Hacia una nueva seguridad social en el siglo XXI: sin solidaridad en el financiamiento no habra universalidad / Towards new social security systems in the 21st century: universal coverage is impossible without cohesion in financing

In the countries of Latin America and the Caribbean, social security systems have traditionally been almost exclusively the responsibility of the public sector. These systems have had major shortcomings, such as low coverage rates, unbalanced budgets, inadequate funding, and poor management of resources. In order to solve these problems and face the increased demands associated with demographic and epidemiological transitions, in the 1990s a number of countries began to reform their social security systems. These reforms have been characterized by three fundamental features: a) a search for a closer link between contributions and benefits, in order to better balance income and expenses, b) changes in the public-private composition of the systems that allow a greater private role in the financing and delivery of services, and c) an emphasis on market mechanisms as a way to promote efficiency in applying resources, and leaving to the State a role as a regulator and as a guarantor of basic benefits to groups that, because of their socioeconomic conditions, cannot make certain minimum contributions. This article looks at some of the problems raised by the reforms carried out so far, and the lessons that can be learned from them. The piece also analyzes the relationship between universal coverage and societal unity. In addition, the article suggests that the main challenge with social security reforms is that of moving toward universal systems that sinificantly expand coverage. In order to achieve that, it is necessary to strengthen the mechanisms of cohesion in financing and to improve efficiency by introducing market instruments that do not negatively affect the unitarian character of the financing. The piece concludes that it is necessary to increase coverage; improve management; be concerned about the design of the public-private makeup; identify the responsibilities of the private sector and of the government in financing, provision, and regulation of social security systems; and introduce and strengthen unity mechanisms in financing (AU)

Wealth management strategies [abstract]

Many of us expect to live longer, but find it hard to make the first step to find our retirement. One reason many people put off buliding their wealth temple is that they often lack direction or guidance. Simply put, we need a plan to act on. The four financial pillars which support our wealth temple are short-term savings, wealth accumulation, asset protection and income protection. No matter where we are in our life cycle and what our financial goals are at that juncture, we can best achieve them once we determine our personal and family goals and make plans to attain those goals with help from a financial adviser, and the appropriate investment tool or strategy that the financial adviser believes is best suited for us and our family. The younger we are, the more we should focus on buliding an investment strategy to save and accumulate assets for the future. A budget is needed in every life cycle, but more so in early adulthood. During the career development life cycle, or in our twenties and thirties, earnings are low and need to be channelled to make costly expenditures for a first home and to start a new family. At age 40 to 50 years, we enter the mid-life cycle. In this period, our earnings rise significantly, however, we must provide for children's college needs and life after work. Simultaneously, with larger salaries comes hugh spending on a second home or perhaps a vacation home, a boat, and the desire to start and build a business. While asset growth is still a key objective, we must shift gears to focus on asset preservation. In the golden years of the sixties to seventies, we stand at the door of retirement. Our financial cycle now advances to preservation and liquidation. A retiree's dream is to have a life similar to that enjoyed while working, with a vacation or two, and adequately tending to the necessary medical costs when they arise. Today, as biotechnology reforms healthcare, we will live longer and spend more than 20 years in retirement. If we plan to live longer, we will have an active lifestyle, so we need to establish a regular investment programme for the long-term. So, how can an investment programme support a vibrant lifestyle? Investing is a question of risk versus return. Since 1926, equities have been the best performing asset class. There appears no reason why investments in stocks should not continue to outperform real estate, fixed income, annuities, money markets or any other investment strategy. (AU)

Hospitals in Latin America and the Caribbean

Health service provided by public or private institutions at the primary and hospital referral levels should be coordinated so that the available resources are distributed equitably to meet the needs and aspirations of the population. The challenge is to improve the quality of hospital care and the existing pattern of public and private services in Latin America and the Caribbean.(AU)

Issues in Resource Management: A model hospital

This paper seeks to present the issues in resource management facing Health Administrators in the English Speaking Caribbean against a service delivery backdrop. Using a model 150 bed acute care general hospital, the authors would try to demonstrate the benefits and value of accountability management change and paradigm shifts in the management of hospitals. The model hospital is characterised by high quality, efficiency and effective delivery of service, continuous improvement and value added to the community. All aspects of the organization will be considered. * Financial Resources - Adequacy and Control; * Human Resources - Staffing, Development and Planning; * Technology - Appropriateness use and Relevance; * Information - Decision support Services, Decision Making; * Quality - Service standards, Continuous improvement; * Organizational Design and Development; * Management Systems Development; * Policies and Procedures; * Physical Plant and Equipment; * Aesthetics; * Public and Community Relations (AU)

Five year health sector plan

Presents a plan aimed at guiding the development of the infrastructure, manpower, management and the delivery and provision of health services on the islands of Grenada, Carriacou and Petit Martinique. Objectives include decreasing mortality and morbidity and strengthening the initiatives of health for all by the year 2000. Details on the current health services; priority programmes for health development; health infrastucture and facilities; and details of legislation pertaining to health are given. Also outlines health policy statements of the Government. The general objectives of the plan are outlined and the strategies that should be used to achieve these goals are included