First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
As a consequence of new technology, labour markets are changing. This article’s central aim is to discuss variations among welfare states in Europe to adjust to changing labour markets. These variations in adjustment suggest that some welfare states are more prepared than others, including their capacity to ensure their sustainable financing. In the years to come, the predicted impact of technological development on labour markets will be huge. Impacts will include stronger “dualization” and new cleavages between “insiders” and “outsiders”. Fewer industrial jobs are to be expected, and service-sector employment faces a risk of decline due to automation. While the creation of new jobs is likely, it remains to be seen whether these will replace the number of jobs destroyed, leaving the risk that many people whose skills become obsolete will become unemployed in the short as well as the longer term. Furthermore, even if the same number of jobs are eventually created, there will be a period of transition. In the light of this, welfare states will be challenged, not only in how they can finance their activities but also in terms of the threat posed to social cohesion by emerging labour market “winners” and “losers”, with an accompanying higher risk of increasing inequality. The article offers suggestions as to how welfare states may cope with the changes related to the financing of welfare states, and how active labour market policy can be part of the response to help alleviate the expected dramatic changes. Also required is a discussion on the annual average number of hours people will work and how this might be a factor in lower future levels of unemployment.
This article assesses the effectiveness of pension provision and health insurance in preventing ill health among older people in developing countries. It argues that, until recently, social protection agendas devoted insufficient attention to health risk prevention, instead focusing on the reduction of income poverty through cash transfers. The article shows that there is little reliable evidence to indicate that providing older people with pension benefits enhances their health status and that these effects should not be taken for granted by policy‐makers. The article then focuses on the effect of inclusion in health insurance schemes on health outcomes for older people, with specific reference to outcomes related to hypertension. Drawing on newly‐available data from the World Health Organization for Ghana, Mexico and South Africa, it shows that older people with health insurance are marginally more likely to be aware of health conditions such as hypertension and more likely to have them under control. Nevertheless, the great majority of hypertensive older people, insured or uninsured, are not effectively treated. The chief barriers to treatment are shown to be mainly related to awareness and service provision, rather than financial ones. Consequently, the capacity of pensions or health insurance to enhance health outcomes for older people in such countries, including in rural areas, is heavily contingent upon health education, health screening and adequate health service provision. These interventions should be viewed as an integral element of mainstream social protection strategies, rather than adjuncts to them. Yet, in practice, social protection and health promotion continue to be treated as almost entirely separate spheres, thus presenting substantial institutional barriers to developing combined interventions.