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Insured but without benefits: Non-take-up in Swedish occupational sickness insurance
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Swedish sickness insurance has been undergoing a transformation away from an encompassing public welfare system towards a greater dependency on collectively negotiated occupational plans. With the increased importance of occupational insurance, the ability to secure the take-up of such benefits is increasing in importance. This study uses longitudinal, individual administrative data to investigate the take-up of occupational benefits within the public sector in Sweden, particularly during disability pension spells. It is argued that the non-take-up of benefits is a key aspect of the growing stratification in income protection in the Swedish society. Detailed administrative data allow the identification of both an eligible population and eligible non-claimants in Swedish occupational sickness insurance, meaning that common problems in the field of non-take-up, such as misreporting, recall and measurement errors in survey data, are avoided. Analysing Swedish occupational sickness insurance offers new insights into the literature on non-take-up, where focus traditionally has been on means-tested benefits, primarily in Anglo-Saxon countries and Germany. The non-take-up rate is found to be close to 17 percent of every spell of disability pension between 2007 and 2014. Low-income earners, young persons, men and individuals diagnosed with mental and behavioural disorders or injuries, poisoning and certain other consequences of external causes, have a higher non-take-up of occupational benefits, causing a new basis for the stratification of income protection. The non-take-up of occupational benefits has consequences for the extent to which and for whom we can expect occupational insurance to complement public insurance. Future research should not assume that occupational systems work as well in practice as they do in theory.

Keywords [en]
non-take-up, occupational welfare, sickness insurance, disability pension, Sweden
National Category
Political Science (excluding Public Administration Studies and Globalisation Studies)
Research subject
Political Science
Identifiers
URN: urn:nbn:se:uu:diva-397566OAI: oai:DiVA.org:uu-397566DiVA, id: diva2:1372055
Available from: 2019-11-21 Created: 2019-11-21 Last updated: 2019-11-22
In thesis
1. Changing Swedish sickness insurance: Policies, institutions and outcomes
Open this publication in new window or tab >>Changing Swedish sickness insurance: Policies, institutions and outcomes
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis is to contribute to welfare state theorising by analysing changing risk protection in Swedish sickness insurance and demonstrate how the understanding of such, and its implications, can be enhanced by strategic methodological choices. When analysing formal policy change in the compulsory sickness insurance system, it is concluded that the Swedish system fulfils almost every aspect of a so called social democratic welfare state, and no institutional shift can be discerned over time. When instead studying the interaction between compulsory and occupational benefits, and when investigating differences between diverse groups on the labour market and changes over time, it is demonstrated that there has been an institutional shift in the Swedish system. The balance in regulation between state and collective agreements has moved substantially in the direction of the latter. In terms of the basis for entitlements, a shift from citizenship/residence and labour force participation towards occupational categories has occurred. Considering the replacement levels of the public system, there has also been a shift towards inadequate benefits due to a low ceiling. Such findings emphasise the importance of including occupational systems, and of not treating the population as a homogenous mass, when studying risk protection. When focusing the analysis on how a system functions in practice rather than in theory as is usually done, and thus focusing on non-take-up of occupational benefits, it is shown that a large group of individuals are missing out on the benefit to which they have a right due to their occupational category. Such a fact has implications in terms of risk protection. The most obvious implication of high levels of non-take-up of occupational insurance is reduced individual income security for the affected groups. As the non-take-up is unevenly distributed among groups, such results also indicate that the traditional stratification in the system is strengthened but also that new groups of individuals are worse off than others, thus causing a new basis for stratification within the system.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 65
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 175
Keywords
Sickness insurance, disability pension, Sweden, occupational welfare, policy change, stratification, social policy analysis, non-take-up
National Category
Political Science (excluding Public Administration Studies and Globalisation Studies)
Research subject
Political Science
Identifiers
urn:nbn:se:uu:diva-397628 (URN)978-91-513-0823-4 (ISBN)
Public defence
2020-01-10, Brusewitzsalen, Östra Ågatan 19, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2019-12-18 Created: 2019-11-22 Last updated: 2020-01-13

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Grees, Nadja

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