• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.91-99
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• 2017

Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

• East Asian Journal of Business Economics (EAJBE)
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• v.1 no.3
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• pp.71-84
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• 2013

Purpose: The South African government is determined in alleviating poverty while encouraging job creation and protecting the disposable incomes of poor households. This article looks at the challenges that are facing the South African Social Security system and argues that the provision of income security is amongst the most practical expressions of a nation's cohesion and values. Research Design, Data and Methodology: There are seven proposals in the Social Security and Retirement Reform and these proposals are based on the following two principal objectives of the government, that is, to ensure a basic standard of living and to prevent destitution in old age or in circumstances of unemployment or incapacity partly or wholly through redistributive measures, and to encourage savings to provide for the replacement of income on retirement, disablement or death through long-term insurance arrangements. Results: This article evaluates these seven proposals, state old age pension, wage subsidy, mandatory participation in a national social security system for all, mandatory participation in private occupational or individual retirement funds, Voluntary additional contributions to occupational or individual retirement funds, reform of the governance and regulation of the retirement funding industry and reform of the tax system. Conclusion: This article concludes that the population size of South Africa has increased significantly to 51, 8 million in 2011 and therefore the time is right for bold new steps in improving income security of the poor and strengthening the fabric of social solidarity that binds all South Africans together.

• 한국사회정책
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• v.25 no.1
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• pp.45-70
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• 2018

After critically assessing the effectiveness of basic income as an alternative to the existing social security system, this article argues that basic income is fundamentally incapable of providing an adequate protection for those in social risks or welfare needs. The proponents of basic income often claims that technological innovations will lead to the end of work and thus that basic income will be required for all citizens in the future. Moreover, they emphasize that labor market flexibility is making a large segment of work forces unstable working poor, what is often called the precariat who are not effectively protected by the existing social insurance programs. For them, basic income is the best source of social protection for the precariat of today and the citizens in the future, freeing them from the necessity of having a paid work. This article, however, points out the ineffectiveness of basic income as social protection due to its unustainably high cost that comes from unconditional benefit provisions regardless of levels of income, social risks, and welfare needs. Also it challenges the simplified 'Luddites' image of workless society in the future, arguning that techological unemployment can be overcome by new job creation as seen in Silicon Valley and job sharing following working time reduction. It maintains that it is more cost-effective and reliable to strengthen the welfare state based on the principle of reciprocity that aims at 'universal sufficient protection for those in social risks and welfare needs.'

• 한국사회정책
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• v.24 no.4
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• pp.113-150
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• 2017

This study analyzes how workers become impoverished and have their jobs less stabilized after they suffer from non-job-related sickness. Given that South Korea lacks sickness benefits, which most of OECD member states legislate and implement except US and Switzerland, this study examines its impact on laborers' job stability and povertization in Korea. The researchers have conducted in-depth interviews with nine former or present laborers who have the experiences and four experts on the issue in July-September, 2017 for the qualitative analysis. It is found that laborers, after becoming aware of their sickness, at first endure their pain without informing their employers not to lose their jobs. The attititude is observed especially among non-standard laborers, because sickness more often leads to job loss for them than for standard laborers. After workers have to leave their jobs due to their sickness in the end, they have no choice but to keep working in less stable jobs to compensate for income losses. They become gradually impoverished with their social capital like family bond declining. We observe laborers who are eligible for industrial accident insurance compensation could not benefit from the system because some employers refrain from the legal reporting duty. Due to this illegal practices, some industrial accident victims unduly lose their jobs due to "non-job-related sickness". Second, some employers report to the authority that their sick laborers have left their jobs 'voluntarily' even when they have quitted it without their volition, in which case the newly unemployed are not eligible for unemployment benefits. Large holes in Korea's safety nets for those suffering from multiple risks of sickness and unemployment.

• Health Policy and Management
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• v.22 no.2
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• pp.275-296
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• 2012

Graduate School of Public Health, Seoul National University The national health insurance system in Korea is characterized as relatively high out-of-pocket payments, which are the principal source of catastrophic health expenditure (CHE). The objectives of this study are to estimate the incidence of household CHE and to clarify the characteristics that affect the occurrence and recurrence of household CHE using the Seoul Welfare Panel Survey database for 2008 and 2010. Thresholds to estimate CHE were 10% and 20% of the total household income (T/X), and 25% and 40% of the income excluding food share (T/Y). Determinants of the occurrence and recurrence of CHE at the threshold of T/X=10% were analysed using multiple logistic regression models. Out of the 3,665 households that responded in 2008 survey, households with CHE were 12.07% (T/X${\geq}$10%), 5.34% (T/X${\geq}$20%), 6.84% (T/Y${\geq}$25%), and 4.44% (T/Y${\geq}$40%). Risk factors associated with household CHE included living with a spouse, non-Medicaid beneficiary, householder unemployment, low household income, the number of disabled members, poor subjective health, and the number of chronic diseases. A total of 41.78% of households with CHE in 2008 repeatedly experienced CHE in 2010. Risk factors of CHE recurrence included decreased household income and an increase in chronic diseases over the two time periods, the number of members with disability or chronic diseases, and the presence of cancer patients in 2008. Households with lower socioeconomic and health status had a higher financial burden on health care than do their counterpart households. There is a need to enhance society-wide financial protection from health spending among vulnerable citizens in Seoul, particularly, households with low income, disabled members or cancer patients.

