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Social Protection: Year In Review 2001

Benefits and Programs

The financial viability of social protection programs continued to be a matter of worldwide concern. In 2001 many countries restructured their various schemes with a view to ensuring their long-term stability. In the process the pros and cons of private elements in public social protection programs were debated as well as the question of what was the “right” public-private mix for each scheme. Governments and social security administrators also strove to improve the delivery of social services and to give more people access to benefits.

North America

As with so many other areas of life, social protection was deeply affected by the terrorist attacks in the United States on September 11 and by the nation’s prolonged economic downturn. High-priority legislation to provide prescription drug assistance for Medicare patients and federal support for faith-based charities was relegated, at least temporarily, to a back burner. Pledges that the Social Security Trust Fund would not be used to finance other needs were broken. Greater stress was put on the welfare system by an explosion of jobless workers. For the most part, as the federal government turned to more immediate concerns, social welfare activity was limited to debate, studies, and postponed action.

The two giant social programs for the elderly, Social Security and Medicare, had received good news early in the year when the funds’ trustees reported that both would be solvent longer than previously predicted—until 2038 for Social Security, a year longer than had been forecast earlier, and 2029 for Medicare, four years longer. Nevertheless, concerns about the financial health of Social Security, which in 2001 covered some 45,526,000 retired and disabled persons, continued because of the approaching retirement of approximately 77,000,000 baby boomers and the increasing life span of beneficiaries. In 2001 three to four workers supported one retiree; that ratio was expected to be just two to one by about 2030. Past strategies for dealing with the developing demographic problems centred mainly on such “tune-ups” as reducing benefits, increasing payroll taxes, and raising the retirement age (already slated to rise gradually from 65 to 67).

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U.S. Pres. George W. Bush favoured a plan for totally overhauling the system by partially privatizing it and allowing individual workers to invest a percentage of their payroll taxes in personal accounts. These, it was argued, would earn greater returns than the Trust Fund’s more conservative investments. Opponents of that idea contended that it would deplete the Trust Fund more quickly and could be disastrous for individuals if stock values collapsed.

Bush appointed a 16-member bipartisan commission in May to explore the issue and recommend solutions. Although it was a bipartisan group, critics charged that it was stacked with proponents of privatization. The commission announced in December that it had agreed unanimously on three options, all of which would rely on personal retirement investment accounts, reduce traditional benefits for retirees, and require further actions for long-term sustainability.

The government announced a cost-of-living increase of 2.6% in Social Security benefits starting in January 2002. The average retiree would get $874 a month, up $22 from the $852 in 2001, and the average couple would receive $1,458 a month, an increase of $36. By law, annual increases in Social Security payments must equal increases in the consumer price index.

Disagreement also flared over a cornerstone of the president’s “compassionate conservatism,” his faith-based initiative for dealing with social problems. The administration wanted to extend federal financing for the charitable work of religious groups and make it easier for individuals to contribute to them. Proponents of the plan argued that religious organizations could reach some individuals with food, housing, job training, and additional assistance when many other types of social initiatives could not. Critics voiced concerns about violating First Amendment guarantees of separation of church and state. They raised the possibility that the plan would permit religious organizations to hire only members of their own faith and would exempt them from state and local laws that forbid discrimination in hiring based on sexual orientation.

In a delicate constitutional balancing act, the U.S. House of Representatives narrowly approved a watered-down version of the Bush plan. It would allow faith-based groups to use federal aid for religious activities if they received it indirectly (through vouchers, for example) and if they kept religious activities separate from social services and allowed those they helped to refrain from religious observances. The measure also allowed tax deductions for small donations for taxpayers who did not itemize their deductions. Late in 2001, faced with strong Democratic opposition in the Senate and pressures from the war on terrorism, Bush dropped the most controversial aspects of his proposal.

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The upbeat report on Medicare’s financial condition was tempered by studies showing that dramatic increases in the cost of prescription drugs could create serious problems. One study by a nonprofit, nonpartisan group found that spending on these drugs had risen 18.8% in 2000 to $131.9 billion. With large budget surpluses forecast early in 2001, both political parties backed legislation to add some kind of prescription drug coverage for the 40 million elderly and disabled Americans who had Medicare, but they disagreed on how to do it. Democrats generally favoured working through Medicare, while the administration looked to private insurers. By the end of the year, however, the window of opportunity that was open earlier had been closed by the recession and the costs of fighting terrorism. No action was taken, and hopes faded for any in 2002, which was a midterm election year.

