It has been almost one year since the new Regulations No 883/2004 and 987/2009 came into force on 1.5.2010. These regulations replaced the former Regulations No 1408/71 and 574/72, which had been laying down the rules for coordination of the national social security systems for almost 40 years. As the extent of issue is relatively huge I have focused only on some aspects of coordination. The first chapter concerns the general concept of coordination and the sources of coordination law. It also includes the detailed description of personal and material scope of regulations. One part of this chapter is dealing also with some of the new concepts included in the regulation. The second chapter describes the basic social security coordination principles, ie. the principle of equal treatment, the principle of single applicable legislation, the principle of exporting the benefits and the aggregation principle. In addition to these four basic principles mentioned above new rule for the assimilation of facts is described. This is in fact a new principle, previously applied only on the basis of case-law. The third chapter focuses on organizational aspect at both EU and national levels. There are lists of all relevant bodies included together with description of their roles and responsibilities. The fourth chapter...

Purpose of this study is to identify and to evaluate the main trends in the development of old-age pensions and sickness benefits schemes (by designing social insurance system models) and to determine the possible ways how to increase the efficiency in consumption smoothing policy and how to increase the financial sustainability of the old-age and sickness insurance schemes. This study searches for answers to the questions: how to maintain the consumption opportunities of beneficiaries, how to maintain a balance between the contributions paid and benefits received (the balance between the price paid and goods received), how to reduce the risk of budget deficit explosion and how to maintain the consumption opportunities of beneficiaries and insured. Consumption smoothing analysis focuses on the identity between the contributions paid and benefits received, on the analysis of replacement rates, on the analysis of pensioners to insured ratio (and on the possibilities of interpretation the analysis provide). The study determined the cycles of Lithuanian social insurance system development, examined and evaluated three different pensions' indexation policies, examined and evaluated the utility and performance of second pillar pension funds and carried out the study of possibilities of raising the efficiency in Lithuanian sickness benefits scheme. This study helps to deeper the understanding of how population aging affects the economy and provides the materials for future... [to full text] / Disertacijos tikslas – sudarant socialinio draudimo sistemos modelius, nustatyti ir išanalizuoti svarbiausias senatvės pensijų ir laikinojo nedarbingumo išmokų raidos tendencijas, atsižvelgiant į jas, pagrįsti efektyvumo ir tvarumo didinimo galimybes senatvės ir laikinojo nedarbingumo socialinio draudimo išmokų programose (srityse). Disertacijoje ieškoma atsakymų į klausimus: kaip palaikyti išmokų gavėjų vartojimo galimybes, kaip išlaikyti pusiausvyrą tarp sumokėtų įmokų ir gautų išmokų (pusiausvyra tarp sumokėtos kainos ir gautos prekių apimties), kaip sumažinti socialinio draudimo biudžeto deficito atsiradimo riziką ir palaikyti dirbančių asmenų ir išmokų gavėjų vartojimo galimybes. Vartojimo galimybių palaikymo efektyvumo įvertinimas apima tapatumo tarp sumokėtų įmokų ir gautų išmokų analizę, pakeitimo normos analizę, išmokų gavėjų ir dirbančių asmenų santykio analizę, šių rodiklių ir sąryšių interpretacijos atskleidžiamas galimybes. Disertacijoje nustatyti Lietuvos socialinio draudimo sistemos raidos ciklai, išnagrinėti ir įvertinti trys išmokų indeksavimo variantai, įvertintos antros pakopos kaupiamųjų pensijų fondų sistemos galimybės ir veiklos rezultatai, atliktas laikinojo nedarbingumo išmokų sistemos efektyvumo didinimo tyrimas. Šis darbas padeda geriau suprasti visuomenės senėjimo padarinius ir numatyti priemones būsimų procesų reguliavimui.

The aim of the thesis is to evaluate selected social security systems in Sweden and France. It is conducted through comparative analysis of sickness and family benefits. Document is divided into four chapters. The first chapter is devoted to the theoretical introduction of the concept of social security and the definition of terms such as social security or social policy. The second chapter is dedicated to the Swedish social security. It contains a description of the basic characteristics of the Swedish social security and deep study of the sickness and family benefits. Chapter three uses the same structure as the previous chapter but with a focus on France. The fourth chapter compares the historical context of social systems, specifies significant differences in sickness and family benefits, the concept of family policy and gender equality in both countries.

