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Biletta, Isabella, Jorge Cabrita, Franz Eiffe, Barbara Gerstenberger, Agnès Parent-Thirion, Oscar Vargas & Tina Weber (2021): Working conditions and sustainable work. An analysis using the job quality framework. (Eurofound flagship report), Dublin, 72 S. DOI:10.2806/938302

Abstract

"This flagship report summarises the key findings of Eurofound’s research on working conditions conducted over the programming period 2017–2020. It maps the progress achieved since 2000 in improving working conditions and examines whether all workers have benefited equally from positive change. It highlights which groups are the most at risk of experiencing poor working conditions and being left behind. Given the changes in the world of work, emerging challenges for good job quality are identified. The report also provides evidence for measures that could lead to the further improvement of work and the achievement of fair working conditions for all in the EU. The analysis shows that, overall, job quality in the EU is improving, if slowly. Not all workers are benefiting to the same extent, however. Furthermore, gender, age and contractual status have a significant bearing on a person’s working conditions. And while digitalisation helps to address some job quality issues, it also creates new challenges. The COVID-19 pandemic has exacerbated trends, reinforcing concerns and highlighting the importance of achieving job quality for all." (Author's abstract, IAB-Doku) ((en))

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Checchi, Daniele, Alessandra Fenizia & Claudio Lucifora (2021): Public Sector Jobs: Working in the Public Sector in Europe and the US. (IZA discussion paper 14514), Bonn, 38 S.

Abstract

"This paper reviews recent theoretical and empirical work on public employment management and presents novel stylized facts on public sector jobs. In the first part, we examine the evolution of managerial practices in the public sector and discuss the contractual arrangement of public sector workers and the labor market institutions that are prevalent in this setting. We argue that, for public sector employees, standard incentive schemes have a low power and are generally less effective than in the private sector. In the second part, we use two international surveys (6th European Working Conditions Survey, covering 28 European countries, and 2nd American Working Conditions Survey for the United States) to investigate selection into public sector employment, public-private pay differentials, and differences in working conditions in Europe and the US. While in Europe the public-private earning gap is positive for low-skilled workers and turns negative for skilled individuals, the gap is negative and relatively flat over the skill distribution in the US. We also document a positive public-private earnings differential in healthcare and education services in Europe, and a negative differential, though not statistically significant, in the US. We find that, in the US, two out of three public sector employees are exposed to some performance-related pay scheme, while in Europe is less than one in four. We do not find evidence that the public sector ensures a fairer work environment, as instances of harassment, discrimination, and obnoxious behavior are widespread." (Author's abstract, IAB-Doku) ((en))

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Leoni, Thomas (2021): Sick but at work: Graded sick leave in a comparative perspective. In: Social Policy and Administration, Jg. 55, H. 1, S. 65-81. DOI:10.1111/spol.12612

Abstract

"Measures to activate sick-listed workers and to combine work with sickness benefits are a growing but little-studied policy field. This article investigates graded sick leave benefits in Sweden, Finland and Germany. The analysis reveals some commonalities between countries, as well as substantial differences in terms of institutional background, benefit design and governance. The schemes range from models in which grading has become an integral component of the regular sickness certification process, to models in which the graded-work option is targeted at a much smaller category of workers and has a stronger therapeutic character. The variation in design and governance of the models is reflected in large differences in terms of their diffusion. All schemes face a common set of obstacles and challenges. They relate in particular to the distribution of stakeholders' roles and responsibilities, the involvement of employers and the assessment of residual work ability." (Author's abstract, IAB-Doku, Published by arrangement with John Wiley & Sons) ((en))

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Nikolova, Milena, Boris Nikolaev & Christopher Boudreaux (2021): Being Your Own Boss and Bossing Others. The Moderating Effect of Managing Others on Work Meaning and Autonomy for the Self-Employed and Employees. (IZA discussion paper 14909), Bonn, 37 S.

Abstract

"We examine the moderating role of being a supervisor for meaning and autonomy of self-employed and employed workers. We rely on regression analysis applied after entropy balancing based on a nationally representative dataset of over 80,000 individuals in 30 European countries for 2005, 2010, and 2015. We find that being a self-employed supervisor is correlated with more work meaningfulness and autonomy compared with being a salaried supervisor working for an employer. Wage supervisors and self-employed supervisors experience similar stress levels and have similar earnings, though self- employed supervisors work longer hours. Moreover, solo entrepreneurs experience slightly less work meaningfulness, but more autonomy compared with self-employed supervisors. This may be explained by the fact that solo entrepreneurs earn less but have less stress and shorter working hours than self- employed supervisors." (Author's abstract, IAB-Doku) ((en))

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Parteka, Aleksandra, Joanna Wolszczak-Derlacz & Dagmara Nikulin (2021): How digital technology affects working conditions in globally fragmented production chains: evidence from Europe. (Working paper series A / GUT Faculty of Management and Economics 66), Gdańsk, 68 S.

