In the US, the most predictable way to decide what is social security is to look at the Social Security Act. This includes Medicare!

Social security, a term long used by the ILO, is defined (ILO, 2000, p. 29) as ‘‘the protection which society provides for its members, through a series of public measures9 [FOOTNOTE 9 BEGINS] 9 A key difference between ‘‘social security’’ and ‘‘social protection’’ is that the former is provided through public measures. The term ‘‘social security’’ was first officially used in the title of U.S. legislation – the Social Security Act of 1935 – even though this Act initiated programs that focused only on the risks of old age, death and disability (ILO, 1989, p. 3). [FOOTNOTE 9 ENDS]: to offset the absence or substantial reduction of income from work resulting from various contingencies (notably sickness, maternity, employment injury, unemployment, invalidity, old age and death of the breadwinner); to provide people with health care; and to provide benefits for families with children.’’

This definition of social security corresponds to the ILO Social Security Standard (Minimum Standards) Convention, 1952 (no. 102). The contingencies identified (except unemployment) affect individuals rather than communities. Collective risks such as drought, bad harvests, natural disasters and war, also affect people’s income security, especially in developing countries. In most cases, existing social security systems do not specifically addresses these risks but cover them only through general ‘‘social assistance.’’ The ILO definition of social security includes social insurance (i.e., contributory schemes), social assistance (i.e., tax-financed benefits provided only to those with low income through means-test or income test); and universal benefits, i.e., tax-financed benefits provided without being income- or means-tested (ILO, 2000, p. 29).10 [FOOTNOTE 10 BEGINS] 10 See ILO (1989) for details on the distinction between social insurance and social assistance. [FOOTNOTE 10 ENDS] Social insurance provides insurance for wage earners. The principle elements of social insurance are as follows: (1) participation is compulsory, with few exceptions; (2) it is financed by contributions which are normally shared between employers and workers, with, perhaps, state participation in the form of a supplementary contribution or other subsidy from general revenues; (3) contributions are accumulated in special funds out of which benefits are paid; (4) surplus funds are invested to earn further income; (5) a person’s right to benefit is secured by his contribution record without any test of need or mean; (6) and contribution and benefit rates are usually related to what the person is or has been earning (ILO, 1989, p. 4).

Social assistance is the assistance provided by the government to the general public who are in need, particularly the elderly, the sick, invalids, survivors and the unemployed. Its main characteristics are: (1) a person does not have to join the program (by paying contribution) prior to receiving benefits; benefits are paid as a legal right in prescribed categories of need; (2) the entire cost of the program is met by the government; (3) eligibility is determined by a person’s other income and resources. The benefit grant is designed to bring the person’s total income up to a community-determined minimum, taking into account other factors such as family size and unavoidable fixed obligations such as rent; grants are not related to the applicant’s previous earnings or customary standard of living; and (4) social assistance is more or less the same as social welfare or social work. It is problem-oriented and provides a certain amount of scope for discretion in determining awards, within the framework of the rights established under the law (ILO, 1989, p. 5).

Social assistance, according to ILO, consists of poverty alleviation measures or anti-poverty programs.11 [FOOTNOTE 11 BEGINS] 11 As such, the ILO definition of social security includes anti-poverty programs. [FOOTNOTE 11 ENDS] The ILO admits that this is a much broader definition than is used by other organizations, governments and scholars.12 [FOOTNOTE 12 BEGINS] 12 In the United States, the term ‘‘social security’’ refers only to retirement, survivor and disability benefits paid by the federal government. [FOOTNOTE 12 ENDS] In many other countries a sharp distinction is drawn between social security and poverty alleviation measures, notably social assistance (ILO, 2000, p. 29). Social assistance is considered a ‘‘safety net’’ when social insurance fails (ILO, 1989, p. 6).

The ILO also expressed the view that the definition of social safety nets should not include social insurance systems since social insurance is financed from employers and workers. It also urges that social safety nets play a selective and residual role in social policy, essentially filling in gaps. Too much emphasis on social assistance and safety nets naturally erodes the role of social insurance as a major pillar of social protection (Wickramsekara, 1999, p. 3).13 [FOOTNOTE 13 BEGINS] 13 Other routes to social security include direct provision from the government, wholly or largely from general revenue, of standard benefits to each resident in a specified category. These benefits may include a pension to every elderly, invalid, orphaned or widowed resident. Some countries, including Thailand, operate a national health service providing medical care for all without a contribution or means test. The cost may be met wholly or mainly from public funds, although there may be partial charges for dental, ophthalmic or specialist services, family benefits, provident funds and provision made by employers. [FOOTNOTE 13 ENDS]