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Assessing the Coverage
Gap
CRSP assembled and led an international team of
renowned experts to examine who is excluded from social security
coverage, and why, in 15 countries around the world. The case study
countries are: Australia; Costa Rica; Czech Republic; Finland; Germany;
Hungary; India; Mali; Mexico; Morocco; Tanzania; Thailand; UK; Uruguay;
and USA. The study examines coverage for old age and healthcare
in all 15 countries and coverage for unemployment in Australia,
Finland, Germany, UK and USA. In addition the study asked which
programmes suffer most from lack of universality of coverage, and
what policy options are available in the short and medium term to
extend coverage?
The study found that exclusion is 'non-random',
there are, across countries, systematic similarities in who is least
likely to be covered by social security, and identified women, migrants,
and agricultural and urban informal sector workers as most likely
to be excluded. The study found that these groups are unprotected
largely because of the interface between their labour market position
and the role and design of contributory schemes, which lie at the
heart of most of the case study countries' social security systems.
The problem of an over-concentration on formal sector worker insurance
is exacerbated for healthcare in some of the case study countries
by an inappropriate focus on providing services that are not relevant
to the prevailing sickness profiles and epidemiological patterns,
and failure to provide for women's healthcare needs. These findings
have important implications for the design of policies to extend
coverage of social security.
The findings suggest a link between funding method
and coverage: coverage appears to increase the further the scheme
moves away from a direct equivalence between individual contributions
and benefits and towards a social security scheme that redistributes
resources. The relationship between redistribution and coverage
is perhaps not all that surprising. While schemes that are based
on equivalence between individual contributions and benefits can
provide security in old age and sickness for 'insiders' they are
closed to those who may need social security the most. In many cases
it is not feasible to bring the excluded within the scope of contributory
benefits. Providing adequate social protection for these groups
will necessitate a complete or partial de-linking of contributions
and benefits and a redistribution of resources. The study concluded
that the key political challenge that closing the coverage gap poses
is to secure legitimacy at both the national and the global level
for the sharing of risks and redistribution of resources so that
a commitment can be made to providing and maintaining social security
for all, not just a few.
Publications
International Social Security Association (2004) ISSA Initiative
Toolkit. Geneva.
Roberts, S., Stafford, B., and Ashworth, K. (2004)
A Synopsis of the ISSA Initiative Study. ISSA Initiative Findings
and Opinions No. 12, Geneva.
Roberts, S., Stafford, B., and Ashworth, K. (2002)
Gaps in coverage for old age pensions and healthcare in 15 countries.
Paper presented to the Conference on the ISSA Initiative, Vancouver,
Canada, 10-12 September.
Roberts, S., Stafford, B. and Ashworth, K. (2002)
'Assessing the coverage gap: A summary of early findings from an
ISSA Initiative study', ISSA Initiative Findings & Opinions
No. 4, Geneva.
Project team
Simon
Roberts, Karl Ashworth, Bruce
Stafford, Rachel Youngs.
The project commenced in 2001 and completed in
2004.
Sponsor
The International
Social Security Association (ISSA)
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