Abstract
Background and Objectives
Since 1995, Germany has operated one of the longest-running public programs providing universal support for the cost of long term services and supports (LTSS). Its ...self-funding, social insurance approach provides basic supports to nearly all Germans. We discuss its design and development, including recent reforms expanding the program and ensuring its ongoing sustainability.
Research Design and Methods
The study reviews legislative and programmatic changes, using program data, as well as legislative documents and program reports.
Results
The program is widely accepted among citizens and has achieved many of its original goals: ensuring access to LTSS and reducing reliance on the locally-funded safety-net social assistance program, which can be used to cover nursing home costs. It also strengthened the LTSS provider infrastructure and expanded access to home care. Recent reforms have addressed some of the program’s key issues: the benefit’s decreasing value, the eligibility and benefit structure that largely excluded cognitive impairment, and the program’s longer-term financial sustainability—particularly its ability to sustain newly expanded benefits, which provide stronger protections to caregivers, index-link benefits, and more systematically incorporate cognitive impairment via a new assessment system. It has addressed financing issues by increasing premiums, introducing subsidies for the purchase of private insurance, and creating a “demographic reserve fund.”
Discussion and Implications
The reforms constitute a significant strengthening of the program, remarkable in an era of retrenchment. Overall, the program provides evidence for the financial viability of a social insurance model, although longer-term challenges may yet arise.
Endometriosis, a chronic noncancerous gynecologic condition commonly characterized by disruptive physical and psychosocial symptoms, can be disabling. Individuals in the United States with ...endometriosis who are unable to work before retirement age can apply for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI). Given the multi-step process of disability review, it is important to better understand how disability decisions are made. This study aimed to examine approaches and rationales of U.S. federal appeals courts reviewing SSDI and/or SSI claims involving endometriosis-related issues of appeal.
We searched Westlaw and Nexis Uni records, available as of January 2021, for federal appeals of SSDI and SSI claims including endometriosis as an impairment. Two independent reviewers screened full-text cases and extracted data. Framework Analysis was applied to courts’ rationales regarding endometriosis-related issues of appeal.
Eighty-seven appeals addressed an endometriosis-related issue. Three themes—evidence, treatment, and time—were identified across the decisions. The courts' discussions across themes exposed rationales and evidentiary requirements that posed challenges for claimants with endometriosis. The courts found subjective reports of symptoms insufficient evidence of impairment and positive responses to treatments to indicate cures or prevent claimants from demonstrating the necessary continuous 12 months of impairment. Some courts expected claimants to use treatments such as contraception or hysterectomy without addressing the risks of such treatments or the fact that they might have been counter to claimants’ needs and preferences.
Individuals with endometriosis face evidentiary obstacles and common misconceptions about disease, diagnosis, and treatment in disability claims. SSDI and SSI endometriosis claims are systematically disadvantaged, particularly among those without access to care. The health care, policy, and legal systems can leverage the findings in this study to create a more equitable disability application and review system for those with chronic pain conditions such as endometriosis.
This article deals with the regulatory violation of issuing sick leave with an evident absence of medical grounds. Two problematic aspects present in the sanctioning practice of the Social Security ...Regulatory Agency are analyzed: the discrepancy between the wording of the regulation and its application, and the multiplicity of duties that can configure the behavior defined by the law, although they do not constitute fraud against the sick leave system. The context of this study is the bill that seeks to lower the standard for the regulator to impose administrative penalties on offenders who issue unjustified sick leave and aggravate those penalties.
Türk vatandaşlarının sahip olduğu sosyal, ekonomik, siyasal Kelimeler ve hukuki temel hakların Türk Diasporası açısından da değerlendirilmesi artık kaçınılmazdır. Bu temel haklardan biri de sosyal ...güvenlik haklarıdır. Sosyal güvenlik hakkının bulunulan veya hukuki açıdan bağlı olunan ülkede korunması ve devamlılığının sağlanması son derece önemlidir. Türk Sosyal Güvenlik Sistemi, Türk vatandaşlarına belli haklar ve güvenceler sağlamaktadır. Türk Diasporası açısından durum değerlendirildiğinde, mevcut hakların yalnızca vatandaşlık bağının devamlılığına odaklanması, sosyal güvenlik bakımından korunma düzeyinde bir eksikliğe dikkat çekmektedir. Çalışmada, yurt dışında bulunan Türk vatandaşlarına özgü sosyal güvenlik uygulamalarının Türk Diasporası açısından da değerlendirilmesine ilişkin bir durum tespiti yapılmaya çalışılmaktadır. Bu kapsamda yurt dışındaki Türk vatandaşlarına ilişkin ulusal mevzuattan kaynaklanan durumlar incelenerek, mevcut hüküm ve uygulamaların Türk Diasporası açısından uygulanabilirliği değerlendirilecektir. Söz konusu incelemeler ve değerlendirmeler sonucunda Türk Diasporasını da kapsama alabilecek hükümler belirlenecek, mevcut eksiklikler ile yapılabilecek düzenlemelere ve uygulamalara ilişkin bazı öneriler sunulacaktır.