In addition, the administration pushed to increase enrollment of Medicare recipients in health maintenance organizations (HMOs). In 2001 slightly more than 14% of Medicare beneficiaries were already enrolled. A potential setback to greater participation occurred when 58 HMOs serving 536,000 people announced that they would withdraw from the Medicare program in 2002.

As efforts bogged down at the federal level, states began setting up programs of their own to help low-income Medicare recipients buy prescription drugs. For example, Pennsylvania paid part of the cost of each prescription, while California and Florida put caps on how much pharmacies could charge elderly customers. By the end of the year, more than half of the states had taken steps to help with drug costs.

Welfare moved back into the spotlight in the U.S. Massive layoffs of workers following the terrorist attacks created unexpected problems for the social protection system just as Congress began to gear up for reauthorization of the 1996 welfare reform act in 2002. Pulled by the booming job market and pushed by tighter laws that limited their eligibility for welfare, nearly seven million people had left welfare rolls since 1996. Meanwhile, the U.S. Census Bureau reported that the number of people in the nation living in poverty fell in 1999 for the fourth consecutive year—to 11.8%, compared with 13.7% in 1996.

Despite those encouraging numbers and even before the terrorist impact, critics of the new welfare system had questioned how well it could withstand a weakening of the national economy. Moreover, they argued, people still on welfare rolls were those who had the most serious problems and needed as much, or more, federal spending to help them escape. There was also concern about many of those who had left welfare. The Urban Institute in Washington, D.C., reported that one-third of former recipients had to skip meals or eat less and that 46% had not been able to pay their rent or utility bills during the previous year. Supporters of the 1996 overhaul, on the other hand, claimed that the new safety net was the strongest ever and pointed out that welfare rolls continued to decline in some states even as unemployment there rose.

In September Health and Human Services Secretary Tommy G. Thompson announced a series of national “listening and discussion” sessions to air issues and ideas about the coming welfare reauthorization. One of those issues was poverty among the young. Although conditions had improved since 1993, when child poverty reached its peak, children under 18 continued to have a higher poverty rate than any other age group. Democrats pressed for action in areas such as affordability and availability of day care, restoration of cuts in food stamps and Medicaid for immigrants, and an increase in the minimum wage, which had not been raised since 1997. Republicans generally favoured tax credits and more money for policies that emphasized work and reductions in single-parent families.

Welfare reform also was a major issue in Canada, where Ontario, the most populous province, announced plans to impose the toughest rules ever in Canada for welfare recipients. Persons would be required to pass a literacy test before they could receive public assistance, and benefits would be cut off to those who had drug or alcohol problems and had refused treatment for them. Anyone who failed the literacy test would be required to enroll in a workfare program.

Critics labeled the measure mean-spirited and overly harsh and said it was a possible violation of Ontario’s human rights code. Officials responded that those receiving assistance needed to be pushed toward independence. They said that welfare rolls in Ontario had been cut by 60% in six years, but those who remained on them were the toughest cases.

In other action the Canadian government raised the maximum pensionable earnings for 2001 under the Canada Pension Plan by Can$700 (Can$1 = about U.S. $0.63) to Can$38,300. The contribution rate was increased to 4.3% for employees and 3.9% for employers, which brought the maximum employee contribution, after a basic Can$3,500 exemption, to Can$1,496.40 per year.


Portugal endowed itself with a new framework law on social protection, which came into force in February. France modernized its social protection system by introducing new benefits, such as a “parental attendance allowance,” to allow the parents of seriously ill children to take time off from work. In Romania the social protection system was adapted to new socioeconomic realities in that survivors’ pensions were now also granted not only to widows but also to widowers.

In Poland a discussion was under way to reform agricultural social insurance in order to build in mechanisms for structural reform based on solutions used in the European Union. The Netherlands took another step toward integrating the special system for civil servants into the general system for employee benefits when special unemployment regulations for employees in public service were abolished. Earlier, civil servants had been covered under the general Disability Benefits Act.

Ireland took measures to reduce long-term costs related to disability benefits. The government encouraged disabled people to return to work by allowing them to retain part of their benefits during the first few years of employment after having been on government disability benefits. Attempts to keep people in the labour force were also made in Italy. Beginning in April social security contributions were waived for those employees eligible for a seniority pension who postponed their retirement.