Abstract

"This paper uses a sample of over 9.5 million workers from 22 European countries to study the intertwined effects of digital technology and cross-border production links on workers' wellbeing. We compare the social effects of technological change exhibited by three types of innovation: computerisation (software), automation (robots) and artificial intelligence (AI). To fully quantify work-related wellbeing, we propose a new methodology that corrects the information on remuneration by reference to such non-monetary factors as the work environment (physical and social), career development prospects, or work intensity. We show that workers' wellbeing depends on the type of technological exposure. Employees in occupations with high software or robots content face worse working conditions than those exposed to AI. The impact of digitalisation on working conditions depends on participation in global production. To demonstrate this, we estimate a set of augmented models for determination of working conditions, interacting technological factors with Global Value Chain participation. GVC intensification is accompanied by deteriorating working conditions - but only in occupations exposed to robots or software, not in AI-intensive jobs. In other words, we find that AI technologies differ from previous waves of technological progress - also in their impact on workers' wellbeing within global production structures." (Author's abstract, IAB-Doku) ((en))

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Pega, Frank, Balint Nafradi, Natalie C. Momen, Yuka Ujita, Kai N. Streicher, Annette M. Prüss-Üstün, Alexis Descatha, Tim Driscoll, Frida M. Fischer, Lode Godderis, Hannah M. Kiiver, Jian Li, Linda L. Magnusson Hanson, Reiner Rugulies, Kathrine Sørensen & Tracey J. Woodruff (2021): Global, regional, and national burdens of ischemic heart disease and stroke attributable to exposure to long working hours for 194 countries, 2000-2016. A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. In: Environment International, Jg. 154. DOI:10.1016/j.envint.2021.106595

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Reuter, Marvin, Nico Dragano & Morten Wahrendorf (2021): Working while sick in context of regional unemployment: a Europe-wide cross-sectional study. In: Journal of Epidemiology and Community Health, Jg. 75, H. 6, S. 574-580. DOI:10.1136/jech-2020-214888

Abstract

"Background Research suggests that areas with high unemployment have lower rates of sickness absence, but the underlying mechanisms remain unclear. One assumption is that when unemployment is high people are more likely to work while being sick (discipline hypothesis). Against this background, we investigate the association between regional unemployment and sickness presenteeism. Second, we study interactions with factors of occupational disadvantage. Methods: We combined survey data of 20 974 employees collected 2015 in 232 regions from 35 European countries with data on regional unemployment rates obtained from Eurostat. Presenteeism was assessed by the fraction of days worked while ill among all days with illness (presenteeism propensity). To investigate if unemployment was related to presenteeism, we estimated multi-level models (individuals nested in regions) that were adjusted for socio-demographic and occupational covariates to account for compositional differences of the regions. Results: The mean presenteeism propensity was 34.8 (SD 40.4), indicating that workers chose presenteeism in 1 out of 3 days with sickness. We found that a change in unemployment by +10 percentage points was associated with a change in presenteeism by +5 percentage points (95% CI 1.2 to 8.6). This relationship was more pronounced among workers with low salary, low skill-level, and industrial and healthcare workers. Conclusion: Our results support the assumption that high unemployment elevates presenteeism, and that people in disadvantaged occupations are particularly affected. Policies managing presenteeism should consider the labour market context, particularly during the aftermath of the COVID-19 pandemic." (Author's abstract, IAB-Doku) ((en))

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Riekhoff, Aart-Jan, Oxana Krutova & Jouko Nätti (2021): The 24/7 economy and work during unsocial hours in Europe: Examining the influence of labor market dualization, regulation and collective bargaining. In: Economic and Industrial Democracy, Jg. 42, H. 4, S. 1080-1104. DOI:10.1177/0143831X19846330

