The Social Protection Floor

Christine Nathan Regional Workers’ Specialist, ILO Bangkok

The Social Protection Floor
• Agenda:
– – – – The SPF concept The SPF initiative The SPF in Asia Assessment & costing

I hope that you will become strong supporters of the Social Protection Floor!

The SPF concept
• A set of basic social rights, services and facilities that each member of society should enjoy • For a social protection floor to be established:
Essential services are available: -Housing -Water & Sanitation -Education/skills -Health care supply -Information These services are accessible through basic transfers in cash or in kind: -Subsidized health insurance / health cards, -Scholarships & school buses, -Food distribution -Income support to families with children, the working poor and the elderly

• Notion of availability and accessibility – both work hand in hand, are articulated

The SPF concept
• Four guarantees:

 
 

All residents have access to essential health care All children enjoy income security through transfers in cash or kind  access to nutrition, education and care All those in active age groups who cannot earn sufficient income enjoy a minimum income security (transfer in cash or in kind & employment guarantee schemes)

All residents in old age and with disabilities have income security through pensions or transfers in kind

The SPF is the 1st step of the Social Vertical dimension: providing higher security staircase
levels of social security benefits
Objective 2 – Higher levels of income security: Objective 3Beyond the floor
Additional contributory benefits

Adapted social insurance

-statutory social insurance -voluntary insurance Etc.

Objective 1 - Social Protection Floor
Entitlement to at least a minimum level of benefits

Poor and near poor & Informal economy (80% population)

Formal sector (20% population)

Horizontal dimension: increasing the number of persons covered

The SPF is NOT a Social Safety Net
• SSNs are targeted towards the poor and vulnerable; no graduation towards higher levels of benefits nor comprehensive/coherent system; inclusion/exclusion errors (targeting)

??? SSNs


Social protection floor Formal sector

Poor & informal economy

The SPF is NOT a Social Safety Net
Social Safety Nets
Population covered Objectives & role The poor Protection against income shocks Poverty reduction Transitory response measures (crisis, reforms) No reference to rights

Social protection floor & SSecurity
All the population Protection against financial consequences of contingencies Poverty eradication ≠Permanent protection against poverty for all residents ≠Rights-based

Type of interventions

Targeted set of non≠Universal entitlement to contributory transfers, protection through a defined basic depending on govt’s priorities package for all in need Graduation within the SS Staircase Minimum (levels of benefits ≠Guaranteed at national poverty may not close the poverty gap) lines

Benefit levels

The Social Protection Floor
• Agenda:
– – – – The SPF concept The SPF initiative The SPF in Asia Assessment & costing

The SPF initiative
• One of the nine initiatives of the UN CEB to face the crisis and accelerate recovery (2009)
1. 2. 3. 4. 5. 6. 7. 8. 9. Additional financing for the most vulnerable Food Security Trade A Green Economy Initiative A Global Jobs Pact A Social Protection Floor Humanitarian, Security and Social Stability Technology and Innovation Monitoring and Analysis


The SPF initiative
• • • • • • • • • A coalition in place (17 UN agencies) A manual & strategic framework Tools development (ex: rapid assessment) SPF success stories (South-South exchange initiative) Knowledge sharing through the GESS platform Joint training programme (Turin) Joint briefings of UN resident coordinators UNDG-AP briefing note SPF teams or working groups in the countries (ex: Thailand) • A SPF Advisory Group headed by Mrs Bachelet • A flagship Global SPF Report under preparation • Upcoming G20 (sept. 2011) on Social Protection Floor

The Social Protection Floor
• Agenda:
– – – – The SPF concept The SPF initiative The SPF in Asia Assessment & costing

The SPF in Asia
• Many countries have some elements of the SPF :
– Established universal & non-contributory (OR highly subsidized) schemes – Developed national strategies to accelerate the implementation and scaling up of diverse and scattered basic social protection programs

The SPF in Asia
India: RSBY, NREGA China: minimum living standard guarantee program; new rural corporative medical care (NRCMC); health insurance for urban uninsured residents (HIUR); rural old-age pension INSERT MAP (TOO HEAVY FOR KSP) Lao: extension of SHP for all Philippines: 4Ps Thailand: UC scheme, minimum pension scheme (500 THB) Vietnam: 10 years Social security strategy