Submitted by Felipe Guimaraes Uchoa (felipe.g.uchoa@gmail.com) on 2015-02-19T15:38:56Z No. of bitstreams: 1 Dissertação_FelipeUchoa_MPFE_19.02.2014.docx: 155271 bytes, checksum: 623619d1f24dfa627add019a29b984e7 (MD5) / Rejected by Renata de Souza Nascimento (renata.souza@fgv.br), reason: Felipe, O trabalho não está de acordo com as normas da ABNT. Segue abaixo, o que deverá ser alterado: - O arquivo deve estar em PDF e não em Word (conforme a postagem). - Nas páginas onde constam SÃO PAULO 2014, deverá alterar o ano para 2015 (pois a apresentação ocorreu em 2015). - Nas páginas dos Agradecimentos/ Resumo/ Abstract, o texto deve estar alinhado, sem os espaços dos parágrafos. Aguardo as alterações e nova submissão. Att Renata on 2015-02-19T16:16:02Z (GMT) / Submitted by Felipe Guimaraes Uchoa (felipe.g.uchoa@gmail.com) on 2015-02-19T16:28:37Z No. of bitstreams: 1 Dissertação_FelipeUchoa_MPFE_19 02 2014.pdf: 445064 bytes, checksum: be6196a10fa113b69d2388db5149cc7b (MD5) / Rejected by Renata de Souza Nascimento (renata.souza@fgv.br), reason: Felipe, Falta somente ajustar os textos. Encaminharei por e-mail. Att Renata on 2015-02-19T17:22:15Z (GMT) / Submitted by Felipe Guimaraes Uchoa (felipe.g.uchoa@gmail.com) on 2015-02-19T17:41:56Z No. of bitstreams: 1 Dissertação_FelipeUchoa_MPFE_19 02 2014.pdf: 445771 bytes, checksum: 7d62e511d073b5de4cf00c2a38d2db77 (MD5) / Approved for entry into archive by Renata de Souza Nascimento (renata.souza@fgv.br) on 2015-02-20T10:11:57Z (GMT) No. of bitstreams: 1 Dissertação_FelipeUchoa_MPFE_19 02 2014.pdf: 445771 bytes, checksum: 7d62e511d073b5de4cf00c2a38d2db77 (MD5) / Made available in DSpace on 2015-02-20T12:06:22Z (GMT). No. of bitstreams: 1 Dissertação_FelipeUchoa_MPFE_19 02 2014.pdf: 445771 bytes, checksum: 7d62e511d073b5de4cf00c2a38d2db77 (MD5) Previous issue date: 2015-01-20 / Per year, more than R$ 15 billion reais are spent with the statutory sickness benefits issued by the Brazilian National Insurance Institute (Instituto Nacional do Seguro Social, INSS) and the costs related with the whole process. In addition, around 7 million medical examinations are held by the INSS medical examiners in order to grant the benefit, from which 2 million are denied by them. The main objective of this work is to assess the whole process of issuing statutory sickness benefits held by the INSS with a Game Theory approach. Analyzing the game structure of the process and the interactions of both, claimants and examiners, with the INSS and the unwanted incentives generated by the current structure. The claimant has an incentive for requiring the benefit even though he does not fit all the requirements for the benefit to be granted. As a result, the number of exams rise, lowering their quality and eventually making the INSS to issue unnecessary benefits. The examiner faces a high complex task without necessary time to perform it with all the caution required. Besides, once it is mandatory to inform the exam result immediately to the claimant, the examiner may have an incentive for conceiving the benefit even when the claimant does not fit all the requirements needed, given that the time provided to the examiner to analyze the case is too short to take a full evaluation.. Once made the parallel with the Game Theory and the Common Pool Resources (CPR) issue, it is possible to research the literature about mitigating this kind of problems. It is also interesting to perform a research on the Market Design literature. Both have showed positive results in mitigating similar issues and may have successful results with the sickness benefit process. / Por ano são gastos mais de R$ 15 bilhões de reais entre os benefícios de auxílio-saúde emitidos pelo INSS e os custos para viabilizar o processo. São realizadas, em torno de 7 milhões de pericias, das quais mais de 2 milhões tem resultado contrário por parte do médico perito. O objetivo deste trabalho é realizar uma leitura do processo de concessão de benefícios de auxílio-saúde pelo INSS sob a ótica da Teoria dos Jogos, com a análise da estrutura das interações entre segurado e perito com o INSS e os incentivos indesejados resultantes desta estrutura. Sendo que o segurado é incentivado a buscar o benefício mesmo sem ter, de fato, a necessidade. Resultando num aumento na quantidade de perícias realizadas por ano, diminuindo sua qualidade e eventualmente concedendo benefícios desnecessários. O perito, por sua vez, se defronta com uma atividade de alta complexidade e não dispõe do tempo necessário para uma análise cautelosa. Além disso, tem o incentivo a, em momentos de incerteza, conceder o benefício mesmo que o segurado não se enquadre corretamente nos requisitos necessários. Isto pode ocorrer, dentre outros fatores, devido ao tempo disponibilizado ao perito para analisar o caso com a atenção necessária não ser suficiente. Uma vez traçado o paralelo com a Teoria dos Jogos e os problemas de Common Pool Resources (CPR), é feita uma pesquisa nessa literatura em busca de maneiras de mitigar problemas similares ao pesquisado. Este paralelo também traz a possibilidade de pesquisar a literatura de Market Design acerca do redesenho da estrutura de mercados, com intuito de corrigir e desenvolver estes mercados. Estudos recentes apresentaram resultados positivos, sendo indicado, portanto, para trabalhos futuros, a implementação desta metodologia para o processo de concessão de benefícios de auxílio-saúde.

