATMENT 8 1.2.3 SOLIDARITY AND INCOME
REDISTRIBUTION RO 1.2.4 COMPREHENSIVENESS AND SUFFICIENCY OF BENEFITS 12
1.2.5 UNITY, STATE RESPONSIBILITY, EFFICIENCY, AND SOCIAL PARTICIPATION
IN ADMINISTRATION 14 1.2.6 FINANCIAL SUSTAINABILITY 17 1.2.7 REFORM
ASSUMPTIONS/GOALS: PROMOTION OF NATIONAL SAVING AND CAPITAL MARKETS 21
1.2.8 REFORM ASSUMPTION: IMMUNITY TO STATE AND POLITICAL INTERFERENCE 21
1.2.9 CONCLUSIONS: ENFORCEMENT OF PRINCIPLES IN THE REGION BEFORE THE
REFORMS 21 PART II. PENSION REFORMS AND THEIR EFFECTS 2 PENSION REFORMS:
TAXONOMY, GOALS, AND ACTORS 27 2.1 PRIVATE AND PUBLIC SYSTEMS: TAXONOMY
IN LATIN AMERICA 27 2.2 TYPES OF REFORMS: STRUCTURAL AND PARAMETRIC 28
2.2.1 STRUCTURAL REFORMS 28 2.2.2 PARAMETRIC REFORMS OR LACK OF REFORMS
31 2.3 GOALS AND ASSUMPTIONS OF PENSION REFORMS 32 XIV CONTENTS 2.4
EXTERNAL INFLUENCES, INTERNAL ACTORS, AND POLITICO-ECONOMIC ENVIRONMENT
32 2.5 ONE SINGLE TYPE OF REFORM/MODEL OR SEVERAL TYPES/MODELS? 34 3
EFFECTS OF PENSION REFORMS ON UNIVERSAL COVERAGE 36 3.1 STATISTICAL
COVERAGE OF THE LABOR FORCE BY THE CONTRIBUTORY SYSTEM 36 3.1.1 PRIVATE
SYSTEMS - - . * ' . * ' 36 3.1.2 PUBLIC SYSTEMS 39 3.1.3 COMPARISON OF
PRIVATE AND PUBLIC SYSTEMS '*''' ! COVERAGE " * 39 3.2 LEGAL AND
STATISTICAL COVERAGE OF GROUPS DIFFICULT TO AFFILIATE . , * ' 40 3.2.1
URBAN INFORMAL SECTOR 41 3.2.2 RURAL SECTOR - 45 3.2.3 MEASURES TO
IMPROVE COVERAGE OF DIFFICULT GROUPS 46 3.3 SOCIAL ASSISTANCE PENSIONS
FOR THE UNINSURED AND IMPACT ON POVERTY 47 3.4 COVERAGE OF THE OLDER
POPULATION 51 3.5 IMPACT OF THE REFORMS ON COVERAGE 52 3.5.1 COVERAGE IN
PRIVATE AND PUBLIC SYSTEMS, AND REGIONAL TRENDS 52 3.5.2 GROUPS
DIFFICULT TO COVER 53 3.5.3 SOCIAL ASSISTANCE AND POVERTY 54 3.5.4
COVERAGE OF THE ELDERLY 55 4 EFFECTS ON EQUAL TREATMENT, SOLIDARITY, AND
COMPREHENSIVENESS-SUFFICIENCY 58 4.1 EQUAL TREATMENT 58 4.1.1 SURVIVAL
OF PRIVILEGED SCHEMES AND THEIR UNEQUAL ENTITLEMENT CONDITIONS. 5 8
4.1.2 GENDER INEQUALITY 59 4.2 SOLIDARITY AND INCOME DISTRIBUTION 63
4.2.1 SOLIDARITY VERSUS EQUIVALENCE 63 4.2.2 MECHANISMS FOR AND AGAINST
SOLIDARITY 64 4.3 COMPREHENSIVENESS AND SUFFICIENCY OF BENEFITS ' 67
4.3.1 RETIREMENT AGES AND SPANS, AND CONTRIBUTION YEARS IN ALL SYSTEMS
68 4.3.2 THE PENSION FORMULA IN PUBLIC PENSIONS 70 4.3.3 ADJUSTMENT OF
PRIVATE AND PUBLIC PENSIONS 72 4.3.4 LEVELS OF NONCONTRIBUTORY PENSIONS
IN PRIVATE AND PUBLIC SYSTEMS 73 4.3.5 ARE PRIVATE PENSIONS HIGHER THAN
PUBLIC PENSIONS? 74 CONTENTS XV 4.4ILMPACT OF THE REFORMS ON EQUAL
TREATMENT, SOLIDARITY, AND COMPREHENSIVENESS/SUFFICIENCY 76 4.4.1 EQUAL
TREATMENT 76 4.4.2 SOLIDARITY 77 4.4.3 COMPREHENSIVENESS AND SUFFICIENCY
78 5 EFFECTS ON UNITY, STATE RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL
