“Prevention is not restricted to safety and health at the workplace, but forms part of a wider strategy for social security systems as a whole in response to a series of concurrent challenges,” the President of the International Social Security Association (ISSA), Corazon de la Paz-Bernardo, told the gathering.

“By tackling risk factors through prevention, early intervention or other proactive measures, social security can offer a contribution to the individual and society that goes beyond the traditional scope of benefit payments. Compensation is an integral part of social security, but prevention and rehabilitation are also central elements,” Ms de la Paz-Bernardo underlined.

The international seminar on the benefits of prevention for social security, which involved safety and health specialists and senior administrators of social security schemes from over 20 countries, was organized in Geneva by the ISSA and its Special Commission on Prevention, the body responsible for occupational safety and health issues, which brings together an international network of 11 specialized Prevention Sections.

Proactive strategies for prevention

Prevention strategies of social insurance schemes have historically focused on occupational safety and health. Studies reveal that workplace accidents and lost potential due to sickness and absenteeism can amount to between 1 and 10 per cent of national GDP.

But research confirms that the comparative costs of investment in prevention are low, and proactive promotion of workplace health results in reduced illness and increased motivation and innovation for enterprises, with direct outcomes for economic productivity and growth.

In recent years, the traditional role of social security schemes to protect people in the case of life-cycle risks has been increasingly broadened through the inclusion of proactive measures in other areas, said Olaf Petermann, Chairperson of the ISSA Special Commission on Prevention.

“Proactive strategies to improve workplace health can reduce accidents and positively impact health outcomes, thereby strengthening organizational productivity and directly relieving the statutory social insurance systems,” Petermann stated.

“Return on Prevention”

The ISSA has just launched a global study project on the “Return on Prevention” which seeks to quantify the economic benefit of investments in occupational safety and health. According to Walter Eichendorf, Deputy Director General of the German Social Accident Insurance, a pilot project involving 39 enterprises in Germany confirms that there is a significant and measurable financial advantage to invest in prevention strategies.

One study demonstrated that enterprises that run health promotion and prevention programmes reduced the rates of work-related absenteeism by between 12% to 36%, confirmed Jean-Claude Poirier, Director of Prevention of Occupation Risks at the Caisse régionale d’assurance maladie d’Ile de France (CRAMIF). The study estimated that every dollar invested in such programmes brings a return of USD 2.5 to USD 4.8 to the employer.

However, Mr Eichendorf recognized that economic pressures, an evolving workforce and the impact of the economic crisis have increased pressures to reduce safety and health budgets in many countries, and he called for strengthened international cooperation to save resources and embed prevention activities in all aspects of social security and social accident insurance.

Prevention in pension and employment schemes

Preventative approaches can also play an important role in pension systems and employment schemes, argued Adriana Lender, Director General of the Swedish Social Insurance Agency.

“A preventative approach can give the individual the opportunity to stay in the workforce, or to enjoy a healthy retirement,” Ms Lender said.

Ms Lender outlined how Sweden experienced a rise in invalidity and workplace sickness and absenteeism in the 1990s, and the social security system decided on a comprehensive mitigation and preventative approach, which successfully contained rising costs.

Lender pointed to some of the factors involved in the response, including an effort to promote early rehabilitation, greater coordination among medical and social services, active promotion of a return to the labour market, and measures addressed at lowering the risk of poor ageing.

In another example of preventative strategies, George Carlens, Director General of the Belgian National Employment Office, described the range of unemployment policies adopted by the social security system in response to the economic crisis.

Proactive and temporary social security measures that supported workers and enabled enterprises to maintain flexibility and were able to prevent an increase in structural unemployment, Mr Carlens explained. The OECD estimates that in Belgium, proactive measures taken during the crisis have preserved 60,000 jobs, or 1.3 per cent of the workforce.

“These measures are costly, but less expensive than the long-term economic and social costs of increased unemployment,” Mr Carlens reminded participants.

 
The health-care “atomic bomb”

The seminar also discussed the role of accident insurance systems in moving beyond a medical approach to a more comprehensive public health approach, in response to the growing health-care burden in many countries. New and emerging risks were also analysed, including the development of nanotechnology and psychosocial hazards, and trends in chronic diseases.

The World Health Organization estimates that the prevalence of chronic diseases may increase by as much as 30% by 2030, which could become an “atomic bomb” for health-care and social insurance costs, according to Marc de Greef, Managing Director of PREVENT, the Belgian Institute for Prevention, Protection and Welfare at Work.

Prevention for all parts of society

Concluding the seminar, Hans-Horst Konkolewsky, the ISSA Secretary General confirmed that the ISSA is giving a strong strategic priority to proactive and preventative approaches in social security.

“Prevention must cover all parts of society, not only the workplace. We are facing more complex risks, and growing concerns about chronic illness and mental health. There is a need to address these multiple challenges through a change in culture and more integrated approaches across areas. Prevention cannot be ignored by any sector of social security,” Mr Konkolewsky stated.