No abstract

No abstract

This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries.

The use of a gender-neutral annuity divisor introduces an intra-generational redistribution from short-lived towards long-lived individuals; this entails a transfer of wealth from males to females and from low socioeconomic groups to high socioeconomic groups. With some subpopulations consisting of females from low socioeconomic groups (or males from high groups), the net effect of the redistribution is unclear. The study aims to quantify the lifetime income redistribution of a generic NDC system using two types of divisor – the demographic and the economic – to compute the amount of an initial pension. With this in mind, the redistribution (actuarial fairness) among subpopulations is assessed through the ratio between the present value of expected pensions received and contributions paid. We find that all subgroups of women and men with high educational attainment benefit from the use of the unisex demographic divisor. This paper also shows that the value of the economic divisor depends markedly on population composition. When mortality differentials by gender and level of education are considered, economic divisors are mostly driven by the longevity effect corresponding to gender.

The Health Insurance Card Scheme (HICS), a national insurance scheme for cross-border migrants in Thailand, provides a vast range of benefit packages, including antiretroviral treatment (ART) for HIV/AIDS. This study aimed to assess and compare the reimbursement claimed by the HICS for ART beneficiaries per person against the actual ART unit cost at district, provincial, and regional hospitals. Data were retrospectively collected from two main datasets. The first dataset was used for the calculation for ART reimbursement between 2015 and 2017. There were 148 public hospitals included in the reimbursement analysis. The second dataset was used for calculating the actual ART unit cost. Eight public hospitals were selected for unit-cost calculation. Findings showed that the average ART reimbursement amount per person per year varied between US$ 191.9 and US$ 235.1 while the actual ART unit cost ranged from average US$ 135.8 to US$ 421.0. Though the overall difference demonstrated non-statistical significance by Student t-test, this difference at provincial hospitals exhibited statistical significance (p=0.03) by Mann-Whitney U test. The Ministry of Public Health should update the fee schedule for ART reimbursement to better reflect the providers’ actual unit cost and allow the ART reimbursement rate varying by facility types instead of applying the flat-rate system as per the status quo.