Abstract

"This article examines the individual- and country-level factors that contribute to the risk of working unsocial hours in 30 European countries. Using the EU labor force survey data, the authors test for the influence of labor market dualization, product- and labor market regulation, and collective bargaining on the individual risk of working unsocial hours. The risks of working unsocial hours are strongly dualized in all countries, but the size of the risk gap between low-skilled outsiders and high-skilled insiders varies. In countries where collective bargaining plays a greater role in regulating work hours the gap between low- and high-skilled workers is smaller." (Author's abstract, IAB-Doku) ((en))

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Balz, Anne & Klaus Pforr (2020): Operationalization of Employment Protection Legislation and Implications for Substantive Results. Example of Perceived Job Insecurity and Temporary Employment Risk. (GESIS papers 2020,19), Mannheim, 39 S. DOI:10.21241/ssoar.70793

Abstract

"Almost all comparative research on the effects of employment protection legislation of regular employees (EPLR) is based on the index of the OECD. This study argues that this index is methodologically flawed and proposes a new EPLR index, following a theory-driven formative index construction approach. To demonstrate the implications using the OECD EPLR index versus the new index, we use two empirical applications: First, the effects of EPLR on perceived job insecurity, using multi-level models with data from the European Social Survey, the European Working Condition Survey, and the European Quality of Life Survey. Secondly the temporary employment risk for new hires, using multi-level models with data from the European Labour Force Survey. Whereas the results based on the OECD EPLR index significantly deviate from the hypotheses in the literature, the results using the new EPLR index is compliant with the hypotheses in the literature. This demonstrates higher criterion validity of the theory-driven new EPLR index and also calls for replications of previous research that is based on the index of the OECD." (Author's abstract, IAB-Doku) ((en))

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Russo, Concetta & Marco Terraneo (2020): Mental Well-being Among Workers: A Cross-national Analysis of Job Insecurity Impact on the Workforce. In: Social indicators research, Jg. 152, H. 1, S. 421-442. DOI:10.1007/s11205-020-02441-5

Abstract

"Drawing on 2011 and 2016 European Quality of Life Survey data from eight European countries, this paper considers the importance of subjective indicators of employment conditions in impacting mental well-being. Among employment conditions, job insecurity has been discussed as having a negative impact on mental well-being by enhancing the worker's sense of unpredictability. The idea of losing one's job brings with it the fear of an uncertain or unclear future and the sense of lack of agency—i.e. feeling powerless with respect to the risk of becoming unemployed. Thus, we investigate two dimensions of job insecurity, namely 'cognitive job insecurity' and 'labour market insecurity'. Our dependent variable is mental health well-being, measured using the 5-item World Health Organization Well-Being Index (WHO-5), which is a self-reported health scale validated by several studies and internationally adopted for measuring psychological well-being. We apply a fixed-effects model and use a set of individual control variables to obtain parameter estimates. Moreover, to control for country-level heterogeneity, two macro-level variables are considered: the type of welfare regime and employment protection. The novelty of this research lies in disentangling the concept of precariousness from the dichotomy of open-ended/non-open-ended contract and in including in the analysis subjective categories such as self-perceived job insecurity. The findings of our study suggest that self-perceived job insecurity is negatively related to mental well-being for both permanent and temporary workers, making this stressor an important feature in predicting the emergence of psychological distress (i.e. feelings of anxiety or depression) among the workforce." (Author's abstract, IAB-Doku, © Springer-Verlag) ((en))

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Wiß, Tobias, Lisa Schmidthuber & Valeria Bordone (2020): Quality of Working Conditions, Sector of Employment and Age at Retirement. In: Management revue, Jg. 31, H. 2, S. 145-166. DOI:10.5771/0935-9915-2020-2-145

Abstract

"Prolonging employment and postponing retirement are seen as promising solutions to make labour markets and pension systems sustainable in ageing Europe with low employment rates of older people and widespread early retirement. The aim of the paper is to identify to what extent quality of working conditions and sector of employment affect the actual age at retirement. Based on SHARELIFE data on 13 European countries, we investigate the association between age at retirement on the one hand and 12 quality of working conditions attributes and six economic sectors on the other using linear regression models. Our results show that freedom to decide how to do the work is significantly associated with a higher age at retirement and adequate salary with a lower age at retirement among both men and women, while working in a comfortable environment, without emotional demands, and where employees experienced fair treatment is positively related to age at retirement only for men. Furthermore, our analysis provides evidence that quality of working conditions attributes are more important for age at retirement in the service, manufacturing and industry sectors than in the finance, trade, and primary sectors. A stronger focus on improving quality of working conditions is likely to promote a higher age at retirement among both men and women." (Author's abstract, IAB-Doku) ((en))