• Korean Journal of Social Welfare Studies
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• v.48 no.3
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• pp.5-28
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• 2017

Using 2006~2015 Korean Welfare Panel Survey data, this study analyzed the poverty reduction effects of social security benefits. The results show that social security benefits have substantial impacts on reducing the poverty gap. National Basic Livelihood Security, public pensions, and Basic Pension have relatively larger poverty reduction effects. Other benefits such as disability benefits, workers' compensation unemployment insurance, and childcare subsidies have much smaller poverty impacts. Two determining factors of the poverty reduction effect are (1)the amount and (2)the poverty reduction efficiency of social security benefits. With the expansion of the social security system in recent years, the poverty reduction efficiency has decreased in general. Due to a greater increase in the amount of benefits, however, the poverty reduction effect has gradually increased. In order to increase the anti-poverty effect of social security, it is important to find ways to improve efficiency while minimizing the disadvantages of the selectivistic welfare benefits.

• Annals of Occupational and Environmental Medicine
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• v.34
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• pp.17.1-17.10
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• 2022

Background: This study aimed to investigate the decline in quality of life (QOL) by examining changes in the employment status of workers who had completed medical treatment after an industrial accident. Methods: This study utilized the Panel Study of Worker's Compensation Insurance cohort (published in October 2020) containing a sample survey of 3,294 occupationally injured workers who completed medical care in 2017. We divided this population into four groups according to changes in working status. A multivariate logistic regression model was utilized for evaluating QOL decline by adjusting for the basic characteristics and working environment at the time of accident. Subgroup analysis evaluated whether QOL decline differed according to disability grade and industry group. Results: The QOL decline in the "maintained employment," "employed to unemployed," "remained unemployed," and "unemployed to employed" groups were 15.3%, 28.1%, 20.2%, and 11.9%, respectively. The "maintained employment" group provided a reference. As a result of adjusting for the socioeconomic status and working environment, the odds ratios (ORs) of QOL decline for the "employed to unemployed" group and the "remained unemployed" group were 2.13 (95% confidence interval [CI], 1.51-3.01) and 1.47 (95% CI, 1.13-1.90), respectively. The "unemployed to employed" group had a non-significant OR of 0.76 (95% CI, 0.54-1.07). Conclusions: This study revealed that continuous unemployment or unstable employment negatively affected industrially injured workers' QOL. Policy researchers and relevant ministries should further develop and improve "return to work" programs that could maintain decent employment avenues within the workers' compensation system.

• Journal of Labour Economics
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• v.29 no.1
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• pp.153-184
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• 2006

This study examines the job changes and the coincidence of job and major In the case of the youth, science and engineering graduates in Korea. The pattern of job changes and the coincidence of job and major get observed in the Unemployment Insurance Database and the Graduate List. This data enables us tracing all job changes in the labor market, and analysing the coincidence of job and major. The average rate of coincidence is not so high, the rate at first job is roughly one third. The youth with coincidence of job and major have earned less income than the youth without coincidence of job and major. But this result is impressive in the lower wage earners, any differences in regard to coincidence is not found in the upper wage earners. The probability of the coincidence of job and major is higher in case of the high wage and the high study attainments. The results suggests that the problem of the science and engineering graduates should be concentrated only on the lower manpower in the scientist and engineer jobs. Korean government have to lessen the number of entry into the science and engineering college and enlarge the number of entry into the science and engineering graduate school. Korean government have to prepare the system that aids establishment where the employee with coincidence of job and major earns more income.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1295-1301
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• 2015

Background: Cancer imposes a significant economic burden on individuals, families and society. The purpose of this study was to estimate the economic burden of cancer using the healthcare claims and cancer registry data in Korea in 2009. Materials and Methods: The economic burden of cancer was estimated using the prevalence data where patients were identified in the Korean Central Cancer Registry. We estimated the medical, non-medical, morbidity and mortality cost due to lost productivity. Medical costs were calculated using the healthcare claims data obtained from the Korean National Health Insurance (KNHI) Corporation. Non-medical costs included the cost of transportation to visit health providers, costs associated with caregiving for cancer patients, and costs for complementary and alternative medicine (CAM). Data acquired from the Korean National Statistics Office and Ministry of Labor were used to calculate the life expectancy at the time of death, age- and gender-specific wages on average, adjusted for unemployment and labor force participation rate. Sensitivity analysis was performed to derive the current value of foregone future earnings due to premature death, discounted at 3% and 5%. Results: In 2009, estimated total economic cost of cancer amounted to $17.3 billion at a 3% discount rate. Medical care accounted for 28.3% of total costs, followed by non-medical (17.2%), morbidity (24.2%) and mortality (30.3%) costs. Conclusions: Given that the direct medical cost sharply increased over the last decade, we must strive to construct a sustainable health care system that provides better care while lowering the cost. In addition, a comprehensive cancer survivorship policy aimed at lower caregiving cost and higher rate of return to work has become more important than previously considered.