Ten years after the introduction of publically-funded universal health insurance, the Mexican health system finds itself at a critical juncture. Unquestionably, some measures of health and health system performance have improved: those previously uninsured now use health services more often, whilst numbers reporting impoverishing health expenditure having fallen from 3.3% to 0.8%. Other indicators, however, remain worrying. Rates of survival after heart attack or stroke are markedly worse than in other OECD countries. Prevention is a particular concern: with 32% of the adult population obese, Mexico ranks as the second most obese nation in the OECD and almost 1 in 6 adults are diabetic. Other key metrics imply deep-rooted inefficiencies in the system: administrative costs, at 8.9% of total health spending, are the highest in the OECD and have not reduced over the past decade. Likewise, out-of-pocket spending has stuck at nearly 50% of total health spending - the highest in the OECD - and implies that individuals feel the need to visit private clinic despite having health insurance. In short, Mexico’s massive public investment in its health system has failed to translate into better health and health system performance to the extent wished and a programme of continued, extensive reform is needed. This report sets out the OECD’s recommendations on the steps Mexico should take to achieve this.
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This edition of Migration Policy Debates scrutinises the factors that facilitate human trafficking, as well as the smuggling routes to OECD countries. It synthesises available evidence and reviews existing policy tools for tackling such crime.
More equal access to employment services and better co-ordination between the government and social partners could help disadvantaged laid-off workers get back into employment, according to a new OECD report.
Job displacement (involuntary job loss due to firm closure or downsizing) affects many workers over their lifetime. Displaced workers may face long periods of unemployment and, even when they find new jobs, tend to be paid less and have fewer benefits than in their prior jobs. Helping them get back into good jobs quickly should be a key goal of labour market policy. This report is the fourth in a series of reports looking at how this challenge is being tackled in a number of OECD countries. It shows that Sweden has been relatively successful in minimising the adverse effects of displaced workers, manily due to the longstanding tradition of collaboration between the social partners to share responsibility for restructuring by creating special arrangements and practices that provide help to workers much faster that in other OECD countries. Despite this positive institutional framework, there is room to improve policies targeted to displaced workers as remarkable inequalities still exist in both the Swedish labour market and in the way workers are treated.
The OECD’s most recent ‘Investing in Youth’ country reviews identify three broad streams of solutions to provide disadvantaged youth with the skills they need and thus reduce the share of youth outside of education or employment.
Colombia’s record in extending health insurance and health services to its population is impressive. In 1990, around 1 in 6 of the population had health insurance. Now, nearly 97% do, with greatest expansion occurring amongst poorer households. Likewise, in 1993 out-of-pocket spending made up 52% of total national expenditure on health. By 2006, this had fallen to less than 15%. Although Colombia has high rates of income inequality (with a Gini coefficient of 53.5 in 2012, compared to the OECD average of 32.2), access to health care services is much more equal. In urban populations, for example, 1.8% of children aged less than two years of age are recorded as having received no routine vaccinations, compared to 1.0% of rural children. Colombia nevertheless faces important challenges to maintain and improve the performance of its health system. This report looks at Colombia’s health care system in detail and offers recommendations on what Colombia can do to ensure accessibility, quality, efficiency and sustainability.
Tackling mental ill-health of the working-age population is a key issue for labour market and social policies in OECD countries. OECD governments increasingly recognise that policy has a major role to play in keeping people with mental ill-health in employment or bringing those outside of the labour market back to it, and in preventing mental illness. This report on Australia is the ninth and last in a series of reports looking at how the broader education, health, social and labour market policy challenges identified in Sick on the Job? Myths and Realities about Mental Health and Work (OECD, 2012) are being tackled in a number of OECD countries. It concludes that policy thinking in Australia shows well-advanced awareness both of the costs of mental illness for society as a whole and of the health benefits of employment. However, challenges remain in: making employment issues a concern of the health care services; helping young people succees in their future working lives; making the workplace a safe, supportive psychosocial environment; and better designing and targeting employment services for jobseekers with mental ill-health.
Being able to directly measure all the above aspects would be extremely useful but economists and analysts usually face severe data limitations (e.g. small sample size, data comparability, measurement error etc.) and are, in many instances, forced to use second-best proxies to describe skills and build indicators.
Youth who have disconnected from the education system and are not working or planning to return to training are at high risk of marginalisation. Review of programs and other initiatives to re-connect.
High-skilled jobs as an important driver of overall employment growth in the EU and the impact of high-skill job creation goes beyond the highly educated workforce. If European regions are very unequal in terms of high-skill intensity, they are converging slowly.