In Russia a pension-reform program that would create a three-pillar system was brought before the State Duma (parliament) in the summer and was expected to come into force in 2002. Latvia made progress in the construction of its three-pillar pension program. The law on funded state pensions went into force in July, establishing the legal basis for a capital-funded second pillar of the system that, together with the first pay-as-you-go pillar, formed the compulsory government scheme.

In the United Kingdom “stakeholder pensions” became a reality in April. The stakeholder pension was initially foreseen as a low-cost supplement to the basic government pension for people without an occupational pension or other form of privately funded pension arrangements, but its scope was broadened to allow the inclusion of people who either had personal pensions or were members of occupational programs.

In Germany pension-reform legislation was enacted in May, providing for government support for supplementary pensions in the form of cash subsidies or tax relief. At the same time, it was decided to reduce slightly and gradually the main (first) pillar of the system, essentially by introducing changes in the pension adjustment so that the replacement rate would decline from 70% to 67% of average net wages by 2030. Low-income pensioners were granted entitlement to a minimum income equal to 115% of the social assistance payment to a head of household. Workers were given the right to have a certain percentage of their wages paid into an occupational pension scheme. Vesting rights were modified, with employer-financed benefits becoming legally vested after five years and benefits from deferred remuneration becoming vested immediately. Prior to the reform an employee had to work for a company for 10 years to qualify for a pension.

To cut health care costs, Switzerland developed a new payment model for medicines; beginning in January advisory services provided by pharmacists and dispensing physicians were to be refunded by the social sickness insurance separately from the preparation and sales element of the costs of medicines in order to eliminate mechanisms that made it advantageous to dispense large quantities or particularly expensive medications. Austria restricted access to illness benefits as of January. Earlier, an employee’s partner who was not covered in his or her own right by social sickness insurance automatically received coverage through the working partner. This coverage was now restricted to people with children. The European Court of Justice declared during the year that medical services fell within the freedom to provide services, one of the four basic freedoms in the Maastricht Treaty.

Industrialized Asia and the Pacific

In June Australia passed legislation that provided for the split of superannuation (mandatory occupational pension) entitlements upon the breakdown of a marriage, whether by agreement or court order. Either a new account would be created in the superannuation fund for the nonmember spouse, or the nonmember’s interest would be rolled over into a savings account or similar regulated product.

Thailand’s Securities and Exchange Commission formally approved the framework for a new system of individual retirement mutual funds, and the Revenue Department made it known that it would grant tax deductions for personal contributions to those funds. In Singapore the health minister announced the creation of a voluntary long-term-care program based on insurance underwriting principles, which the government would subsidize.

In Japan the Ministry of Health and Welfare and the Ministry of Labour were merged in January to create a more transparent administration with more effective political leadership. Also in January the Medical Care Insurance Reform Act went into force. It was designed to cope with rising health care expenditures, essentially by revising the co-payment system. A new cost-sharing system for patients over the age of 70 was introduced, moving from flat-rate to percentage contributions; the “high-cost medical benefits scheme” was also revised, with people now having to self-finance larger shares of medical expenses before receiving a benefit.

South Korea’s government proposed to introduce a system of individual medical savings accounts. It would be possible to withdraw funds from the account, up to a specified limit, to pay for medical expenses. The public health care system would cover amounts exceeding that limit. Hong Kong’s Social Welfare Department made a similar proposal in relation to medical expenses after retirement.

Emerging and Less-Developed Countries

Many social protection systems in Africa and Asia continued to suffer from financial imbalances stemming from unfavourable economic conditions. Nonetheless, efforts were made to extend coverage, provide better benefits and services, and proceed to structural reform.

Uganda worked on implementing legislation adopted in 2000 to transform the National Social Security Fund, established in 1967 as a provident fund, into a social insurance pension scheme. In order to be able to finance future unemployment benefits in addition to existing retirement benefits, the Board of the Nigeria Social Insurance Trust Fund approved a new broader basis for calculating members’ contributions, setting higher contribution rates and a new ceiling on insurable earnings.

A health insurance program for civil servants was established in Rwanda and became operational in March. The program was designed to provide protection for the whole family; in cases where both spouses were civil servants, only one was required to contribute. In Tunisia a major reform of health insurance was under way. At the end of the process, Tunisia would possess a basic unified compulsory scheme (covering both public and private sectors) that would guarantee coverage for the most prevalent forms of sickness and an optional complementary program whose management would be open to both social security funds and private insurance companies.

