Thesis (MAcc)--University of Stellenbosch, 2009. / AFRIKAANSE OPSOMMING: Op 9 Februarie 2007 het President Thabo Mbeki in sy “State of the Nation Address” aangekondig dat voorstelle vir ‘n bydraende verdienste-gebaseerde nasionale maatskaplike aftreefonds as deel van die 2007- begroting voorgelê sal word. Die raamwerk vir so ‘n nasionale maatskaplike aftreefonds is uiteengesit in ‘n dokument wat gepubliseer is in ‘n geskrif wat deur die Nasionale Tesourie beskikbaar gestel is vir openbare terugvoer. Hierdie stelsel beoog om deur middel van ‘n verpligte belasting wat maandeliks van lede se salarisse afgetrek sal word, ‘n fonds daar te stel wat ten doel het om ‘n sekere vlak van inkomste ná ‘n lid se aftrede te verseker. Die aangeleentheid het onlangs dekking in die pers ontvang onder die opskifte “Lede wat nie vroeg genoeg doodgaan nie, kan pensioenfondse knou”, “Aftreefonds-paniek” en "Nasionale fonds straks deur private sektor bestuur, staat gaan nie almal se geld vat”. Uit hierdie artikels kan afgelei word dat die Suid-Afrikaanse publiek bekommerd is oor die vooruitsig dat die regering aangedui het dat hulle voortaan aftreefondse sal bestuur onder die nasionale maatskaplike aftreefonds. Dit is ‘n welbekende feit dat soortgelyke stelsels in baie ekonomieë wêreldwyd teenwoordig is, en tans onder geweldige finansieringsdruk gebuk gaan. Hierdie navorsing is onderneem om die Suid-Afrikaanse publiek in staat te stel om ‘n ingeligte besluit te neem oor die risiko van ‘n finansieringskrisis by die voorgestelde Suid- Afrikaanse nasionale maatskaplike aftreefonds deur die volgende te doen: · Identifisering van die oorsake van finansieringsprobleme by maatskaplike aftreefondse wêreldwyd. · ‘n Vergelyking te tref tussen die voorgestelde Suid-Afrikaanse nasionale maatskaplike aftreefonds en beter praktyke vir maatskaplike aftreefondse. · ‘n Oorweging of die bogenoemde oorsake van finansieringsprobleme by maatskaplike aftreefondse wêreldwyd, van toepassing is op die Suid-Afrikaanse situasie. iii Die navorsing het op die volgende gedui: · Die hoofoorsake van finansieringskrisisse by nasionale maatskaplike aftreefondse wêreldwyd is: die teenwoordigheid van finalebydraeskemas, afname in die aftreeouderdom van die bevolking, die teenwoordigheid van langer lewensverwagtings en die afname in bevolkingsgroei. · Die voorgestelde Suid-Afrikaanse nasionale maatskaplike aftreefonds is byna identies aan die stelsel van beste praktyke soos voorgelê deur die Wêreldbank. Die feit dat die struktuur van die stelsel gebaseer is op soortgelyke stelsels wat reeds suksesvol geïmplementeer is in die res van die wêreld, behoort die Suid Afrikaanse publiek positief te beïnvloed. · Die Suid-Afrikaanse nasionale maatskaplike aftreefonds sal nie gebaseer wees op ’n finalebydraeskema nie en sal gevolglik nie blootgestel wees aan die risiko nie. Die fonds sal egter, soortgelyk aan die internasionale situasie, blootgestel wees aan ‘n afname in aftree-ouderdom, afname in geboortes en ‘n toename in lewensverwagting. Gebaseer op die bogenoemde bevindinge is dit duidelik dat die Suid-Afrikaanse voorstel vir ’n nasionale maatskaplike aftreefonds, wel blootgestel sal wees aan finansieringsrisiko’s. Die skrywer glo egter dat deur die Suid-Afrikaanse voorstel te baseer op die beste praktyke soos uiteengesit deur die Wêreldbank, hierdie risiko’s op die mees effektiewe manier gehanteer sal word. Die Suid-Afrikaanse voorstel is dus weens sy samestelling, nie voor sy inwerkingtreding reeds gedoem tot die ontwikkeling van ’n finansieringskrisis nie. / ENGLISH ABSTRACT: On 9 February 2007 President Thabo Mbeki announced in his “State of the Nation Address” that proposals for an earnings-based national social security fund will be tabled as part of the 2007 budget. The framework for such a national social security fund is documented in a paper released by National Treasury and currently available for public feedback. The purpose of this system is to establish a fund which will ensure that members retain a certain level of income after retirement. This will be done by way of a compulsory tax, which will be deducted from members’ salaries on a monthly basis. This matter recently received widespread press coverage under the headlines “Lede wat nie vroeg genoeg doodgaan nie kan pensioenfondse knou”,”Aftreefonds-paniek” en “Nasionale fonds straks deur die private sektor bestuur, staat gaan nie almal se geld vat”. It is clear from these articles that the South African public is concerned about the prospect that the government indicated that they will