Gabriel Martinez

Seguro Social de Salud (Social Health Insurance)

The English version of this paper can be found at http://ssrn.com/abstract= 2358669.El gobierno de Mexico definio entre los anos noventa y los dos mil principios de reforma a los seguros de salud e intento implementarlos. Las principales iniciativas aprobadas definieron esquemas voluntarios, en un caso basado en aseguradoras privadas (que tienen muy baja penetracion), y en otro, en una nueva instancia publica que funciona como mecanismo de distribucion del gasto federal hacia los estados, el Seguro Popular (SP). En la actualidad el reto principal, como hace treinta anos, es la integracion de planes de atencion para cada familia, pues cada una de ellas enfrenta gran incertidumbre acerca de que institucion es responsable de financiar sus cuidados de salud y de proveer los servicios. En este contexto, existen multiples propuestas de reforma, la mayor parte de ellas guiadas practicamente por los mismos principios. Argumentamos que posiblemente el gobierno de Mexico no tiene incentivos para efectuar una reforma en los terminos que se han planteado y se esta convergiendo a un modelo de reembolso a los estados como proveedores para poblacion de bajos ingresos, con la mayor parte de la poblacion cubierta por la seguridad social y dejando a las familias el riesgo de enfrentar la incertidumbre en la provision del servicio. Postulamos pasos que creemos definen un proceso de evolucion factible para alterar ese curso y adoptar un camino que llegue a la adecuada integracion de los planes para la familia, sin obligar a ninguna integracion horizontal de instituciones financiadoras o proveedoras, al impulso de nuevas instituciones proveedoras de servicios. Las instituciones existentes deben transformarse en proveedores mas flexibles, y la participacion en un plan de aseguramiento debe ser obligatoria para todos los residentes.Between the 1990s and the two thousands, the government of Mexico defined principles of reform to health insurance and has sought to implement them. Major approved initiatives defined voluntary schemes, in one case private insurance (which has very low penetration), and in another a new public program, the Seguro Popular, that operates as a mechanism for distribution of federal spending to the states. Currently, the main challenge, as it was thirty years ago, is the integration of care plans for every family. Each citizen faces great uncertainty about which institution is responsible for financing his or her health care and providing services. In this context, there are multiple proposals for reform, most of them guided by the same principles. We argue that possibly the government of Mexico does not have incentives to carry out a reform in those terms; it is converging to a model of reimbursement to states as providers for low-income populations, with most of the population staying in social security facing risks in service provision. We put forward steps we believe define a feasible evolutionary process to alter that course, taking a road that focuses on the proper integration of health plans for the family. This process will allow consolidation of financing and service provision for each family, without mandating the horizontal integration of financing agencies or even of service provision agencies, or the growth of new service agencies to compete with the ones already existing. Existing institutions will be transformed into more flexible providers, and participation in an insurance plan will be mandated for all residents.

Programas de Pensiones, Empleo y Familia (Pensions, Employment and Family Programs)

The English version of this paper can be found at http://ssrn.com/abstract= 2358645.Los programas de pensiones, empleo y familia constituyen tres de las cuatro grandes categorias de la politica social (la cuarta siendo los de salud). En este articulo se analizan opciones para su diseno dentro de un marco de universalidad de la seguridad social en Mexico. Si bien estos programas tienen componentes de beneficios monetarios centrales, tambien requieren de estrategias solidas y especificas a cada uno de ellos en materia de regulacion de proveedores, marco fiscal e interaccion con otros programas e instituciones. Los programas de empleo requieren de un diseno sin costuras con el sistema educativo y con los programas de capacitacion de empresas, y se requiere instituir un seguro de desempleo. La categoria de programas de familia incluyen a los principales para combatir la pobreza extrema, los cuales deben ser incorporados de manera tal que sirvan de vehiculo para que los beneficiarios se integren al flujo principal de la sociedad. Tambien, los programas de familia son la clave para resolver los retos especiales de las mujeres trabajadoras, para lograr la integracion de los discapacitados al mercado de trabajo, para adoptar una politica amplia de desarrollo de ninos pequenos y para comenzar a atender el problema creciente de cuidados de largo plazo de personas con discapacidad. Finalmente, en la categoria de pensiones se requiere de una plataforma para articular aspectos fiscales, soluciones de servicio y la multiplicidad de programas para el envejecimiento y la invalidez que existen y que seguiran surgiendo en el pais.Pension, employment, family, and health insurance programs constitute the four major categories of social policy. This report discusses the options for the design of programs within the first three categories based on a framework that aims at providing universal social security protection throughout Mexico. Although the core benefits of these programs are monetary benefits, their provision requires application of solid strategies specific to each program for the regulation of suppliers, provision of a fiscal framework, and interaction with other programs and institutions. Employment programs require use of a seamless design within the educational system and business training programs, as well as the adoption of an unemployment insurance program. Family programs, including the main programs that combat extreme poverty, should be incorporated into a general framework to allow them to serve as vehicles for the integration of the beneficiaries into society. At the same time, implementation of family programs is key to solving the special challenges of female workers, integrating the disabled into the labor market, adopting a policy for the comprehensive development of young children, and addressing the growing problem of long-term disability care. Finally, realization of successful pension programs requires a platform upon which to articulate the fiscal aspects, service solutions, and multiplicity of the increasing number of programs that serve the elderly and disabled.

