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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.

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.

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.

A growing body of work suggests that welfare and punishment should be understood as alternative, yet interconnected ways of governing poor and marginalized populations. While there is considerable evidence of a punitive turn in welfare and penal institutions over the past half century, recent studies show that welfare and carceral institutions increasingly comanage millions of people caught at the intersection of the welfare and penal sectors. The growth of “mass supervision” and the expansion of the social services sector help explain the blurring of welfare and punishment in the United States in daily practice. We suggest that these developments complicate the idea of an institutional trade-off and contend that welfare and punishment are best understood along a continuum of state management in which poor and socially marginalized populations are subjected to varying degrees of support, surveillance, and sanction. In presenting the punishment–welfare continuum, we pay particular attention to the “murky middle” between the two spheres: an interinstitutional space that has emerged in the context of mass supervision and a social services–centric safety net. We show that people caught in the “murky middle” receive some social supports and services, but also face pervasive surveillance and control and must adapt to the tangle of obligations and requirements in ways that both extend punishment and limit their ability to successfully participate in mainstream institutions.

Recidivism is often used to measure the success of the criminal justice initiatives. We explore alternate measures of success that were identified for special offenders through the development of program theory. Using content analysis of 50 closed files from the Special Offenders Services program in Lancaster County, PA, we found that most offenders completed the program without re-offending, maintained their medication, participated in counseling, fulfilled their court cost obligations, and had few housing transitions. However, there were differences between parolees and probationers in terms of their outcomes. We recommend that special offender programs use uniform data-recording procedures.