be managing retirement funds under the national social security fund. It is also a well-known fact that similar systems worldwide are currently facing major financial pressure. The purpose of this research was to enable the South African public to make an informed decision regarding the financing risk associated with the proposed South African national social security fund by performing the following steps: · Identification of the causes of financing problems at social security funds worldwide. · To compare the proposed South African national social security fund to better practice for social security funds. · To consider whether the abovementioned causes of financing problems in social security funds worldwide, is also applicable to the South African situation. The research indicated the following: v · The main causes of financing crises in national social security funds worldwide are: the presence of final contribution schemes, the decline in the retirement age of the population, the presence of longer life expectancy and the decline in the population growth. · The proposed South African national social security fund is basically identical to the system of best practices as published by the World Bank. · The South African national social security fund will not follow the system of a final contribution scheme and will therefore not be exposed to the risk associated with these schemes. The fund will, however, in line with the international situation, be exposed to the risks associated with the decline in age of retirement, decline in population growth and an increase in life expectancy. Based on the findings listed above it is apparent that the South African proposal for a social security fund will be exposed to finance risks. The writer however believes that by basing the proposal on the best practices as set out by the World Bank, these risks will be mitigated in the most effective manner. The South African proposal is therefore, due to its composition, not doomed to the development of a financing crisis before its coming into existence.

Asthma is a chronic respiratory disease characterized by inflammation of the airway and the presence of recurrent attacks (exacerbations) of breathlessness, wheezing, cough, chest tightness, or some combination of these symptoms. In the US, about 53% of people with asthma had an asthma attack in 2008, and 57% of these, were children. One in ten children (10%) had asthma in 2009, and boys were more likely than girls to have asthma. Internationally, the prevalence of asthma varies widely in different countries, but the disparity is narrowing due to rising prevalence in low and middle income countries. Unfortunately, we do not have statistics for asthma in the Republic of Panama, neither epidemiological data nor costs, which is the reason why this research is needed. The Panamanian Social Security Fund (CSS) provides protection to workers, their immediate families and the pensioned. By the end of 2010, the total insured population was 2,862,202 (83% of the total population of Panama). Of the total insured population 58% were dependent. Of this, 1,205,607 (42%) were children. On the basis of this information, we decided to develop the research study using information from the CSS, specifically in the Hospital de Especialidades Pediatricas (HEPOTH). It is the only tertiary level of healthcare children's hospital of the CSS. A quantitative-descriptive design was used to develop this study. Data was collected from medical records of patients diagnosed with asthma in the HEPOTH from January to June 2012. We reviewed the medical records of each care area by month, and numbered each clinical record of children diagnosed with asthma in crisis and randomly selected 10% of the medical records from a minimum of 2000 records. Information on treatment costs was also obtained. Once all the information was collected, it was typed in the digital data log created for this study and the responses were code converted and the information was entered into a database. The data were exported to IBM SPSS Statistics 21. The average cost of asthma attacks in Panama is estimated at $205.52. We were able to confirm that there are variations in this average by gender, age, geographic area of residence, season, severity, whether treated in the emergency department or hospitalization, and the type of treatment received. It was also possible to obtain secondary information about the epidemiology of asthma that allowed us to confirm that our statistics matched international statistics.