Social Insurance (Pensions and Health), Labour Markets and Coverage in Latin America

This chapter analyses the relationship between the labour market, social insurance pensions and health programmes, and the coverage of the labour force and the population in Latin America and is divided into four sections. The first section describes changes in the labour market which have led towards increasing informality and labour flexibilization and have resulted in jobs that lack social insurance coverage; examines the difficulties in the incorporation of the informal sector (self-employed, domestic servants, employees in microenterprises) and of the rural population and peasants; and identifies potential factors that could explain coverage differences between countries. The second section evaluates the impact of external factors and the system itself, as well as health and pension reforms, on various aspects of coverage, such as overall statistical coverage before and after the reforms, inequalities in coverage by income, gender, geographical areas and indigenous peoples, and coverage of the poor and the elderly. The third section outlines policies to extend coverage to the excluded sectors, compares divergent approaches of international and regional organizations and identifies common objectives, specifies policies to incorporate difficult groups and reduce inequalities by income, gender, geography and among indigenous peoples, and to protect the poor and the elderly. Finally, the fourth section draws policy lessons from the Latin American experience for other developing countries.