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Addison, John T. & Paulino Teixeira (2019): Workplace employee representation and industrial relations performance. New evidence from the 2013 European company survey. In: Jahrbücher für Nationalökonomie und Statistik, Jg. 239, H. 1, S. 111-154. DOI:10.1515/jbnst-2017-0146

Abstract

"Using cross-country data from the European Company Survey, we investigate the relationship between workplace employee representation and management perceptions of the climate of industrial relations, sickness/absenteeism, employee motivation, and staff retention. For a considerably reduced subset of the data, a fifth indicator - strike activity - is also considered alongside the other behavioral outcomes. From one perspective, the expression of collective voice through works council-type entities may be construed as largely beneficial, especially when compared with their counterpart union agencies either operating alone or in a dominant position. However, if heightened distributional struggles explain these differential outcomes in workplace employee representation, it should not go unremarked that the influence of formal collective bargaining is seemingly positive." (Author's abstract, © De Gruyter) ((en))

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Aleksynska, Mariya, Janine Berg, David Foden, Hannah Johnston, Agnès Parent-Thirion & Julie Vanderleyden (2019): Working conditions in a global perspective. (Eurofound research report / European Foundation for the Improvement of Living and Working Conditions), Luxemburg, VII, 178 S. DOI:10.2806/870542

Abstract

"Job quality is a major focus of policymakers around the world. For workers, the enterprises that employ them and for societies, there are benefits associated with high-quality jobs, and costs associated with poor-quality jobs. This report - the result of a pioneering project by the International Labour Organization and Eurofound - provides a comparative analysis of job quality covering approximately 1.2 billion workers in Europe, Asia and the Americas. It analyses seven dimensions of job quality: the physical environment, work intensity, working time quality, the social environment, skills and development, prospects, and earnings, finding both important differences and similarities between countries. By analysing positive and negative aspects of job quality in different countries and societies, the report provides a way to look beyond national explanations, to see how some groups of workers are affected more than others and understand the particular issues for women workers around the world - in support of evidence-based policymaking to improve job quality." (Author's abstract, IAB-Doku) ((en))

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Goerke, Laszlo (2019): Absence from work, sick pay and positional consumption concerns. In: Labour, Jg. 33, H. 2, S. 187-211. DOI:10.1111/labr.12144

Abstract

"We analyse labour supply and absence from work choices, assuming that individual preferences exhibit relative consumption concerns. We show that contractual hours and the length of absence periods may vary equally with the strength of positional considerations. In this case, positional concerns do not affect their difference, i.e. overall or effective working time. Moreover, the nature and intensity of relative consumption effects influence the impact of sick pay and of true illness periods on contractual work hours and absence behaviour. Consequently, the profitability of employing individuals also varies with the strength of their positional concerns." (Author's abstract, Published by arrangement with John Wiley & Sons) ((en))

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Kubicek, Bettina, Matea Paškvan, Roman Prem, Julia Schöllbauer, Matthias Till, Jorge Cabrita, Agnès-Parent Thirion & Mathijn Wilkens (2019): Working conditions and workers' health. (Eurofound research report / European Foundation for the Improvement of Living and Working Conditions), Luxemburg: Europäische Kommissionm, Amt für Veröffentlichungen, V, 69 S. DOI:10.2806/909840

Abstract

"This report uses European Working Conditions Survey data to examine working conditions and their implications for worker's health. Ensuring the sustainability of work in the context of ageing populations implies a greater number of people in employment who can remain in the workforce for longer. The report examines the interplay between work demands - which carry an increased risk of exhaustion - and work resources - which support workers in greater engagement and well-being. The findings indicate that physical risks have not increased but remain important, while emotional demands have increased, underlining the growing importance of psychosocial risks at work. Changes over time suggest that although the risk of poor health is concentrated in certain occupations, those occupations traditionally considered to be protected are increasingly exposed to risks that are likely to affect workers' health and well-being." (Author's abstract, IAB-Doku) ((en))

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Nachreiner, Friedhelm, Anna Arlinghaus & Jana Greubel (2019): Variabilität der Arbeitszeit und Unfallrisiko. In: Zeitschrift für Arbeitswissenschaft, Jg. 73, H. 4, S. 369-379. DOI:10.1007/s41449-019-00172-z

