1. TRENDS AND CHALLENGES IN SOCIAL SECURITY: LESSONS FROM LATIN AMERICA Andras Uthoff Independent consultant. Ex Officer in Charge Social Development Division Economic Commission for Latin America and the Caribbean Experiences from Latin America Inter-Regional Tripartite Meeting The Future of Social Security in Arab States Amman, 6 to 8 May 2008

2. CONTENTS  MAIN CHALLENGES  CURRENTS TRENDS  LESSONS  AS APPLIED TO PENSIONS  AS APPLIED TO HEALTH  AS APPLIED TO POVERTY ALLEVIATION

3. MAIN CHALLENGES: Structural factors of LA development that have limited the construction of a labor based welfare state  A REGION OF MEDIUM INCOME ECONOMIES  A REGION OF WORLD LARGEST INEQUALITY  A REGION WHOSE DEVELOPMENT IS:  ASSOCIATED WITH FAST DEMOGRAPHIC TRANSITION  ASSOCIATED WITH LARGE UNDEREMPLOYMENT  ASSOCIATED WITH A RELATIVE SMALL TAX BURDEN

4. MAIN CHALLENGES: All countries face a gap between the total dependents per formal workers and that number of dependents per formal worker that can receive a sustainable universal benefit PROFILE OF THE GAP OF DEPENDENTS PER FORMAL WORKERS THAT CAN BE SUSTAINABLE COVERED BY INCOME PER CAPITA LEVELS

5.  Before the 90’s the welfare State founded upon the concept of a labour-based society has not lived up to expectations  Limited coverage, which is a factor in social exclusion  Income inequality carries over into social protection  The reforms of the 1990s sought to improve financing and access by:  Creating a closer link between employment and protection based on the formalization of the labour market: Trends to include a full capitalization pillar Trends to include private health insurance firms  Placing more emphasis on incentives and efficiency than on solidarity Defined contribution vs defined benefits Lack of concern with non contributive sub system CURRENT TRENDS The issue of access, financing and solidarity

6. CURRENT TRENDS Contributory coverage has not increased since 1990 COUNTRIES WHERE COVERAGE IMPROVED COUNTRIES WHERE COVERAGE WORSENED LATIN AMERICA: COVERAGE IN 1990 AND 2002 (% of employed persons paying contributions)

7. Urban Rural Urban Formal Urban Informal Men Women (% working age population) Q5 Q1 (rich) (poor) CURRENT TRENDS Inequity in the structure of contributions

8. LESSONS Social protection: a change in approach  Employment should no longer be seen as the only mechanism for access to social protection  Need to strike a better balance between incentives and solidarity  New forces of change in demographics, epidemiological patterns and family structure A new social covenant is needed in order to universalize social protection

9.  Explicit, guaranteed and enforceable rights  Definition of levels and sources of financing (solidarity mechanisms)  Development of a framework of social institutions LESSONS Content of a new social covenant

10. LESSONS Sectoral proposals  Health-care systems  Pension systems  Anti-poverty social programmes Reforms are non-replicable processes

11. LESSONS The health reform agenda should include (1)  Integration of public and social security systems:  Solidarity: Access to services regardless of contributions, payment capacity and individual risk levels  Efficiency: Improved risk management and avoidance of duplications  Establish benefits with universal coverage and guaranteed entitlements (health needs)

12. LESSONS The health reform agenda should include (2)  Policies on the organization and delivery of services  Separation of financing from service provision  Coordination of the supply of health-care services  Improvement of payment mechanisms  Regulation and oversight  Policies on public health and the expansion of primary care  Strengthening of primary-care prevention and treatment  Decentralization

13. LESSONS Pension reform agenda  Strengthen non-contributory pensions  Reform PAYG systems  Emphasis on contributory solidarity  Promotion of participation in contributory system (e.g., a closer link between contributions and benefits)  Financial viability (notional or parametric reforms)  Standardization and unification of pension systems  Supplement with individual capitalization  Diversify economic, financial and demographic risks  Transition costs  Industrial organization  Gender equity (labour market and life tables)

14. Non-contributory pensions for over-65s to cut the poverty rate in half COST OF PENSION BENEFITS EQUIVALENT TO ONE POVERTY LINE (As percentage of GDP)

15. LESSONS Proposals for enhancing conditional transfer and employment programmes  Share the programme-generated workload within the household (CCT)  Incorporate social capital criteria  Proactive role for the State in incorporating beneficiaries into the programmes  Ensure supply of health and education services to match programme-induced increase in demand (CCT)  Explicit exit rules  Strengthen skills-building in employment programmes

16. In summary  The task of universalizing and improving social protection is yet to be completed  Employment alone is not enough to universalize coverage  Greater complementarity between solidarity and incentives  The contributory and non-contributory systems need to be integrated Reforms in the context of a social pact in which rights are the normative horizon and economic inequalities are constraints to be overcome

17. TRENDS AND CHALLENGES IN SOCIAL SECURITY: LESSONS FROM LATIN AMERICA Andras Uthoff Independent consultant. Ex Officer in Charge Social Development Division Economic Commission for Latin America and the Caribbean Experiences from Latin America Inter-Regional Tripartite Meeting The Future of Social Security in Arab States Amman, 6 to 8 May 2008