Comments on 'The End of Informality in Mexico? Fiscal Reform for Universal Social Insurance' by Arturo Anton, Fausto Hernandez and Santiago Levy

This is a review of the paper by Anton, Hernandez and Levy (2012), which is motivated by the analysis by Santiago Levy (2008) on the impact on the labor market of subsidized programs that deviate demand from funded social insurance programs. The paper deals with the evaluation of a fiscal reform and proposes an hypothesis on the determinants of the evolution of social policy. The first issue is amenable to empirical verification, while on the second, the arguments presented are not consistent with history or with a view based on the competition of ideas.

Workers of Heterogeneous Ability and Fiscal Structure

The existence of a large informal labor market — those citizens who do not pay taxes or make social security contributions, but receive social benefits — is a major issue for taxation and social protection policies. Why do some government policies seem to increase the cost to workers and firms for entering the formal economy? The proposed model to explain the behavior of the government assumes that workers have varied levels of ability, and combining these different skills to achieve optimum output while providing social benefits costs businesses significantly. Not being able to observe skill levels, the government faces the classical dilemma of social policy: generous social benefits may discourage workers from displaying the optimal level of effort, but it is not easy to distinguish the “deserving poor” from the lazy. Given the high costs of auditing, the model defines incentive constraints that motivate workers to reveal their true productivity type. The solution is not free of costs. Low-skilled workers are discouraged from working in those positions for which they are qualified. Highly skilled workers work efficiently because the government finds the cheapest way to induce work by the lowest-ability worker, and then offers a contract to the more highly skilled worker. A contract that pays more and requires a level of effort that is unattainable by the low-skilled worker. To preclude the low-skilled worker from accessing the high-wage contract, he is discouraged from delivering an optimal level of effort. Thus, low-skilled workers look lazy and receive social benefits that comprise a relatively large portion of their income. The proposed model incorporates endogenously the efficiency cost of taxation, which seems to be very high and a limiting factor for the expansion of social expenditures.

An Estimation of Labor Supply Elasticities for Mexico

The empirical values of the response of labor supply to changes in wages, taxes, fertility, family structure and social insurance are of central importance to deal with many policy issues. This article presents estimates of the parameters of a labor supply function are presented in this article. The specification of the labor supply function has been varied in three main forms to reach estimates. First, within the framework of the linear IV model, we can vary the set of exogenous regressors, the set of exogenous instruments, and the set of regressors made endogenous (that is, instrumented). Second, we introduce models that consider explicitly the censored nature of variables. Finally, we compare the results obtained from a cross-sectional dataset, and a sample that has longitudinal features. After choosing a baseline specification we found that the variations in estimates due to changes in statistical methods or do not seem to be very important. Thus, the wage-elasticity of hours worked is similar across IV specifications, models that correct for censoring and models that use longitudinal information. The baseline models imply near-zero wage-elasticities for both genders. For men, the impact of having children of all ages at home is large and positive: males with children work more. For women there is a negative impact of having children, and the small-children variable has a larger impact on hours worked. The variable for other family income has a positive effect on hours of both men and women.

Unemployment in Mexico: Policy Options, Unemployment Insurance and a Comparison with EPL Rules

This document aims to provide a set of recommendations for the adoption of an unemployment insurance program in Mexico. It describes the situation of unemployment in Mexico, of the labor contracts, of the main federal employment programs and of the effectiveness of the employment protection legislation. It summarizes the main economic debates on the unemployment problem, and the way in which programs in the Americas have evolved. Reforms have followed the main theoretical recommendations. We provide estimates of the probabilities of finding and exiting employment based on survey data, which are used to produce time series of unemployment and a database of individual work histories, in turn used to evaluate the programs. We simulate a UI program similar to the Chilean program, and compare it with EPL rules on compensation for separation similar to those existing in Mexican legislation. Finally, specific recommendations on the adoption of an unemployment insurance program are given.

Distortions in the Mexican Labor Market

The variation of real wages in the Mexican labor market has been very large over the last three decades, either measured in dollar terms or adjusted by national price indexes. The overall economic activity has also been subject to three episodes of Depression-sized business cycles. This paper uses aggregate data to measure distortions in the labor market, which can be part of an explanation. The main question is how much of the difference between the marginal product of labor and the marginal rate of substitution between consumption and work can be explained by the distortions we identify. A main conclusion is that the evolution of taxation explains a large part of the variation over time of the measured distortions. Very high tax rates during the early eighties generated high deviations between the marginal product of labor and the marginal rate of substitution, a gap that has decreased since then. A “wage puzzle” arises due to the difference between two measurements of the marginal product of labor: one based upon labor inputs and the other on market wages. The measurement based on real wages shows a huge fall at the beginning of the end of the centralized planning-total protectionism times of the early eighties. However, it seems that the move from generalized regulations on trade and industry and foreign exchange markets towards a freer economic regime was associated with very large changes in relative prices and an adjusted measurement of real wages dissolves the puzzle. Besides taxation, we consider also inflation as a source of the gap between marginal product of labor and the marginal rate of substitution. Inflation has been a very large tax, often reaching levels equivalent to one fifth of total tax collections or more.

Advances in Health Economics and Health Services Research

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