PARTICIPATION, AND REFORM GOALS 83 5.1 UNIFICATION VERSUS SEGMENTATION
83 5.2 THE ROLE OF THE STATE 87 5.3 REFORM GOALS: FREEDOM OF CHOICE AND
PRIVATIZATION 89 5.4 REFORM GOAL: COMPETITION 93 5.5 INFORMATION 95 5.6
EFFICIENCY 97 5.7 ADMINISTRATIVE COSTS ' 98 5.8 SOCIAL PARTICIPATION IN
THE ADMINISTRATION 102 5.9 IMPACT OF THE REFORMS ON UNITY, STATE
RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL PARTICIPATION, AND REFORM
GOALS 105 5.9.1 MOST SYSTEMS ARE STILL SEGMENTED OR HIGHLY SEGMENTED 105
! 5.9.2 THE STATE ROLE CONTINUES TO BE FUNDAMENTAL RATHER THAN
SUBSIDIARY 106 5.9.3 REFORM GOALS: FREEDOM OF CHOICE AND PRIVATIZATION
106 5.9.4 REFORM GOAL: COMPETITION DOES NOT WORK PROPERLY OR DOES NOT
EXIST *. 107 5.9.5 THE INSURED LACK INFORMATION 107 5.9.6 UNEVEN GAINS
IN EFFICIENCY 108 5.9.7 HIGHER ADMINISTRATIVE COSTS IN PRIVATE THAN^ IN
PUBLIC SYSTEMS 108 5.9.8 ABSENCE OF SOCIAL PARTICIPATION IN PRIVATE
SYSTEMS 109 6 EFFECTS ON FINANCIAL SUSTAINABILITY AND REFORM GOALS 112
6.1 CONTRIBUTIONS 112 ,6.2 COMPLIANCE 116 6.3 COMPONENTS OF FISCAL COSTS
IN PRIVATE SYSTEMS IN THE TRANSITION AND BEYOND , 120 6.3.1 OPERATIONAL
DEFICIT OF THE PUBLIC SYSTEM 120 6.3.2 RECOGNITION BOND 122 6.3.3
MINIMUM PENSION 122 6.3.4 OTHER STATE GUARANTEES ' 123 6.4 ESTIMATES AND
PROJECTIONS OF FISCAL COSTS IN PRIVATE SYSTEMS 123 6.5 FINANCIAL AND
ACTUARIAL EQUILIBRIUM IN PUBLIC SYSTEMS 126 6.6 POPULATION AGING 131 XVI
CONTENTS 6.7 REFORM GOALS/ASSUMPTIONS: PRIVATE SYSTEMS PROMOTION OF
NATIONAL SAVING, CAPITAL MARKETS AND RETURNS, AND IMMUNITY AGAINST
POLITICAL INTERFERENCE 132 6.7.1 CAPITAL ACCUMULATION 133 6.7.2 INCREASE
IN NATIONAL SAVING 134 6.7.3 DEVELOPMENT OF THE CAPITAL MARKETS AND
PORTFOLIO DIVERSIFICATION 136 6.7.4 CAPITAL RETURNS 140 6.7.5 IMMUNITY
AGAINST STATE AND POLITICAL INTERFERENCE 143 6.8 IMPACT OF THE REFORMS
ON FINANCIAL SUSTAINABILITY AND REFORM GOALS/ASSUMPTIONS 145 6.8.1
PRIVATE SYSTEMS IMPOSE HIGHER CONTRIBUTIONS ON WORKERS 145 6.8.2
COMPLIANCE DETERIORATION 145 6.8.3 PROJECTION OF FISCAL COSTS JN PRIVATE
SYSTEMS 146 6.8.4 FINANCIAL AND ACTUARIAL EQUILIBRIUM IN PUBLIC SYSTEMS
146 6.8.5 POPULATION AGING 147 6.8.6 REFORM GOALS/ASSUMPTIONS: PROMOTION
OF NATIONAL SAVING, CAPITAL MARKETS AND CAPITAL RETURNS, AND IMMUNITY
AGAINST STATE-POLITICAL INTERFERENCE 147 PART III. HEALTH CARE REFORMS
AND THEIR EFFECTS 7 HEALTH CARE REFORMS: TAXONOMY, OBJECTIVES, AND
ACTORS RSS 7.1 HEALTH CARE AND PENSION REFORMS COMPARED 155 7.2
DEFINITION OF HEALTH CARE REFORM 158 7.3 HISTORICAL SUMMARY OF THE
REFORMS 159 7.4 REFORM GOALS 159 7.5 TAXONOMY OF HEALTH CARE SYSTEMS AND
THEIR REFORMS 160 7.6 EXTERNAL INFLUENCES, INTERNAL ACTORS, AND
POLITICAL ENVIRONMENT 161 7.7 MEASURING THE EFFECTS OF HEALTH CARE