<p>This thesis consists of a summary and four papers. The first two concerns health care and sickness absence, and the last two pharmaceutical costs and prices.</p><p>Paper [I] presents an economic federation model which resembles the situation in, for example, Sweden. In the model the state governments provide health care, the fed-eral government provides a sickness benefit and both levels tax labor income. The re-sults show that the states can have either an incentive to under- or over-provide health care. The federal government can, by introducing an intergovernmental transfer, in-duce the state governments to provide the socially optimal amount of health care.</p><p>In Paper [II] the effect of aggregated public health care expenditure on absence from work due to sickness or disability was estimated. The analysis was based on data from a panel of the Swedish municipalities for the period 1993-2004. Public health care expenditure was found to have no statistically significant effect on absence and the standard errors were small enough to rule out all but a minimal effect. The result held when separate estimations were conducted for women and men, and for absence due to sickness and disability.</p><p>The purpose of Paper [III] was to study the effects of the introduction of fixed pharmaceutical budgets for two health centers in Västerbotten, Sweden. Estimation results using propensity score matching methods show that there are no systematic differences for either price or quantity per prescription between health centers using fixed and open-ended budgets. The analysis was based on individual prescription data from the two health centers and a control group both before and after the introduction of fixed budgets.</p><p>In Paper [IV] the introduction of the Swedish substitution reform in October 2002 was used as a natural experiment to examine the effects of increased consumer infor-mation on pharmaceutical prices. Using monthly data on individual pharmaceutical prices, the average reduction of prices due to the reform was estimated to four percent for both brand name and generic pharmaceuticals during the first four years after the reform. The results also show that the price adjustment was not instant.</p>

This thesis consists of a summary and four papers. The first two concerns health care and sickness absence, and the last two pharmaceutical costs and prices. Paper [I] presents an economic federation model which resembles the situation in, for example, Sweden. In the model the state governments provide health care, the fed-eral government provides a sickness benefit and both levels tax labor income. The re-sults show that the states can have either an incentive to under- or over-provide health care. The federal government can, by introducing an intergovernmental transfer, in-duce the state governments to provide the socially optimal amount of health care. In Paper [II] the effect of aggregated public health care expenditure on absence from work due to sickness or disability was estimated. The analysis was based on data from a panel of the Swedish municipalities for the period 1993-2004. Public health care expenditure was found to have no statistically significant effect on absence and the standard errors were small enough to rule out all but a minimal effect. The result held when separate estimations were conducted for women and men, and for absence due to sickness and disability. The purpose of Paper [III] was to study the effects of the introduction of fixed pharmaceutical budgets for two health centers in Västerbotten, Sweden. Estimation results using propensity score matching methods show that there are no systematic differences for either price or quantity per prescription between health centers using fixed and open-ended budgets. The analysis was based on individual prescription data from the two health centers and a control group both before and after the introduction of fixed budgets. In Paper [IV] the introduction of the Swedish substitution reform in October 2002 was used as a natural experiment to examine the effects of increased consumer infor-mation on pharmaceutical prices. Using monthly data on individual pharmaceutical prices, the average reduction of prices due to the reform was estimated to four percent for both brand name and generic pharmaceuticals during the first four years after the reform. The results also show that the price adjustment was not instant.