The Indonesian government announced that it would abolish the rules that prevented a pension fund from investing more than 20% of its assets in securities of any single issuer, a move essentially aimed at stimulating pension fund investment in government bonds. To speed up administrative procedures and increase client satisfaction, the Social Security Organization of Iran worked on a database that would cover all of the people that it insured, an exercise concerning approximately 26 million employees.

Several Caribbean nations were able to improve their social benefits and services. In Belize a package to modernize social security was introduced. The access to a number of benefits was eased in the British Virgin Islands, and in the Netherlands Antilles the Law on Medical Insurance was amended so as to extend its coverage to retired workers and their family members aged 60 and over.

In Latin America the trend continued for countries to introduce private elements into government-operated social protection programs. In Ecuador the pros and cons of such a mixed system for retirement pensions were discussed throughout the year. In Venezuela a presidential commission tabled a proposal that provided for a substantial proportion of a person’s social security contribution to go into funded personal pension accounts that would be managed by the pension fund administrator of the individual’s choice.

Human Rights

Special attention was given during 2001 to racial discrimination, efforts to end the impunity of major human rights abusers, the expansion of the ethnic conflicts in southeastern Europe to Macedonia, and problems associated with the rapidly growing number of refugees in the world community. In addition, for the first time, major economic and health issues took their place as the focus of international human rights attention. Concerns about economic globalization and the HIV/AIDS pandemic and its treatment received long-overdue recognition as major human rights issues. Finally, the September 11 attacks in the United States and their aftermath raised a number of major issues of human rights concern related to terrorism and to resulting antiterrorism efforts.

Racial and Ethnic Discrimination

The United Nations targeted racial and ethnic discrimination as an issue deserving special attention through the convening of a World Conference Against Racism in Durban, S.Af., in August. A major controversy arose at the conference and in the regional preparatory meetings that preceded it over language proposed for inclusion in the conference report that sought to equate Zionism with racism and also that called for financial reparations for the practice of slavery, particularly in the context of the transatlantic slave trade in the 16th through the early 19th century.

Compromise language finally was adopted that deleted mention of Zionism but did condemn the treatment of the Palestinians by Israel in the first instance and, in the second, that replaced references to monetary compensation for the practice of slavery with demands for debt forgiveness, greater access to markets, and poverty relief for countries in Africa and the less-developed world that were targets of the slave trade. That settlement was not reached, however, until after U.S. and Israeli government representatives withdrew from the conference in protest. Many other government delegates and nongovernmental organization participants also expressed concern that the emphasis given to the Zionism and reparations issues tended to undercut efforts to give attention to a broader range of problems associated with ongoing practices of racism, including the treatment of indigenous peoples.

Human Rights Abusers

The broadening application of criminal sanctions to major human rights abuses represented an important emerging trend in the international community. In addition to indictments and trials by the tribunals for former Yugoslavia and Rwanda established by the UN Security Council, a number of individual nations, such as Belgium and Spain, instituted criminal prosecutions under legislation that provided for the exercise of universal jurisdiction over torture and other major human rights violations by every nation in the world. The principles of criminal accountability and universal jurisdiction established by the tribunals for former Yugoslavia and Rwanda and by the case in the U.K. of former Chilean dictator Augusto Pinochet Ugarte resulted in the conviction by a Belgian court of four individuals accused of participation in the 1994 genocide of the Tutsi in Rwanda, the arrest and trial of former Yugoslav president Slobodan Milosevic by the International Criminal Tribunal for the Former Yugoslavia (ICTY), and the sentencing by the ICTY of Gen. Radislav Krstic, the most senior Bosnian Serb military official prosecuted thus far, to 46 years in prison for genocide and crimes against humanity associated with mass ethnic executions at Srebrenica. The extradition of Milosevic by Yugoslavia to the ICTY in The Netherlands and the initial hearings in his case marked the first time that a former head of state had been subjected to criminal trial for violation of international human rights standards. Milosevic was charged with having authorized and supervised the massacre and forced displacement and deportation of thousands of ethnic Albanians in Kosovo by Serbian forces acting under his control and direction as part of a campaign of terror and violence that included shelling and destruction of homes and villages and mass executions of unarmed civilians. The stakes in the Milosevic case were raised even further when he was charged with genocide during the 1992–95 war in Bosnia and Herzegovina. This was the first time that a head of state had been prosecuted for genocide violations. By the end of 2001, the former Yugoslavia and Rwanda tribunals had indicted 101 and 51 individuals, respectively.