REFORMS 163 8 EFFECTS OF HEALTH CARE REFORMS ON UNIVERSAL COVERAGE 167
8.1 LEGAL COVERAGE AND TARGETS 168 8.1.1 COVERAGE BY THE THREE SECTORS
168 8.1.2 FULFILLMENT OF REFORM COVERAGE TARGETS 173 8.2 ESTIMATES OF
POPULATION COVERAGE 173 8.2.1 PROBLEMS TO ESTIMATE COVERAGE 176 8.2.2
ANALYSIS OF THE AVAILABLE DATA ON COVERAGE: CURRENTLY AND BEFORE THE
REFORM CONTENTS XVII 8.2.3 ROUGH ESTIMATE OF REGIONAL COVERAGE 179 8.2.4
TRENDS IN COVERAGE BY SECTOR 179 8.3 COVERAGE BY LOCATION, URBAN-RURAL
ZONES, AND ETHNIC GROUPS 180 8.4 COVERAGE BY INCOME LEVEL 181 8.5
COVERAGE OF THE SELF-EMPLOYED AND OTHER GROUPS DIFFICULT TO INCORPORATE
184 8.6 ACCESS AND UTILIZATION 186 8.7 CAUSES OF POOR COVERAGE AND
NONFULFILLMENT OF TARGETS 189 8.8 IMPACT OF THE REFORMS ON COVERAGE AND
FULFILLMENT OF TARGETS 193 8.8.1 LEGAL COVERAGE, GROUPS DIFFICULT TO
INCORPORATE AND FULFILLMENT OF TARGETS 193 8.8.2 POPULATION COVERAGE AND
COMPARISONS BEFORE AND AFTER THE REFORM 195 8.8.3 GEOGRAPHICAL, ETHNIC
AND INCOME DISPARITIES IN COVERAGE 196 8.8.4 ACCESS AND UTILIZATION 197
8.8.5 CAUSES FOR LOW COVERAGE AND NONFULFILLMENT OF TARGETS 198 9
EFFECTS ON EQUAL TREATMENT, SOLIDARITY, AND
COMPREHENSIVENESS/SUFFICIENCY 203 9.1 EQUAL TREATMENT 203 9.1.1
STANDARDIZATION OF BENEFITS AND SUBSISTING DISPARITIES 204 9.1.2
FINANCIAL EQUITY BY INCOME LEVELS AND GEOGRAPHIC AREAS 206 9.1.3
INEQUALITIES IN HUMAN AND PHYSICAL RESOURCES AND IN HEALTH INDICATORS:
GEOGRAPHIC AREAS, HEALTH SECTORS, AND ETHNIC GROUPS 209 9.1.4 GENDER
INEQUALITIES IN ACCESS AND CARE 211 9.2 SOLIDARITY AND INCOME
DISTRIBUTION 212 9.2.1 SOLIDARITY VIS-A-VIS EQUIVALENCE 213 9.2.2
MECHANISMS IN FAVOR AND AGAINST SOLIDARITY 214 9.3 COMPREHENSIVENESS AND
SUFFICIENCY OF BENEFITS 217 9.3.1 BASIC PACKAGE OF BENEFITS 217 9.3.2
CATASTROPHIC ILLNESSES AND HIGH-COMPLEX PROCEDURES 224 9.3.3 PERCEIVED
QUALITY OF BENEFITS 225 9.4 IMPACT OF THE REFORMS ON EQUAL TREATMENT,
SOLIDARITY, AND COMPREHENSIVENESS/SUFFICIENCY 227 9.4.1 EQUAL TREATMENT
AND EQUITY 227 9.4.2 SOLIDARITY 229 9.4.3 COMPREHENSIVENESS/SUFFICIENCY
230 XVIII CONTENTS 10 EFFECTS ON UNITY, STATE RESPONSIBILITY,
EFFICIENCY, COSTS, SOCIAL PARTICIPATION, AND REFORM NEW GOALS 235 - 10.1
UNITY OR INTEGRATION OF THE SYSTEM 236 10.1.1 INTEGRATION AND
COORDINATION IN PUBLIC SECTOR A N D SOCIAL I N S U R A N C E -{***- 236
10.1.2 MULTIPLICITY IN THE PRIVATE SECTOR - 240 10.2 REFORM GOAL:
SEPARATION OF FUNCTIONS 241 10.3 ROLE OF THE STATE: REGULATION AND
SUPERVISION- 246 10.4 REFORM GOAL: DECENTRALIZATION 248 10.4.1 DEGREE OF
DECENTRALIZATION ACHIEVED 249 10.4.2 DECENTRALIZATION OF FUNCTIONS 252
10.4.3 EVALUATION OF DECENTRALIZATION RESULTS 253 10.5 REFORM GOAL:
COMPETITION 257 10.6 REFORM GOAL: PRIVATIZATION 261 10.7 REFORM GOAL:
