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Social insurance is a form of social welfare that provides insurance against economic risks. The insurance may be provided publicly or through the subsidizing of private insurance. In contrast to other forms of social assistance, individuals' claims are partly dependent on their contributions, which can be considered insurance premiums to create a common fund out of which the individuals are then paid benefits in the future. [1] [2]
Types of social insurance include:
Social insurance has also been defined as a program whose risks are transferred to and pooled by an often government organisation legally required to provide certain benefits. [4]
In the United States, programs that meet these definitions include Social Security, Medicare, the Pension Benefit Guaranty Corporation program, the Railroad Retirement Board program and state-sponsored unemployment insurance programs. [3] The Canada Pension Plan (CPP) is also a social insurance program.
The World Bank's 2019 World Development Report on The Changing Nature of Work [5] considers the appropriateness of traditional social insurance models that are based on steady wage employment in light of persistently large informal sectors in developing countries and the decline in standard employer-employee relationships in advanced countries.
Social insurance is a public insurance that provides protection against economic risks. Participation in social insurance is compulsory. Social insurance is considered to be a type of social security.
Social insurance differs from public support in that individuals' claims are partly dependent on their contributions, which can be considered as insurance premium. If what individuals receive is proportional to their contributions, social insurance can be considered a government "production activity" rather than redistribution. Given that what some receive is far higher than what they attribute (on an actuarial basis), there is a large element of redistribution involved in government social insurance programs. The largest of these programs is Old Age,[ citation needed ] [6] Survivors' and Disability Insurance Program (OASDI). It provides income not only for pensioners, but also to their survivors (especially widows and widowers) and people with disabilities. Other major social insurance schemes are workers' compensation, which provides compensation for workers injured at work, unemployment insurance providing temporary benefits after job loss, and Medicare. The Medicare Program, which provides medical services in old age (like Medicaid), has grown rapidly since its first introduction in 1965 and is now the second largest program. Social security and Medicare are sometimes called middle class programs because the middle class are the main beneficiaries and benefits are not provided on a need basis, but when people satisfy a certain requirement, for example age. As soon as they satisfy the criteria, they can receive benefits.
Social insurance is based on the premise that there is not always equitable distribution of resources or benefits in a competitive economy and there must be provisions to ensure that participants in the market do not end up with an "all-or-nothing-game". [7] It is a means to allow participants of a dynamic economy to take risks and engage in economic activity with the assurance that in the instance of an emergency, they will be protected through this accumulated fund. Social insurance provides "social justice" and "social stability". [7]
The following reasons specifically identify the features of a market economy that give rise to the need for social insurance:
This is a form of failure in a competitive market where there is not a parity in the provision of information between buyers and sellers or in this situation insurers and the insured. If the risk involved in a transaction is not made equally clear to both parties then the trades are differently valued by the two parties. [8]
The difference in knowledge between insurers and insured about the risk level ultimately leads to the problem of adverse selection. An example of this problem would be the situation where insurers set a particular price for health insurance that is too high for individuals with low risk of getting sick, and thus only those with a high risk of getting sick purchase this insurance. Ultimately the insurance company is losing money since they cannot discriminate between buyers and thus they further increase prices. This increase continues to eliminate individuals whose risk level is not enough to pay the prices of this insurance and insurance companies enter the death spiral. [9]
In order to achieve a better and more equitable distribution of insurance costs, the government intervenes through the means of taxation of low risk individuals in order to subsidise the premiums that have to be paid by high risk individuals. [8] Therefore, there is a redistribution from low risk individuals to high risk individuals. [9] [10] Because of this, income taxes are often used in the efficient implementation of social insurance programs. In the case of the Affordable Care Act, for example, an individual mandate was included which required Americans to purchase health insurance or be subject to a financial penalty. This allowed higher cost individuals, from the perspective of insurance companies, such as people with pre-existing conditions to be covered and not excluded at a reasonable rate. [11] Although causing political controversy, was an example of redistribution within a social insurance program.
If individuals do not have social insurance and are thereby unable to afford the basic right of healthcare, then not only are they subjecting themselves to illnesses but also creating the likelihood that others around them will be infected as well. This would be an example of a negative externality. [9] In the case of the now struck down individual mandate, everyone purchasing health insurance creates a positive externality for those that are high cost to insurance companies as they can now afford health care and cannot be discriminated upon because of various emerging or pre-existing conditions.
The existence of social insurance stems from the acceptance of the ideology that workers should be insured against the risk of losses of economic status due to their participation in the labour market. [12] This inherent idea of fairness has propagated the desirability and subsequent durability of this program.