Cambodia: CARD’s SP strategy for the poor and the vulnerable with clear reference to the SPF … including HEFs, CBHIs, Food distribution, Cash transfers, PEPs…
Indonesia: Implementation of SS Law starting with health: Jamkesmas

The SPF in Asia
Some countries have already “nationalized” the SS staircase and included it in their national social protection strategies… a relevant tool
Expanded social protection Civil servants

Social Insurance (contributory)  Unemployment insurance  Pension  Health insurance  NSSF, NSSFC, SHP

Formal sector workers

Existing programs Poverty and vulnerability Legal framework

Social Protection for the Poor and Vulnerable

Community-based health insurance Near poor

Social Safety Nets (non-contributory):  Public works programmes (cash for work or food for work)  Cash or in-kind transfers (conditional or non-conditional)  Subsidies (to facilitate access to health, education, housing, public utilities) Complementary social welfare services Basic social protection

Poor SVG

Example of Cambodia

The SPF in China
• Health insurance for urban uninsured residents (HIUR)

Urban uninsured residents, i.e. economically inactive populations (elderly, children and students) Approx. 200 million people

Piloted since 2007 with a view to covering all targeted people by 2010.
Voluntary participation but significantly subsidized by the Government. The shares of subsidy as percentage of the total costs are about 36% and 56% for the elderly and children respectively in 2008.

The SPF in China
• New rural corporative medical care (NRCMC)
Target: 54.3% of the total population = rural.

Launched in 2003 with an aim of covering all by 2010. End 2008: NRCMC operated in all rural counties (2,729). End 2009: 830 million people covered.
Voluntary participation, high & increasing subsidies. Ratio of contribution / Government's subsidies: Y10: Y20 in 2003, Y20: Y80 in 2009 and Y30:Y120 in 2010 Hospital care and treatment of serious diseases are covered, but the benefit package is still limited (finances less than 50% of the total health expenditure on average)

The SPF in China
• Rural old-age pension
All rural population (eldelry). Launched in 2009 in 10% of counties. Another 13% of counties in 2010. Target = all rural population by 2020.

Consisting of two pensions: 1- flat-rate universal pension financed by the State (CNY55 per person per month, is payable to all rural residents aged 60), and 2- A pension based on the amount of savings accumulated in the individual accounts (financed by the insured persons and local cooperatives if possible). Therefore, the principle of solidarity is applied

The SPF in China
• Two minimum living standard guarantee programs
Target: Poor urban and rural residents. Piloted in Shanghai in 1993 ; universal coverage in 2007. Since 2007, these benefits have become universally available. In 2008, there was a total of 66 million beneficiaries, nearly 5% of the total population. They provide income security to both urban and rural residents who maintain a revenue level below the locally-defined income threshold.

The SPF in India
• Rashtriya Swasthya Bima Yojana (RSBY)
Lessons learned from previous HIS organized by local govts: poor design, insufficient funding, lack of “portability”. Target group: BPL families Target population: 300 million (by 2012) Implementation started in 2008. Enrolment = 70 million people.++

Benefits – Ceiling =Rs. 30,000 (US$650) for a family of five for one year. Transportation charges of Rs. 1000/- (US$22) per year. Preexisting diseases covered from day 1. One day pre-hospitalisation and five day post hospitalisation covered. No age limit.

The SPF in India
• Rashtriya Swasthya Bima Yojana (RSBY)
Operation: private insurance companies (bidding process) Funding: central govt (75%) and state governments (25%) + nominal registration fee of 30 Rupees paid by the members. Use of technology to minimize admin costs, and limit fraud. •Each enrolled beneficiary receives a biometric smart card. •Beneficiary can visit any empanelled hospital across India. •Beneficiary is provided cashless treatment. •Hospital submits paperless claims to the Insurance Company.

The SPF in India

The SPF in India
• National Rural Employment Guarantee Scheme (NREGS)
Target: Rural unemployed and underemployed Started in 2005, now operational in the whole country, covering 619 districts. 52.5 million households.
Self-targeting Cash-for-work programme + Guarantee of employment of 100 days per household at a specified minimum level (Rs 100 / day). If the State not able to provide 100 days of work, the Household is entitled to the payment of Social Protection unemployment allowance.