FREEDOM OF CHOICE 264 10.8 EFFICIENCY 266 10.8.1 GENERAL INDICATORS OF
EFFICIENCY 267 10.8.2 MAJOR PROBLEMS OF EFFICIENCY 270 10.8.3 MEASURES
TO IMPROVE EFFICIENCY 271 10.9 ADMINISTRATIVE COSTS 273 10.10 SOCIAL
PARTICIPATION IN THE ADMINISTRATION 276 10.10.1 SOCIAL PARTICIPATION IN
THE REFORM PROCESS 277 10.10.2 GENERAL EVALUATIONS OF SOCIAL
PARTICIPATION 278 10.10.3 PARTICIPATORY BODIES, REPRESENTATION,
FUNCTIONS, AND EFFECTIVENESS 279 10.11 IMPACT OF THE REFORMS ON UNITY,
STATE RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL PARTICIPATION, AND
REFORM GOALS 284 10.11.1 INTEGRATION AND COORDINATION 284 10.11.2 REFORM
GOAL: SEPARATION OF FUNCTIONS 284 10.11.3 STATE ROLE: REGULATION AND
SUPERVISION 285 10.11.4 REFORM GOAL: DECENTRALIZATION 285 10.11.5 REFORM
GOALS: COMPETITION, PRIVATIZATION, AND FREEDOM OF CHOICE 287 10.11.6
EFFICIENCY AND ADMINISTRATIVE COSTS 288 10.11.7 SOCIAL PARTICIPATION 289
11 EFFECTS ON FINANCIAL SUSTAINABILITY AND EFFICACY 293 11.1 FINANCIAL
SUSTAINABILITY 293 11.1.1 HEALTH EXPENDITURE TRENDS, DISTRIBUTION BY
SECTORS AND PER CAPITA ( ,. 294 11.1.2 SOURCES OF FINANCING 299 11.1.3
COMPLIANCE 308 11.1.4 REFORM GOAL: SHIFT FROM SUPPLY TO DEMAND SUBSIDIES
* 313 CONTENTS XIX 11.I.5 FINANCIAL AND ACTUARIAL BALANCE 315 11.1.6
IMPACTS OF THE REFORMS ON FINANCIAL SUSTAINABILITY . . . . 32O 11.2
EFFICACY 324 11.2.1 UNFEASIBILITY TO MEASURE THE REFORM IMPACT ON
EFFICACY 324 11.2.2 EVOLUTION OF HEALTH INDICATORS BETWEEN 1990 AND 2002
325 PART IV. TOWARD S A BETTER SOCIAL SECURITY IN THE FUTURE 12 POLICIES
ON PENSIONS AND HEALTH CARE 335 12.1 PENSIONS 335 12.1.1 COVERAGE 336
12.1.2 EQUAL TREATMENT , , 341 12.1.3 SOLIDARITY AND INCOME
REDISTRIBUTION 342 12.1.4 COMPREHENSIVENESS AND SUFFICIENCY OF BENEFITS
343 12.1.5 UNITY, STATE RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL
PARTICIPATION, AND REFORM GOALS 345 12.1.6 FINANCIAL SUSTAINABILITY 349
12.1.7 REFORM GOALS: PROMOTION OF NATIONAL SAVING, CAPITAL MARKETS, AND
CAPITAL RETURNS 352 12.1.8 REFORM ASSUMPTION: IMMUNITY AGAINST STATE
INTERFERENCE 355 12.2 HEALTH CARE, 355 12.2.1 COVERAGE 357 12.2.2 EQUAL
TREATMENT 362 12.2.3 SOLIDARITY AND INCOME REDISTRIBUTION 364 12.2.4
COMPREHENSIVENESS AND SUFFICIENCY OF BENEFITS 365 12.2.5 UNITY, STATE
RESPONSIBILITY, EFFICIENCY, COSTS, SOCIAL PARTICIPATION, AND REFORM
GOALS 367 12.2.6 FINANCIAL SUSTAINABILITY 376 12.2.7 IMPACT ON HEALTH
INDICATORS (EFFICACY) 381 APPENDICES 383 BIBLIOGRAPHY 387 INDEX 412 |
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| author | Mesa-Lago, Carmelo 1934- |
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| discipline | Wirtschaftswissenschaften |
| discipline_str_mv | Wirtschaftswissenschaften |
| edition | 1. publ. |
