Social security and subsidiarity

In this paper we deal with the design of three social insurance schemes (old age social security, health insurance an child benefits) in a federal setting such as the Belgian one. We argue that these three programs need to be reformed to be more efficient and more equitable. In none of these cases regional decentralization would be the most important element of the reform. Yet, in all three cases, some inefficiencies can be removed by a careful design of the relative competencies of the regions and the federal state. An open discussion over these issues is urgently needed to avoid a stalemate in which the necessary reforms are blocked.