Entry point for access, at work site facilities, to other social Social Protection services (health services, safe water, etc.).

The SPF in Thailand
• Universal Health Care Scheme (UCS)
Target: Every Thai citizen not covered under public SS schemes. 47 million (80% total population)

Established in 2001. Funding: General tax revenue Benefit package : - Preventive care: immunizations, checkups, premarital counseling, antenatal
care, family planning, prevention and promotion. - Ambulatory care and in-patient care (high cost treatments: cancer treatments, open heart surgery, ARVs, renal replacement …). - Few exclusions (infertility, cosmetic surgery)

The SPF in Thailand
• Universal Health Care Scheme (UCS)
Registration at primary care contracting unit (CUP) (within 30 minutes travel time from home)
Referral system:
Primary care unit acts as a gate-keeper for access to care. Treatment outside this area is limited to accident and emergency care. Referral system is used for complicated cases to hospitals or special institutes.

Cash less system (benefits are provided free of charge) Management Information System:
A national centralized online registration database links providers to public health insurance schemes. Hospital submits electronic claims to the UCS for inpatient services.

The SPF in Thailand
• 500 Bath old age pension scheme
Target: Every Thai elderly person (60 years or older) who is not in elderly public facilities or does not currently receive income permanently (i.e., government pension recipients, government employed persons).

Target population: 6.87 million (95% of the elderly)
Number of registered: 5.65 million (82.2% of target)

Established in 2009.
Funding: General tax revenue

The SPF in Thailand
• 500 Bath old age pension scheme
Benefits: In cash benefits, 500 Baht per month

Total fiscal expenditure: 33,917 million Baht (approx. 0.37% of GDP)
In the near future implementation of an additional pension scheme for working population in the informal sector on top of the universal non contributory 500 Baht pension.
Basic contribution will be 100 Baht per month. Government will co-contribute on top at rates of 50, 80 and 100 Baht per month, depending on the contributor’s age.

The SPF in Asia
• • • • • SPF country brief: China SPF country brief: India SPF country brief: Thailand SPF country brief: Viet Nam SPF success stories: Thailand, China, India, Cambodia

The Social Protection Floor
• Agenda:
– – – – The SPF concept The SPF initiative The SPF in Asia Assessment & costing

Assessment & Costing
    
Use the social protection floor framework to: •Describe existing schemes •Identify the policy and implementation gaps if any •Draw recommendations

Complete the assessment by : •A rapid costing exercise (estimate the cost of introducing additional social protection provisions) •Comprehensive feasibility studies for the design of the new schemes

Continuous Decide on priority policy developments &
implementation measures through a national dialogue

Assessment & Costing
TAKING  STOCK - Existing schemes, indicators (coverage, benefits) - Planned schemes (NSP strategy) NATIONAL DIALOGUE COMPARING WITH SPF FRAMEWORK -Income security for children, working age, elderly -Health care for all THE GAPS  COSTING How much would it cost to introduce the guarantees that are not foreseen or still “scattered”?

THE GAPS:  FINDING Policy gaps & Implementation issues: low coverage, limited benefits  low adequacy, delivery issues  low accessibility




Assessment matrix
SPF Existing SP What is objectives provision foreseen in the SP Strategy

Design gaps

Agencies Priorities Implemen- involved tation gaps



Working age Elderly

Identify design gaps (population not A consistent framework where all covered due to the lack of SP policy / institutions support Describe :the present and and UN agencies Objective Priority policy options Social Protection Floor legislation interventions can fit. planned social protection A tool to analyse to what extent existing and to be decided template: guarantees and situation, taking into account Identify implementation gaps:national planned (in the SP strategy) social of protection through Mapping & sharing responsibilities objectives SP strategy objectives dysfunction inamong existing policy and provisions fit to the social protection floor template dialogue based and activities actors and moreon schemes (entitlements not meet, results assessment specifically UN agencies…
unavailability or lack of access to services) Basis for the preliminary costing

Assessment matrix completed (Viet Nam, Philippines)

… Take away message
• The SPF is a new and powerful approach to extend social protection coverage • Trade unions may want to:
– Promote the SPF in China and outside China (…G20) – Share Chinese experience (southsouth cooperation) – Assess and monitor the development of the SPF in China

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