71 - སྙ
provident funds.
Social insurance
Judged by social security criteria, pension schemes are a much more effective form of long-term income protection than statutory schemes may not always possess the same degree of flexibility as some non- contributory schemes, but possibly are better able to fix benefit rates on an objective basis. The provision of medical care to the populations of developing countries is an immense task for which there are as yet insufficient human, physical and financial resources. Accordingly, the financial investment and the organisation of demand, resulting from social insurance systems of medical care, operating in full co-ordination with the public health authorities, are effective contributions in this vital field. In many instances, representatives of employers and workers are involved in the planning and control of social insurance schemes which ensures that they are responsive to the needs of both groups.
22. As indicated in the paper "Social Security in Asia", the present stage of development of social insurance schemes in Asian countries is characterised by their limited coverage of long-term risks and their concentration on urban wage earners, other than those in the smallest establishments. The schemes providing medical care have been hampered in their development, and consequent impact, by the general acute shortages and
maldistribution of medical personnel and facilities. The rising cost of medical care has also been a limiting factor. The social insurance system of financing through bipartite or tripartite contributions has encountered the problems of the low paying capacity in many countries (examples of per capita incomes are given in Appendix II) which has restricted the introduction of expansion of schemes. A factor of special significance in Asia is the considerable size of some populations and their wide distribution throughout the territory. Coupled with slow and uneven development of the infrastructure, this has presented severe problems to schemes seeking to cover even centres of population. The lack of adequate numbers of trained personnel has been a considerable handicap because social security administration is of a specialised and exacting nature, often subject to pressure by members who are aware of their rights acquired by virtue of contributions. When the administration has been conducted by a government department it has sometimes been the practice to transfer experienced personnel to other duties, which has impaired the efficiency of the schemes, and also their ability to expand. In these circumstances, there has been a reluctance to undertake the coverage of the numerous small establishments, and of the various categories of casual or temporary workers in the urban centres already within the ambit of the schemes. Comparatively little action has been taken to find solutions to the problems of including those groups of self-employed persons who, whilst requiring social protection, present difficulties regarding the extent of their financial participation, the contingencies to be covered and the enforcement of the law. far the most serious shortcoming in regard to coverage of persons is the present inability of social insurance schemes to overcome the formidable technical problems involved in assimilating the unorganised and traditional agricultural sector. These problems are fundamental and comprehensive and are related to the special structure of farm employment, low incomes, the practice of paying scme remuneration in kind, the lack of suitable institutional frameworks, and the comparative dearth of medical facilities. Because of the large proportion of populations in rural areas and their general need for various forms of social protection, it is of profound importance to devise effective methods for the inclusion of rural workers in social insurance schemes.
Ey
23. It is incumbent upon social security schemes to maintain the real value of benefits, particularly those in respect of long-term contingencies, and this responsibility can pose quite severe problems according to the economic conditions in the countries concerned. The technical aspects of this problem are discussed in the relevant papers on the financial aspects of social security, but it may
be observed that the comparatively slow development of the coverage of long-term contingencies possibly is attributable in part to a reluctance to undertake apparently expensive programmes. this preoccupation of policy makers with the prospective costs of social security is natural, but needs to be examined in the perspective of the actual operations of social security schemes. Examples of self- supporting schemes are provided by Pakistan and the Philippines. In the case of the latter, a pension scheme has been in force since 1958 and has been progressively improved, in conjunction with the other benefits, within the existing financial framework and with little recourse to additional financing. A carefully designed social insurance scheme with a sound financial system is well able to withstand the problem of costs provided that its operations are subject to regular review, and that the financial aspects of proposed developments are elucidated and given the fullest consideration by the authorities.
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