Abstract

"In der letzten Zeit werden Forderungen nach mehr Flexibilität und größerer Anpassbarkeit der Arbeitszeiten, insbesondere an die betrieblichen Anforderungen aber auch an die Anforderungen der Beschäftigten, immer deutlicher und zwar deutlich weitergehend, als das derzeitige Arbeitszeitgesetz in der BRD zulässt. Konfligierend damit legen erste Studien einen Zusammenhang zwischen der Variabilität der Arbeitszeit und dem Unfallrisiko nahe. In diesem Zusammenhang wurde im Rahmen einer Analyse vorliegenden Datenmaterials einer europäischen Umfrage (European Working Conditions Survey 2010) mit Hilfe statistisch den vorzufindenen Verteilungen angemessener logistischer Regressionsansätze der Steigerung des Unfallrisikos und des Risikos von unfallbedingten Ausfalltagen nachgegangen. Die Variabilität der Arbeitszeitsysteme wurde dabei mit Hilfe eines faktorenanalytisch gewonnenen Indizes abgebildet, ebenso wie die Kontrollvariablen zur körperlichen und zur psychischen Belastung wie zur Autonomie bei der Gestaltung der Arbeitsbedingungen. Die Autonomie bei der Gestaltung der eigenen Arbeitszeit wurde durch eine eigene, separate Frage abgebildet.
Die Ergebnisse belegen eine signifikante und deutliche Steigerung des Unfallrisikos durch variable Arbeitszeiten, mit Odds-Ratios im Bereich um 1,25 und damit rund 25 %, und zwar unter Kontrolle potentiell konfundierender Bedingungen wie der berichteten Belastung, dem a priori Risiko der Tätigkeit, der Dauer der Arbeitszeit, Schichtarbeit, sowie weiterer Variablen. Autonomie in der Gestaltung der eigenen Arbeitszeiten senkt das Risiko leicht, allerdings nicht substantiell. Im Prinzip erweist sich damit die Variabilität der Arbeitszeit als bedeutsamer Risiko-Faktor, unabhängig davon, wer sie verursacht oder von wem sie ausgeht.
Grund für diese Risikosteigerung könnte eine Desynchronisierung (oder Anstöße dazu) mit biologischen oder sozialen Rhythmen sein. Aus arbeitswissenschaftlicher Sicht erscheint daher bei der Erhöhung der Flexibilität und damit der Variabilität der Arbeitszeiten erhebliche Vorsicht geboten. Dies gilt auch für Veränderungen der normativen Regelungen zur Gestaltung der Arbeitszeiten.
Praktische Relevanz Die Variabilität der Arbeitszeit, insbesondere bei flexiblen Arbeitszeiten, sollte trotz weitergehender Forderungen nach größerer Flexibilisierung auf ein erträgliches Maß begrenzt werden. So können variabilitätsbedingte Anstöße zur Desynchronisation von biologischen und sozialen Rhythmen und darüber ausgelöste Beeinträchtigungen, wie etwa ein erhöhtes Unfallrisiko, vermieden werden." (Autorenreferat, IAB-Doku)

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Paulus, Stefan (2019): Gefährdungsbeurteilungen von psychosozialen Risiken in der Arbeitswelt. Zum Stand der Forschung. In: Zeitschrift für Arbeitswissenschaft, Jg. 73, H. 2, S. 141-152. DOI:10.1007/s41449-018-0117-8

Abstract

"In der derzeitigen Diskussion um die Zukunft und Entwicklung der Arbeitswelt gilt es als eine der größten Herausforderungen die psychische Gesundheit von Erwerbstätigen zu erhalten. Aktuelle Erkenntnisinteressen liegen darin begründet, zu prognostizieren, wie betriebliche Arbeitsbelastungen mit lebenslagenspezifischen Belastungen und subjektiven Bewältigungsstrategien korrespondieren, um daraus abzuleiten, wie gesundheitsgefährdende Konstellationen entstehen und wie dadurch eine Bewertung von Gefährdungskonstellationen möglich ist. In diesem Artikel wird dementsprechend der aktuelle Forschungsstand zu Gefährdungsbeurteilungen von psychosozialen Risiken aufgearbeitet. Hierbei wird deutlich, dass die Analyse von dynamischen Wechselwirkungen und Abhängigkeitskonstellationen von arbeitsorganisatorischen, individuellen, biologischen und soziokulturellen Bedingungen aus arbeitswissenschaftlicher Perspektive derzeit ein zentrales Forschungsdesiderat darstellt. Im Artikel wird die Frage geklärt, wie Gefährdungsbeurteilungen im Kontext der Konstellationen von Arbeitsbelastungen und gesundheitsgefährdenden Arbeitsbeanspruchungen auf der Grundlage multifaktorieller Wirkungszusammenhänge dynamisch und generisch erstellt werden können.<br> Praktische Relevanz: Durch die Entwicklung von dynamischen und generischen Prozessmodellen, welche multivariate Ursache-Wirkungszusammenhänge von Gefährdungen aufzeigen, können Regelwerke zur Gefährdungsbeurteilung abgeleitet werden, die es ermöglichen Gefährdungskonstellationen zu erkennen und Erkrankungswahrscheinlichkeiten zu prognostizieren." (Autorenreferat)

