Wage Continuation During Sickness: Observations on Paid Sick Leave Provisions in Times of Crises

[Excerpt] The economic costs of working while sick go far beyond increased health care costs due to treating a significantly higher number of people showing more severe signs of ill health. They also involve costs due to lower productivity and subsequent impacts on economic growth and development, in addition to collective costs of growing health and social inequalities. However, many aspects of social health protection including the role, patterns and costs of paid sick leave are misunderstood or underappreciated especially during times of economic crisis and recession. It is often said that paid sick leave schemes are open to abuse, especially if the benefit levels appear generous. This is undoubtedly a danger, and points to the need for strong administration. However, it is all too easy to overstate the case. ILO analyses of stimulus packages and policies addressing the crises reveal that cuts of social and health budgets are among the first national responses to recover the costs of bailing out those that have contributed to the crisis. Concerned are social health protection measures that provide access to health services and financial protection in case of sickness, such as paid sick leave. Limited evidence is available for governments, employers and workers’ unions on the consequences of gaps in providing for paid sick leave and costs of failing to address the needs of the vulnerable. Developing reliable internationally comparable data is constrained by the complex interplay of health and socio-economic conditions including regulations, labour market structure and vulnerability when taking up paid sick leave. Against this background, this paper seeks to focus on the existing national and international evidence and provides some insights into the concepts, patterns and affordability of paid sick leave in countries throughout the world. Further, it is argued that providing for sick leave and related income replacement is a key component of decent work and should be considered within national social protection floors

Health financing reform in Kenya- assessing the social health insurance proposal

Kenya has had a history of health financing policy changes since its   independence in 1963. Recently, significant preparatory work was done on a new Social Health Insurance Law that, if accepted, would lead to universal health coverage in Kenya after a tr&nsition period. Questions of economic  feasibility and political acceptability continue to be discussed, with   stakeholders voicing concerns on design features of the new proposal   submitted to the  Kenyan parliament in 2004. For economic, social, political and organisational reasons a transition period will be  necessary, which is likely to last more than a decade. However, important objectives such as access to health care  and avoiding impoverishment due to direct health care payments should be recognised from the start so that  steady progress towards effective universal coverage can be planned and achieved

a comparative analysis of three African countries

"Recently, there is an increasing focus on social health protection via health insurance as a potential promising way to better to deal with health risks in developing countries. However, the empirical basis for a profound analysis of the effects of health insurance is still very thin. Against this background the ILO, WHO, and the OECD Development Centre sponsored by GTZ have undertaken a collaborative research project in this field. This paper summarizes the results of three individual research projects (Asfaw, 2005; Lamiraud et al., 2005; Xu et al., 2005) measuring the impact of membership in a health insurance scheme in three African countries, namely Kenya, Senegal and South Africa. The structure of the paper is as follows. The first section of this paper is briefly outlining the health care systems in Kenya, Senegal and South Africa followed by a short description of the methodology and data used. The later sections focus on empirical results and policy implications." -- from IntroductionNon-PRIFPRI5; Theme 7; Enhanced food and diet quality; Health, Diet and Nutrition; DCAFCND26 p

Towards Affordable Universal Access to Health Care Through Social Health Protection

The global population covered by some kind of health welfare measure is miniscule. The need to expand coverage can be addressed by a pragmatic strategy rationalizing the use of health financing mechanisms. This allows the sharing of the burden of health care among the whole population. It might turn out to be a milestone for achieving the Millenium Development Goals. [Power Point Presentation]ILO, social health, insurance policies, MDGs, population, coverage

Gaps in social protection for health and long-term care in Europe: Are the elderly faced with financial ruin?

While public expenditure on health care and long-term care (LTC) has been monitored for many years in European countries, far less attention has been paid to the financial consequences for older people of private out-of-pocket (OOP) expenditure necessary to access such care. Employing representative cross-sectional data on the elderly populations of 11 European countries in 2004 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we find that OOP payments for health care and LTC are very common among the elderly across European countries and such expenditures impact significantly on disposable income: up to 95 per cent of the elderly make OOP payments for health care and 5 per cent for LTC, resulting in income reductions of between 5 and 10 per cent, respectively. Failure to prevent financial ruin, as a consequence of excessive OOP payments, is evident in 0.7 per cent of elderly households utilizing health care and 0.5 per cent of elderly households utilizing LTC. Those particularly concerned are the poor, women and the very old