An issue of social insurance is that often, individuals who are insured against certain risks become complacent and more likely to take adverse actions because they are secure in the knowledge that they will be insured against the adverse outcomes of these actions[ dubious – discuss ]. This process is known as moral hazard and is a drawback of providing insurance to everyone because then the government and insurance providers cannot monitor the insured and must bear their costs of immoral actions. [13]
Moral hazard has important implications for optimal social insurance programs, particularly in the case of unemployment benefits: the presence of moral hazard entails that, paradoxical as it may seem, individuals should optimally be only partially insured against unemployment. This is because, in order to incentivize an unemployed worker's job search effort, it is necessary that the benefits paid to the worker during unemployment, meted out as a fraction of the worker's previous salary, are greatest when the individual is actively seeking employment. [14]
Those that critique the program of social insurance bring up the argument that programs such as social security only increase the burden on the employed youth of the country because of the number of retired individuals that are the beneficiaries.
However, this has been mitigated by research that shows that although the number of retirees that benefit from the working youth is significant, the number of children that American families are raising, have considerably fallen. Thus, the number of members in a family that need to be supported have reduced. The question of whether this is fair still remains on the youth who must decide whether this offset in payments is enough of a counteracting effect.
In 2019, receipts from Social Insurance taxes, the second-largest revenue source, increased by $72 billion (or 6 percent), and increased as a share of the economy from 5.8 percent in 2018 to 5.9 percent in 2019, climbing just above the 50-year average of 5.9 percent.
"The increase in payroll tax receipts reflects higher wages and salaries and the reallocations made between payroll and individual income taxes" [15]
Unemployment insurance and workers' compensation are essential aspects of Social Insurance that indeed provide unparalleled assistance to citizens facing uncertainty regarding their jobs. Although these programs have obvious benefits, they also affect the labor supply because they incentivise workers to spend time out of work and thus the time that these citizens are unemployed is longer. [16] Unemployment insurance, an example of social insurance, is inherently faced with determining whether individuals face financial hardship in the form of little or no income by choice or by circumstantial necessity. An unemployed worker is able to rejoin the work force through active, effortful job search. In the case of full unemployment insurance, and job search effort is difficult to be monitored and evaluated, the unemployed individual may have no incentive to keep searching as they receive unemployment benefits. This reveals the inherent social insurance tradeoff of the incentives of the insurance and the risk involved. [14]
Typical similarities between social insurance programs and private insurance programs include:
Typical differences between private insurance programs and social insurance programs include:
Welfare is a large program of social insurance that creates many externalities. With welfare, the beneficiary's contributions to the program are taken into account. A welfare program pays recipients based on need, not contributions. In the US, there are welfare-to-work programs that give unemployed people an incentive to work if they are starting to seek a job. The people who use these programs are government expenditures and are closely monitored to make sure that they are searching for a job. They will receive several benefits once they find a job including wage subsidies and tax breaks. Welfare-to-work programs like these try to give people the incentive to work because, without them, people have a strong incentive to stay unemployed.
Insurance is a means of protection from financial loss in which, in exchange for a fee, a party agrees to compensate another party in the event of a certain loss, damage, or injury. It is a form of risk management, primarily used to protect against the risk of a contingent or uncertain loss.
The Social Security Act of 1935 is a law enacted by the 74th United States Congress and signed into law by U.S. President Franklin D. Roosevelt on August 14, 1935. The law created the Social Security program as well as insurance against unemployment. The law was part of Roosevelt's New Deal domestic program.
Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis. It was begun in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS).
Welfare spending is a type of government support intended to ensure that members of a society can meet basic human needs such as food and shelter. Social security may either be synonymous with welfare, or refer specifically to social insurance programs which provide support only to those who have previously contributed, as opposed to social assistance programs which provide support on the basis of need alone. The International Labour Organization defines social security as covering support for those in old age, support for the maintenance of children, medical treatment, parental and sick leave, unemployment and disability benefits, and support for sufferers of occupational injury.
Unemployment benefits, also called unemployment insurance, unemployment payment, unemployment compensation, or simply unemployment, are payments made by governmental bodies to unemployed people. Depending on the country and the status of the person, those sums may be small, covering only basic needs, or may compensate the lost time proportionally to the previous earned salary.
