Ministry of Labour and Social Affairs proposes reform of health insurance system

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The Czech social welfare and health insurance systems are expected to undergo major changes. The government has been finalising a draft of a major fiscal reform aimed at reducing the growing public finance deficit, including large cuts in the social sphere. The proposed measures, including shifting a greater part of the cost on the employers, however, are not without controversy.

In the last four years, the time Czechs spend on sickness leave has been constantly growing. The problem is not the deteriorating health condition of the Czech population but rather the benevolent social welfare system, a lack of control, and insufficient motivation on the part of employees as well as employers.

The proposed health insurance reform should help eliminate wide-spread abuse of sickness benefits. At the moment, the lower the salary an employee receives the more convenient it is for him to stay at home. Statistics show that the highest sickness rate is among employees with below average wages, higher among married people than single people and more common among blue-collar than white-collar workers. On the other hand, for high-income groups it is less convenient to stay at home, as sickness benefits never exceed 12,500 crowns a month, whereas the average monthly wage is over 15,000 crowns.

However, it is not only the employees but also employers who are taking advantage of the ailing health insurance system. Employers use sickness benefits as a way of solving their problems with sudden falls in demand, seasonal work or temporary lack of money by asking an employee to stay on a sickness leave instead of dismissing him. This can only work due to the benevolence of general practitioners, which has also been often criticised.

Recent proposals presented by the Ministries of Finance and Labour and Social Affairs envisage two major changes in the payment of sickness benefits. One of the proposed measures would eliminate the payment of sickness benefits for the first three days of illness and for weekends.

The other change would mean shifting part of the burden onto the employer. The president of the Union of Health Insurance Companies, Vladimir Kothera, says it is not uncommon in the EU that employers pay sickness benefits to their employees for a certain period of time. Some economists even consider the involvement of employers as the most important assumption for the effective functioning of the system.

However, the main opposition Civic Democrats warn that it by itself, the introduction of payments by the employer would in fact mean a higher tax burden for the corporate sphere, if it is not accompanied by a reduction of payments to the health insurance system. They agree though that the employee should bear a cost of the illness for a few days, then the responsibility should be shifted to the employer and finally it is the state that would be responsible.

The Labour and Social Affairs ministry would also like to introduce tighter supervision, although deputy minister Jiri Hofman admits that it can never be 100 % efficient as it is always people that are doing the job. He proposes that health insurance companies play a bigger role in the matter and push doctors to be more responsible when sending people on sickness leave.

Author: Marta Hudoušková
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