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covers replacement rates for shorter and longer sick spells (the 15
th
and 91
st
day of the sick spell) and for permanently reduced working
capacity (disability pension).
2
The material is then used to calculate
actual replacement rates for different labour groups and income levels
within these. Finally, consequences of the identified institutional shift
within the Swedish sickness insurance are analysed, both at the
individual and the societal level.
Findings
The results show that despite decreasing replacement rates within
the public insurance, sickness insurance as a whole (public and
occupational insurance taken together), still offers replacement rates
that, to a large degree, correspond to the income loss during illness.
However, there has been an institutional shift in the provision of
income protection. The earlier system of universal public provision
that was highly related to former income has developed into a system
where this hold true only for certain groups in the labour market; the
rest of the labour market is dependent on collectively negotiated
solutions. Accordingly, the traditional Swedish institutional model in
which an encompassing public system promotes equality of status has
been transformed over time, giving occupational insurance a larger
role to play in the system of income protection during illness.
Conclusions
The identified change in the institutional structure of the Swedish
sickness insurance with an increased importance of occupational
insurance, increase the complexity of the insurance system and
increase the difference in income protection between groups in
society.
In this way the system as a whole will, to a larger degree than before,
be segmented into different risk pools which are divided along
socioeconomic lines as occupational insurance offers specific
insurance programs for groups in society, creating more
homogeneous risk groups.
2
These specific lengths of sick spell are chosen as these days generally correspond to limits
within the insurance where the regulation changes.