First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
The Swedish Social Insurance Agency (SSIA – Försäkringskassan) and its frontline staff have a key role in the implementation of activation policy. Drawing on ethnographic research conducted at local offices, this article investigates how the transparency ideal, as an integral part of the organizational governance of the activation policy, is negotiated and enacted in the everyday life of a welfare bureaucracy. The analysis shows the central role that the transparency ideal plays in the alignment of frontline staff with the normative regime of the agency. While the transparency ideal is central to the internal organizational life of the SSIA, the analysis shows how transparency is much less salient in relation to clients and other relations with the outside world.
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.
In this paper we explore the reasons for the apparent convergence in sickness and disability policies across the OECD, asking whether and to what extent policy convergence should be seen as a product of policy learning. We conclude that convergence is the result of policy imitation more than policy learning and that learning (from past mistakes) is more likely within countries than across borders. Given limited evidence on what really “works”, when it comes to designing policies that both provide adequate income security and still encourage labour‐force participation, governments look abroad or to bodies like the OECD for possible models and ideas to underlie a reform. However, translating those ideas into workable policies requires great sensitivity to the institutional and political‐economic context — especially the role of the social partners and the nature of policies in existence. When it comes to policy implementation, such contextual learning may be crucial.