Search results

In the 1990s, individuals aged 18–64 were eligible for disability insurance, if their work capacity was reduced by at least 25 percent (50 percent before 1993). In the beginning of the period, before 1991, disability insurance could also be granted for labor market reasons (i.e., if unemployed had been compensated long enough to exhaust their benefits – obtained benefits for 300 days). This possibility was gradually phased out after 1991. In 1995, the enforcement of the rules was tightened. When evaluating applications for disability pensions, local insurance offices now had to request a medical certificate and a work-related test of the applicant's degree of work capacity. Local offices also had to consult the applicant's employer, physician, or other qualified personnel, and even pay personal visits to the applicant. The possibilities for rehabilitating the applicant should also be investigated. From 1997, work incapacity should be evaluated in relation to all possible employment opportunities. Potential income changes resulting from changes in employment should not affect the evaluation⁴ (National Social Insurance Board, 2005).

As a “fictitious commodity” (Polanyi), that cannot be separated from the human being who is its owner, labor has a special moral significance. However, this moral quality is not a given but must be asserted in struggles over the value of labor. With the example of disabled workers in Switzerland, this chapter examines the moralization of labor as a means to revalue a category of workers who range far down the labor queue. Moralization mediates the tension between the normative societal goal of inclusion for disabled people and the freedom of employers to select the most “productive” workers. Drawing on the theoretical approach of the Economics of Convention the chapter analyzes the valuation frames proposed by economic and welfare state actors in political debates over the establishment of the Swiss disability insurance and the role of employers regarding occupational integration. A core concept used in negotiations of the value of disabled labor in the public arena and within individual businesses is the “social responsibility” of employers. Historically, employers’ associations successfully promoted the liberal principle of voluntary responsibility to prevent state interference in the labor market. In contrast, disability insurance argues predominantly within the market and the industrial convention to “sell” its clientele in the context of employer campaigns and case-related interactions with employers. Only recently, both sides started to reframe the employment of disabled people as a win–win affair, which would reconcile economic self-interest and the common good.

Access to health care, particularly for children, remains a topic of great importance to policy makers in the United States. Recent attention focuses primarily on the enactment and subsequent expansions of the Children’s Health Insurance Program (CHIP) (Kenney, Ullman & Weil, 2000). Though the legislation affects all qualifying low-income children, the unique service needs of children with disabilities justify a closer look at the relationship between health insurance, income, and needs amongst children with disabilities. This analysis seeks to answer the following questions. To what extent do children with disabilities need various supportive health services? Does this need vary across type of disability or income level? Do children with health insurance, either public or private, have fewer unmet needs than children without health insurance? Answers to these questions will assist policy makers when determining who should be targeted to receive additional assistance in the future as well as evaluate the effectiveness of current mechanisms in delivering supportive health services to children with disabilities.

Two strands of the literature are combined, namely the modeling of disability insurance and the design, valuation and discussion of insurance-linked securities.

This paper provides a discussion regarding the advantages and detriments of disability-linked securities in comparison with mortality-linked bonds and swaps as well as regarding potential disability-linked indices and the potential use. The discussion is followed by an introduction of a potential design and a corresponding valuation of disability bonds and swaps.

This securitization will provide useful tools for the risk management of disability risk in a risk-based regulatory framework.

No disability-linked securities have been defined and discussed so far.

Persons with disabilities can experience problems obtaining health care. Using the 1994–1995 National Health Interview Survey disability supplement, we examined health insurance coverage and access to health services for working-age adults with mobility problems (difficulty walking, climbing stairs, standing): 6.1% (estimated 9.48 million) of persons 18–64 years old. People reporting minor and moderate mobility difficulties had slightly lower health insurance rates than those without mobility problems (around 76% compared to almost 80%). People with mobility difficulties were more likely than others to be denied coverage and to cite pre-existing health conditions as the reason.

This chapter reviews the existing empirical evidence on how social insurance affects health. Social insurance encompasses programs primarily designed to insure against health risks, such as health insurance, sick leave insurance, accident insurance, long-term care insurance, and disability insurance as well as other programs, such as unemployment insurance, pension insurance, and country-specific social insurance programs. These insurance systems exist in almost all developed countries around the world. This chapter discusses the state-of-the art evidence on each of these social insurance systems, briefly reviews the empirical methods for identifying causal effects, and examines possible limitations to these methods. The findings reveal robust and rich evidence on first-stage behavioral responses (“moral hazard”) to changes in insurance coverage. Surprisingly, evidence on how changes in coverage impact beneficiaries’ health is scant and inconclusive. This lack of identified causal health effects is directly related to limitations on how human health is typically measured, limitations on the empirical approaches, and a paucity of administrative panel data spanning long-time horizons. Future research must be conducted to fill these gaps. Of particular importance is evidence on how these social insurance systems interact and affect human health over the life cycle.

The purpose of this paper is to summarise the initial experiences of Australia’s National Disability Insurance Scheme (NDIS). It highlights some of the main challenges being faced by participants, service providers and government, and demonstrates how research can contribute to the ongoing implementation and success of the scheme.

