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Actuarial Report on Social Insurance

Estimating the results of legislative proposals to expand health insurance coverage is challenging, partly because there is so little empirical evidence concerning individual people’s responsiveness to health insurance mandates. Since 2007, adults in Massachusetts have been required to have health insurance or face penalties for noncompliance, but it may be too soon to infer the effect of mandates from that experience. Moreover, that experience itself could be unique to Massachusetts. In the absence of direct empirical evidence, research from three different disciplines—health economics, tax compliance, and behavioral economics—provide alternative perspectives on the effect of the mandate on coverage | Actuarial Report on Social Insurance Prague 2004 Ministry of Labour and Social Affairs 2004 ISBN 80-86878-07-4 3 CONTENTS INTRODUCTION 11 PART A GENERAL INFORMATION ABOUT THE SOCIAL INSURANCE SYSTEM 13 A.l. Brief system characteristics 13 A.1.1. Pension insurance 13 A.1.2. Sickness insurance 16 A.1.3. Funding 17 A.1.4. Social security organization and implementation 18 A. 2. Legislative changes since the beginning of 2002 19 A.2.1. Pension insurance 19 A. 2.2. Sickness insurance 24 PART B EVALUATION OF THE BASIC INDICATORS OF SOCIAL INSURANCE DEVELOPMENT 27 B. l. Parameters influencing the development of social insurance 27 B. 1.1. Economic development 27 B.1.2. Demographic development 28 B.1.3. Employment development 30 B.2. Social insurance indicators 31 B.2.1 Premiums 31 B.2.2. Pension insurance 38 B.2.2.1. Revenues and expenditure 38 B.2.2.2. Number of pensioners and pensions 40 B.2.2.3. Amount of pensions 51 B.2.2.4. Reduction in pensions on early retirement 59 B.2.2.5. Differentiation of pensions based on the amount of the pension 61 B.2.3. Sickness insurance 63 B.2.4. Fulfillment of international conventions 70 B.2.4.1. Pension insurance 70 4 B.2.4.2. Sickness insurance 73 B.2.5. Operating expenditure 74 PART c SOCIAL INSURANCE PROJECTIONS 77 c.l. Projections of parameters influencing social insurance development 77 c.1.1. Economic development 77 c.1.2. Demographic development 78 c.1.3. Developments in the level of economic activity 80 C.2. Pension insurance 81 c.2.1. Projection of Key Indicators 81 c.2.1.1. Developments in the number of contributors and pensioners 81 c.2.1.2. Ratio of the average old-age pension to the average wage 85 c.2.1.3. Developments in revenues and expenditure 87 c.2.2. Evaluation of developments in key indicators 88 c.2.3. Analysis of the sensitivity of the pension insurance system in relation to possible parametric adjustments 89 c.2.3.1. Financial viability 89 c.2.3.2. Sufficiency of benefits 93 c.2.3.3. Transformation deficit and