Military action erupted in Macedonia in February when the frustrations of ethnic Albanians, who constituted over 22% of the population, bubbled over and both sides resorted to military means. An agreement brokered by NATO in August called for the ethnic Albanians to surrender their arms in return for a more substantial political role and greater rights to use their own language, especially in education. The Macedonian legislature began consideration of constitutional amendments guaranteeing minority rights.

An investigation of Israeli Prime Minister Ariel Sharon for massacres at Palestinian refugee camps in Lebanon, was instituted by Belgian courts under the very broad criminal prosecution statute adopted in that country. Ricardo Miguel Cavallo, a naval officer during the period of the “dirty war” in Argentina, was ordered extradited from Mexico to Spain to stand trial for kidnapping and torture violations. Mexico was believed to be the first country in Latin America to have applied the doctrine of universal jurisdiction. (See Law, Crime, and Law Enforcement: International Law.)

Efforts were also under way to establish special courts to try individuals suspected of massive human rights crimes in Cambodia, East Timor, and Sierra Leone and to constitute a permanent international tribunal, the International Criminal Court, that would have ongoing jurisdiction to apply criminal sanctions to a wide variety of international crimes wherever they might occur. Cambodia’s National Assembly, after months of negotiation, approved the creation of a special court with both international and domestic judges to prosecute top members of that country’s Khmer Rouge regime who supervised the extermination of an estimated 1.7 million people in the 1970s.

Economic and Social Rights

Increased recognition of economic and social rights as part of the human rights equation was observed throughout the year. Health needs associated with HIV and AIDS received attention as a result of a series of meetings in Africa following the XIII International AIDS Conference, held in South Africa in 2000. Several countries challenged pharmaceutical companies to make HIV medications more readily available in the less-developed world by permitting the manufacture of those medications in generic form. This would substantially reduce the cost of the treatments and make them more accessible to very-low-income populations, particularly in Africa, where the incidence of HIV/AIDS exceeded 25% of the population in many countries. Cipla Ltd., an Indian company that made generic drugs, announced just such a plan in February, and in April a lawsuit brought by 39 major pharmaceutical firms that had sought to block a law allowing South Africa to manufacture or import low-priced versions of anti-AIDS drugs was dropped.

Large-scale antiglobalization demonstrations took place in a number of cities, including Washington, D.C., Quebec City, and Genoa, Italy, targeting major international trade and banking institutions such as the World Trade Organization (WTO), the World Bank, and the International Monetary Fund. The demonstrators sought improved trade and credit policies for countries in the less-developed world and a greater voice by poor nations in determining international credit and development assistance policies. The demonstrators in Quebec City in April objected to consideration at the third Summit of the Americas of a proposed Free Trade Area of the Americas that would strengthen protections for foreign investments and patents and thereby make it more difficult for poor nations to secure loans and provide social services for their citizens. In July Italian police were accused of having used particularly brutal tactics against demonstrators at the Group of Eight economic summit meeting in Genoa. One protester was fatally shot; more than 200 were reported injured; and nearly 300 were arrested. Similar disruptions were threatened for the WTO meetings that began November 9 in Doha, Qatar, particularly in light of the terrorism concerns in that part of the world raised as a result of the international bombing campaign in Afghanistan, but massive security preparations kept protests to a minimum in Qatar.


The September 11 terrorist attacks in the U.S. and the American reaction to them generated a number of human rights concerns. The extensive aerial bombardment of Afghanistan raised fears about deaths and injury to civilians caused by “collateral damage,” possibly in violation of the humanitarian protections of the Geneva Conventions. Within the U.S. there were a number of incidents of harassment, hate crimes, and discriminatory treatment aimed at those of Middle Eastern or South Asian appearance. The concern with increased security in airports, government offices, postal facilities, and public buildings was also accompanied by questions of freedom of access, individual rights in cases of searches of persons or property, and racial and ethnic profiling. Large-scale detention of suspected terrorists and a presidential order authorizing the use of military tribunals to prosecute aliens, including those residing in the U.S., drew wide criticism from Congress and civil liberties groups. In November a proposed UN treaty designed to combat terrorism was blocked by the demand of the 57-member Organization of the Islamic Conference that anti-Israeli militants and other national liberation groups be exempted from the pact’s provisions.

Social Protection: Year In Review 2001
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