The historical basis for the need for a new approach to disability funding in Australia is explored. The opportunities that exist and the difficulties that are being encountered by those entering and working within the new scheme are discussed.

Several problems were identified including difficult transitions between existing support frameworks to new “NDIS plans”, and the risk of market failure. Both the problems and their solutions are discussed and it is hoped that collaboration between the Commonwealth Government, service users, their families, service providers and universities can lead to a number of lasting improvements.

The new funding framework provides exciting opportunities for increasing the funding of people with intellectual and physical disabilities in Australia. Developments in technology, service provision in rural and remote areas and the opportunity to meet aspirational life goals exist alongside a number of challenges, including the need to ensure that those with multiple and complex disabilities retain existing levels of support.

The implementation of the NDIS is still underway, and opportunities exist to implement changes to the scheme where required. Research findings have an important role to play in the national debate regarding how best to improve quality of life for people with a disability in Australia.

This chapter reports on a hybrid sector of disability provision in Australia and the changes to the sector due to the shift to person-centred care in Australia. It explains the significant changes to the way the sector will respond to government and to client demands and how the organisations are responding to this by re-structuring and building new performance measurement systems including Social Return on Investment.

The first part of the chapter is descriptive of the change to person-centred care in the Australian disability sector using public reports. The second part of the chapter looks at the change at a micro level using an analysis of the literature.

Findings illustrate how the National Disability Insurance Scheme has brought about significant change between sectors of government and between providers, both government and non-government. Organisations have had to make significant changes to adapt to the government’s policy and especially funding change. This includes setting new governance and leadership models, changed human resource management practices and performance measurement systems.

The paper is a report relatively early in the transition phases, and therefore, more evidence is needed as the system change progresses. Still, the Australian disability sector provides a powerful example of significant hybridisation changes as a result of a shift to person-centred care.

This is a dramatic change from the Australian government to impose person-centred care. The adaptations of Australian organisations provide an interesting insight for the international community.

Despite numerous studies, our understanding of the determinants of disability insurance (DI) claim rates in the USA is clouded. When the unemployment (UE) rate soars during an economic downturn such as the spread of COVID-19, assuming a linear positive relationship between the two variables, as the prior literature has suggested, forewarns a large spike in DI claim rates. Yet, if the model is misspecified, it can lead to misinformed decisions such as reducing DI awards during an economic downturn when such awards are needed the most. This study aims to improve the accuracy of the DI claims' prediction.

This study suggests that the relationship between the UE rate and DI claim rate is nonlinear and examines this hypothesis using a panel dataset of 866 state-year observations from 2002–2018.

The results provided compelling evidence in support of the proposed quadratic relationship between the UE rate and DI claim rate and revealed that compared to a quadratic model, the linear model overestimated the DI claim rate by approximately 18 percent or 172,000 claims per year.

Given that DI awards represent hundreds of thousands of dollars in present value terms, the impact of increase in DI claims on the Social Security Disability Fund during an economic downturn might not be as high as some model might forecast.

To our knowledge, no other studies have examined a quadratic relationship between the UE rate and the DI claim rate. This study is especially relevant during the coronavirus (COVID-19) pandemic and its aftermath. In April 2020, the UE rate spiked to nearly 15 percent nationwide, with Nevada and Michigan at 28 percent and 22.7 percent, respectively. The nonlinear model used in this study suggests that, as the UE increases, DI claims increase, albeit at a decreasing rate. On the contrary, a linear relationship between the UE rate and DI claim rates implies that the increase in the DI claim rate would be constant regardless of the UE rate. This misspecification can result in misinformed decisions, such as the reduction of DI awards because of the overestimation of claims during economic downturns. This can lead to lower award rates during economic turmoil when this assistance is most needed.

The purpose of this paper is to describe the mental healthcare system for people with intellectual disabilities (ID) in Switzerland. It covers the current provision of mental healthcare services as well as educational and research aspects, and summarises both the historical development and the current data on demography, health economics, legislation and national policy.

The authors performed an extensive literature research and evaluated the (very sparse) literature, conducted some interviews with recognised experts and carried out extensive internet-based research on the topic.

There are numerous, well-funded, well-staffed and well-equipped facilities for people with ID. These facilities have highly trained special education teachers and social education workers. Legislation, the insurance system as well as the policies and strategies on a national level are basically in line with people’s with ID needs. On the other hand, there are too few specialist physicians and psychologists, not enough training centres and too few specialist psychiatric services, both inpatient and outpatient. Medical and psychological research in this field is also insufficient.

In Switzerland, the development of treatment facilities typically does not start with a decision by a central authority to implement a policy in a top-down process. Usually, these organisations develop on the basis of some local initiatives and spread throughout the country. The process is likely to be similar in the case of services for people with mental health and intellectual disabilities (MHID), and the situation can be expected to be much better throughout the country within a few years. Furthermore, specific training programmes are expected to be created for physicians and psychologists of various disciplines, to promote an interdisciplinary approach.

This review fills a gap in that there are very few published reviews on the provision of MHID services in Switzerland.