First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
The right to social security is enshrined in article 23 of the Belgian Constitution. It is the role of the legislator to implement it, to guarantee the right of all to lead a life in accordance with human dignity. Studies show that platform workers face major difficulties in terms of social protection. The aim of this article is to highlight the limits of existing legislative provisions regarding their ability to implement the fundamental right to social security for platform workers. With regard to these legislative provisions, we are interested in both the general regulations that shape the Belgian social security system and the recent measures adopted by the Belgian legislator with regard to the so-called sharing economy. An analysis of these provisions reveals that a number of platform workers are excluded from social security, both de facto and de jure. At the very least, this raises the question of whether the Belgian legislator is complying with the positive obligation to fulfil the constitutional right to social security for platform workers, and the negative obligation, at least, not to undermine it.
In this article the adequacy of social insurance benefits is addressed from the perspective of eight fundamental goals of social insurance. With respect to these goals, the legislated level of the benefit and other conditions represent tools to achieve adequate levels of benefits vis-à-vis contributory effort. The goals address income risks of various sorts: (i) income compensation; (ii) securing a decent standard of living; (iii) universality, implying simplicity and a high takeup of social rights; (iv) reducing income risk deriving from physical incapacity; (v) safeguarding insurability by balancing the expected payoff to the insured and the value of the contributions paid over the lifetime; (vi) intergenerational equity; (vii) containing work and savings disincentives; and (viii) risk reduction (prevention). A simple model serves to clarify what is needed to achieve benefit adequacy together with insurability and contribution adequacy. An example of income support in working age, based on Israeli data, illustrates the use of specific instruments to achieve a decent standard of living while containing economic disincentives. The example stresses the importance of synchronizing efforts with institutions outside the social insurance system.
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.