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Piasna, Agniezska, Brendan Burchell & Kirsten Sehnbruch (2019): Job quality in European employment policy. One step forward, two steps back? In: Transfer, Jg. 25, H. 2, S. 165-180. DOI:10.1177/1024258919832213

Abstract

"Dieser Artikel analysiert die Entwicklung und Verwendung des Konzepts der 'Arbeitsplatzqualität' in der Beschäftigungspolitik der Europäischen Union (EU). Unter Verwendung einer Reihe sich ergänzender Theorien der Public Policy untersucht das Autorenteam, wie sowohl politische als auch begriffliche Faktoren dazu beigetragen haben, dass es bisher keine signifikanten Fortschritte bei der Definition der Arbeitsplatzqualität in den politischen Zielen und Leitlinien der EU gegeben hat. Eine eindeutige begriffliche Festlegung dessen, was Arbeitsplatzqualität ist (und was sie nicht ist), aus wessen Perspektive sie betrachtet werden sollte und welche Veränderungen als Verbesserung interpretiert werden könnten, sind wichtige Voraussetzungen für eine effektive Integration der Arbeitsplatzqualität in die Beschäftigungsstrategie der EU und in die Ausarbeitung praxistauglicher sozialer Indikatoren. Eine beständige politische Auseinandersetzung zwischen den unterschiedlichen Stakeholdern auf EU-Ebene und die Aufgabe, die oft widersprüchlichen Ansichten der Sozialpartner miteinander zu versöhnen, haben den erfolgreichen Abschluss dieses ersten Schrittes verhindert. Stattdessen wurde versucht, die Arbeitsplatzqualität in den Prozess der Politikformulierung einzubeziehen, ohne dabei gleichzeitig das Gesamtnarrativ anzupassen, das weiterhin Flexibilität und Deregulierung einen höheren Stellenwert gibt. Das Ergebnis waren recht erratische und inkonsequente Bemühungen der Umsetzung politischer Maßnahmen und Aktionen zur Verbesserung der Arbeitsplatzqualität." (Autorenreferat, IAB-Doku)

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Addison, John T. & Paulino Teixeira (2018): The shortfall in formal employee participation at the European workplace. (CESifo working paper 7399), München, 41 S.

Abstract

"Cross-country data are used to establish perceived shortfalls in employee involvement based on the responses of employee representatives in EU establishments with formal workplace employee representation. The desire for greater involvement is smaller where workplace representation is via works councils than union bodies, a finding that also obtains across country clusters. However, the favorable influence of the works council institution, if not information provision, does not carry over to situations in which management is adjudged uncooperative and untrustworthy. Whether the views of these respondents are representative of the workforce and hypothetically of a workforce currently without representation is also considered." (Author's abstract, IAB-Doku) ((en))

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Amelung, Volker, Sherry Glied & Angelina Topan (2018): Health Care and the Labor Market: Learning from the German Experience. In: Journal of health politics, policy and law, Jg. 28, H. 4, S. 693-714. DOI:10.1215/03616878-28-4-693

Abstract

"Many observers have begun to question the U.S. reliance on an employment-based private health insurance system. In thinking about the future of this system, it is instructive to examine the German experience. The German health insurance system is almost entirely organized and financed around the labor market. In recent years, the German labor market has changed in several ways. Among other changes, more German women now work, the proportion of retirees in the population has increased, the share of manufacturing in employment has declined, and the economy has become more open. These labor market changes have made it more difficult to organize health insurance around employment in Germany. Recent changes in the German health insurance system have, to some extent, decoupled health insurance from employment. This decoupling is likely to continue as the labor market changes further. We explore the implications of this experience for the United States." (Author's abstract, IAB-Doku) ((en))