Sammanfattning Regeringens intention med den nya lagen om sjukförsäkring som infördes i juli 2008 och kompletterades i januari 2010, var att gå från en passiv långtidssjukskrivning till ökad rehabilitering och en möjlighet till återgång till arbetsmarknaden samt ett minskat utanförskap.  Den mediala debatten i samklang med våra praktikplatser gjorde oss nyfikna på hur förändringen har påverkat livet för den enskilde individen. Vårt syfte är således att undersöka vilka konsekvenserna blir för enskilda individer i samband med och efter beskedet om utförsäkring från sjukförsäkringen. Vi ville utan att ha några förutfattade meningar lyfta fram intervjupersonernas berättelse så vi valde att ha en explorativ ansats, men tog stöd av en semistrukturerad intervjuguide baserad på tre teman som vi ville veta mer om. Temana är; ekonomisk situation, upplevelser av relationer med berörda myndigheter och upplevelser av samhällets syn och deras syn på sin självbild.   Resultaten är komplexa och visar att de teman vi valt ut påverkar varandra, med det menar vi att det ena inverkar på det andra. De teorier vi valt att använda i analys av materialet är Ekonomi- skam modellen, Kasamteori samt teori om social uteslutning. Vi kan se en väg som leder från ekonomisk uteslutning vidare till social uteslutning för personer som utförsäkrats samt att den ekonomiska stress de utsätt för i kombination med skamgörande erfarenheter ger hög risk för psykisk ohälsa. I vår avslutande diskussion reflekterar vi om lagstiftarens intention med reformerna har haft den avsedda effekten för de utförsäkrade. / Abstract The governments intentions with the new law in sickness benefits that was introduced in July 2008 and was supplemented in January 2010, was to go from a passive long-term sick leave to increased rehabilitation and a possibility to return to the labor market, along with reduced exclusion. The media debate in unison with our trainee jobs made us curious about how this change has affected the individual. Our purpose is accordingly to make researches into the consequences for the individuals in connection with and after expiration of sickness benefits. We wanted without preconceived opinions emphasize the interviewee’s stories so we chose to have an explorative inception. But we took support in a semi- structured interviewguide based on three topics we wanted to know more about. The topics are; economic situation, experiences of the relation with concerned public authorities and experiences of societies view on them and their own view on themselves. The results are complex and show that one factor affects another, which means that one thing, leads to another. The theories we have used are a model for Economics- shame, Kasam and social exclusion theories. We can see a road that leads from economic exclusion to social exclusion for the persons whose period of sickness benefits has expired. And also that the economic stress combined with shameful experiences gives a high risk of psychic illness. In our concluding discussion we reflect about if the government’s intentions with the new laws have had the intended effect for these persons.

This thesis has aims to acquaint the reader with Latin American Social Security systems. For this end, 7 Latin American countries have been chosen. Henceforth, the different Social Security systems operating in these countries are described. It is a comparative analysis, describing the similarities and differences among them. Is necessary to emphasize that this paper does not only provide current information of the different Social Security systems, but also statistical information, which is considered as essential to the context of the economic, demographic and social environments in which are these Social Security systems function. The systems described are: the Pension System, Heath Insurance, Sickness Benefits, Unemployment Insurance, Family Entitlements and last Maternity Benefits. The countries that have been chosen are the following: Argentina, Bolivia, Chile, Colombia, Ecuador, Peru, and Uruguay. In addition to the comparative analysis in this paper, the level of development in the chosen Latin American countries as well as the latest trends concerning the Social Security systems are determined and explained.

The theme of this thesis is draft of measures body related with changes in sick benefit system. The goal of this thesis is the analysis of impact of changes in sick benefit system on employer and the draft of measures for the subject. There is a description of sick benefit system used in CR and in other countries EU in this thesis. There is a describtion of the changes and the impacts on employer are analysed. The last part of the thesis is composed by draft of measures related with these changes.