ABSTRACT Objective: this article proposes the meta atuarial consistente (MAC) (consistent actuarial rate), which is a method that adjusts incompatible actuarial rates in pension funds, after ...investigating and proving that the rate dissociates from the general rule in current regulations (which binds this rate to the expected return of the investments of pension funds). Methodology: a sample with data from 22 defined-benefit plans was collected, and MAC was applied to produce consistent actuarial rates, after panel data methods have identified the elements that influence the definition of the actuarial rate by the pension fund board of trustees. Results: the use of MAC, adjusting actuarial rates of 2018 based on systematic biases in previous rates, enabled a positive effect that unfolds in more reliable estimates for the plans’ mathematical provision, while identifying elements that influence the determination of the annual rate, causing its non-compliance to the general rule. Conclusion: the adoption of MAC by the Brazilian supervisory authority Previc would improve the rules and provide subsidies to better adjust the contribution levels practiced in the plans, making their solvency levels more reliable, which would benefit the development of the insurance and pension market.
RESUMO Objetivo: viabilizar a proposição de um novo método, a Meta Atuarial Consistente (MAC), que evita, ajustando-as, metas atuariais incompatíveis nos fundos de pensão, após investigar e comprovar, na pesquisa, que a meta dissocia-se da regra geral dos normativos vigentes, que adere essa meta à expectativa de rentabilidade dos investimentos do plano de previdência. Metodologia: foi elaborada uma amostra contendo dados de 22 planos BD, onde aplicou-se a MAC depois de os métodos de dados em painel identificarem os elementos que influenciam a definição da meta atuarial ocorrida no conselho deliberativo dos respectivos fundos de pensão. Resultados: a utilização da MAC, adequando as metas atuariais de 2018 a partir dos vieses sistemáticos ocorridos nas metas anteriores, possibilitou um efeito positivo que se desdobra em estimativas mais fidedignas para as provisões matemáticas dos planos, ao mesmo tempo que identificou elementos que influenciam na determinação do valor da meta anual, provocando sua não aderência à regra geral da legislação. Conclusões: a adoção da MAC pela Previc aperfeiçoaria o regramento e forneceria subsídios para melhor adequar os níveis de contribuição praticados nos planos, tornando mais fidedignos seus níveis de solvência, o que beneficiaria o desenvolvimento do mercado de seguros e de previdência.
The continuing urbanization in China has resulted in a loss of land and rights among farmers. The social security of landless farmers has attracted considerable research attention. However, only few ...studies measure the health-related quality of life (HRQOL) of landless farmers by employing scientific standardized scales. By using five-dimensional European quality of life (EQ-5D) scales, this study measures the HRQOL of landless farmers from a new perspective and examines how the social security policies affect their HRQOL.
This study is based on a 2013 household survey that has been conducted among 1,500 landless famers who are residing in six resettlement areas in three cities within the Yangtze River Delta region, namely, Nanjing, Hangzhou, and Yangzhou. This study adopts EQ-5D scales to measure the HRQOL of these farmers. More than 50% of the respondents are in poor or non-serious health conditions, and over 50% are not satisfied with their current social security policies. The health conditions and social security policies are analyzed by multinomial regression analysis and the relationship between these two factors are analyzed via structural equation modeling (SEM).
First, the descriptive statistical analysis shows that more than 50% of the respondents are in poor or non-serious health conditions, and that the largest proportion of these farmers are suffering from anxiety or depression, which is the most serious of the five dimensions. Second, multinomial regression analysis shows that the satisfaction of landless farmers with their social security policies improves their living conditions, particularly in their capacity for self-care, in their ability to perform daily activities, and in the reduction of pain, anxiety, and depression. Third, SEM model analysis shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. Among the five dimensions of EQ-5D, daily activities produce the greatest influence on the HRQOL of landless farmers. As regards social security policies, the land acquisition compensation policy and the employment security policy produce the greatest and weakest influences on the HRQOL of landless farmers, respectively.
The rapid urbanization in China has deprived many farmers of their lands and of the benefits of urbanization. These farmers are often in a disadvantaged position in the land acquisition process. Statistic analysis in this paper shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. The implementation and improvement of social security policies is very important for the long-term and sustainable development of these landless farmers.
Over the last 2 decades, several international indices have been developed to describe the status of older persons. None, however, have examined their human rights. The International Older Persons' ...Human Rights Index (IOPHRI) fills in this gap by analyzing the formal legislative foundation of human rights for older people. The objective of this exploratory study is to examine the IOPHRI while comparing the legislation in 6 countries.
A comparative international exploratory study comparing the human rights legislation of 6 countries: United States, Chile, Ireland, South Africa, India, and Australia in 5 different human rights domains: constitutional, protection, familial and informal support, planning, and empowerment.
The findings suggest that the actual relationship between formal human rights of older persons and the real world is complex: for example, while the IOPHRI index places South Africa in first place, it is far behind compared with all other participants in the Global AgeWatch Index (which measures objective elements such as life expectancy at 60, or poverty rates in old age).
Measuring and indexing human rights of older persons reveal significant methodological issues. Beyond these methodological challenges, comparing the ranking of the IOPHRI to nonlegalistic indices raises significant questions about the relationship between formal human rights and the actual living experiences of older persons.
The U.S. Social Security Disability Insurance (DI) program has grown dramatically over the last 20 years in size and expense. This growth poses significant risks to the finances of the DI program and ...the broader Social Security system, and raises troubling questions as to whether the program is being misused by claimants. This article first provides an overview of the Disability Insurance program, describing who qualifies for the program, how an individual applies for benefits and how the level of benefits is determined. Next, we summarize the factors responsible for the growth in the DI rolls and discuss how the characteristics of DI recipients have changed as a result. We then explore the extent of moral hazard in the DI program and the effectiveness of the screening process in distinguishing meritorious from nonmeritorious claims. Finally, we identify the challenges that the DI program creates for Social Security finances and Social Security reform, and discuss potential reforms to the DI program.
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