Life insurance is a contract between an insurance policy holder and an insurer or assurer, where the insurer promises to pay a designated beneficiary a sum of money upon the death of an insured person. Depending on the contract, other events such as terminal illness or critical illness can also trigger payment. The policyholder typically pays a premium, either regularly or as one lump sum. The benefits may include other expenses, such as funeral expenses.
Health insurance or medical insurance is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among many individuals. By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity.
In macroeconomics and finance, a transfer payment is a redistribution of income and wealth by means of the government making a payment, without goods or services being received in return. These kind of payments are one-sided in nature, i.e. one party enjoys economic benefits from the other party. These payments are considered to be non-exhaustive because they do not directly absorb resources or create output. Examples of transfer payments include welfare, financial aid, social security, and government subsidies for certain businesses.
Two-tier healthcare is a situation in which a basic government-provided healthcare system provides basic care, and a secondary tier of care exists for those who can pay for additional, better quality or faster access. Most countries have both publicly and privately funded healthcare, but the degree to which it creates a quality differential depends on the way the two systems are managed, funded, and regulated.
The U.S. Railroad Retirement Board (RRB) is an independent agency in the executive branch of the United States government created in 1935 to administer a social insurance program providing retirement benefits to the country's railroad workers.
Social welfare, assistance for the ill or otherwise disabled and the old, has long been provided in Japan by both the government and private companies. Beginning in the 1920s, the Japanese government enacted a series of welfare programs, based mainly on European models, to provide medical care and financial support. During the post-war period, a comprehensive system of social security was gradually established. Universal health insurance and a pension system were established in 1960.
In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.
Medicare Advantage is a type of health plan offered by Medicare-approved private companies that must follow rules set by Medicare. Offered since passage of the BBA in 1997, Medicare Advantage/Part C creates a private insurance option that wraps around traditional Medicare, filling in many or most of the coverage gaps and including new options, resulting in a more conventional health insurance experience for Medicare recipients.
Social security is divided by the French government into five branches: illness; old age/retirement; family; work accident; and occupational disease. From an institutional point of view, French social security is made up of diverse organismes. The system is divided into three main Regimes: the General Regime, the Farm Regime, and the Self-employed Regime. In addition there are numerous special regimes dating from prior to the creation of the state system in the mid-to-late 1940s.
Welfare in France includes all systems whose purpose is to protect people against the financial consequences of social risks.
In the United States, the federal and state social programs including cash assistance, health insurance, food assistance, housing subsidies, energy and utilities subsidies, and education and childcare assistance. Similar benefits are sometimes provided by the private sector either through policy mandates or on a voluntary basis. Employer-sponsored health insurance is an example of this.
The Empowering Patients First Act is legislation sponsored by Rep. Tom Price, first introduced as H.R. 3400 in the 111th Congress. The bill was initially intended to be a Republican alternative to the America's Affordable Health Choices Act of 2009, but has since been positioned as a potential replacement to the Patient Protection and Affordable Care Act (PPACA). The bill was introduced in the 112th Congress as H.R. 3000, and in the 113th Congress as H.R. 2300. As of October 2014, the bill has 58 cosponsors. An identical version of the bill has been introduced in the Senate by Senator John McCain as S. 1851.
Social security or welfare in Finland is very comprehensive compared to what almost all other countries provide. In the late 1980s, Finland had one of the world's most advanced welfare systems, which guaranteed decent living conditions to all Finns. Created almost entirely during the first three decades after World War II, the social security system was an outgrowth of the traditional Nordic belief that the state is not inherently hostile to the well-being of its citizens and can intervene benevolently on their behalf. According to some social historians, the basis of this belief was a relatively benign history that had allowed the gradual emergence of a free and independent peasantry in the Nordic countries and had curtailed the dominance of the nobility and the subsequent formation of a powerful right wing. Finland's history was harsher than the histories of the other Nordic countries but didn't prevent the country from following their path of social development.
James Claude Robinson is a professor of health economics at the University of California, Berkeley School of Public Health, where he has the title of the Leonard D. Schaeffer Endowed Chair in Health Economics and Policy. Robinson is also the Chair of the Berkeley Center for Health Technology, which supports research and professional education projects related to coverage, management, and payment methods for innovative technologies including biopharmaceuticals, medical devices, and diagnostics.
South Korea's pension scheme was introduced relatively recently, compared to other democratic nations. Half of the country's population aged 65 and over lives in relative poverty, or nearly four times the 13% average for member countries of the Organisation for Economic Co-operation and Development (OECD). This makes old age poverty an urgent social problem. Public social spending by general government is half the OECD average, and is the lowest as a percentage of GDP among OECD member countries.
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