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| index_date | 2024-07-02T20:22:34Z |
| indexdate | 2024-07-09T21:13:48Z |
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| spelling | Mesa-Lago, Carmelo 1934- Verfasser (DE-588)172256267 aut Reassembling social security a survey of pensions and health care reforms in Latin America Carmelo Mesa-Lago 1. publ. Oxford [u.a.] Oxford Univ. Press 2008 XXVI, 453 S. txt rdacontent n rdamedia nc rdacarrier Geschichte 1981-2008 gnd rswk-swf Soziale Sicherheit Pensions Latin America Social security Latin America Reformpolitik (DE-588)4048960-7 gnd rswk-swf Soziale Sicherheit (DE-588)4055732-7 gnd rswk-swf Lateinamerika Lateinamerika (DE-588)4074032-8 gnd rswk-swf Lateinamerika (DE-588)4074032-8 g Soziale Sicherheit (DE-588)4055732-7 s Reformpolitik (DE-588)4048960-7 s Geschichte 1981-2008 z DE-604 SWB Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016422836&sequence=000001&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Mesa-Lago, Carmelo 1934- Reassembling social security a survey of pensions and health care reforms in Latin America Soziale Sicherheit Pensions Latin America Social security Latin America Reformpolitik (DE-588)4048960-7 gnd Soziale Sicherheit (DE-588)4055732-7 gnd |
| subject_GND | (DE-588)4048960-7 (DE-588)4055732-7 (DE-588)4074032-8 |
| title | Reassembling social security a survey of pensions and health care reforms in Latin America |
| title_auth | Reassembling social security a survey of pensions and health care reforms in Latin America |
| title_exact_search | Reassembling social security a survey of pensions and health care reforms in Latin America |
| title_exact_search_txtP | Reassembling social security a survey of pensions and health care reforms in Latin America |
| title_full | Reassembling social security a survey of pensions and health care reforms in Latin America Carmelo Mesa-Lago |
| title_fullStr | Reassembling social security a survey of pensions and health care reforms in Latin America Carmelo Mesa-Lago |
| title_full_unstemmed | Reassembling social security a survey of pensions and health care reforms in Latin America Carmelo Mesa-Lago |
| title_short | Reassembling social security |
| title_sort | reassembling social security a survey of pensions and health care reforms in latin america |
| title_sub | a survey of pensions and health care reforms in Latin America |
| topic | Soziale Sicherheit Pensions Latin America Social security Latin America Reformpolitik (DE-588)4048960-7 gnd Soziale Sicherheit (DE-588)4055732-7 gnd |
| topic_facet | Soziale Sicherheit Pensions Latin America Social security Latin America Reformpolitik Lateinamerika |
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