ppt - trESS
Bernd Schulte
Project: training and reporting on European Social Security (trESS)
Polish trESS seminar: “Current problems of the co-ordination of social security systems”
Warsaw, 14 June 2013, Social Insurance Institution (ZUS) – Main Headquarters
Long-term care – German experience and the experiences of other countries
Dr. Bernd Schulte, Consultant, formerly Senior Research Fellow at the Max Planck Institute for Foreign and
International Social Law
Marbachstrasse 15 A, D-81369 Munich (Germany); T: +49 (0)89-760 57 91; M: +49 (0)179-593 85 96;
E: dr.bernd.schulte@t-online.de
1. Dependency/long-term care (LTC) – a new social contingency/social risk
OECD: “a range of services required by persons with a reduced degree of functional capacity, physical or cognitive, and who are consequently dependent for an extended period of time on help with basic activities of daily living.”
(distinction of ‘care’ and ‘cure’) provisions by tradition: informal care provided by – mostly female – family members and other informal carers today: growing need for formal long-term care due to demographic development, social change, increase in mobility etc. There is an increase in the need of professional and paid care, in particular with regard to age-related illnesses and disabilities
(e. g. dementia – Alzheimer –)
Dr. Bernd Schulte, wiss. Referent/Consultant, München 2
2. Provision of formal LTC in the EU Member States
Different solutions: a) the LTC insurance model
Germany
Luxembourg
Spain
Belgium / Flemish Community
(Japan, Korea)
Dr. Bernd Schulte, wiss. Referent/Consultant, München 3
b) the tax-financed model
Austria c) the public-service model the Nordic countries d) the residual model the United Kingdom
(England, Scotland)
Dr. Bernd Schulte, wiss. Referent/Consultant, München 4
3. The German case
Social Care Insurance Law (Pflegeversicherungsgesetz)
Code of Social Law – Book XI –
Priority to informal, i. e. in practice mostly family care social insurance schemes designed to cover the costs entailed if insured persons become reliant on care, that is to say, if a permanent need were to arise to resort, in large measure, to assistance from another person in the performance of their daily routine: bodily hygiene, nutrition, moving around, housework, etc.
clear distinction between ‘care’ and ‘cure’ care being excluded from health insurance
Dr. Bernd Schulte, wiss. Referent/Consultant, München 5
dual system consisting of a public LTC scheme which follows the pay-as-you-go principle, and a private LTC scheme which is a funded and (partially) risk-related and premium-financed scheme contrary to health insurance LTC insurance benefits only cover needs of a certain relevant quantity and quality as benefits do not aim at covering the total amount of the cost of care but are intended to provide only a supplement to the help provided by the family and other informal carers or to ease the burden of institutional care
Dr. Bernd Schulte, wiss. Referent/Consultant, München 6
benefits are for home care, nursing home care as well as day and night care
(= benefits in kind) persons in need of care are entitled to choose between those in-kind benefits and cash benefits informal care has been strengthened by specific benefits for carers , e. g. contributions paid on behalf of the care-person to statutory accident at work and pension insurances by the LTC care insurance funds.
Dr. Bernd Schulte, wiss. Referent/Consultant, München 7
4. EU coordination law
a) case-law of the European Court of Justice:
“Molenaar”
“Jauch”
“Chamier-Glisczinski”
“Gaumein-Cerri / Barth”
“Commission ./. Germany”
“da Silva Martins”
“Commission ./. Germany” care benefits must be regarded as sickness benefits for Regulation 883/04
Dr. Bernd Schulte, wiss. Referent/Consultant, München 8
b) Article 34 of Regulation 883/04 is aimed at preventing the overlapping of care benefits (for instance in the case of frontier workers who may receive benefits in cash from the Member State of employment and benefits in kind from the
Member State of residence).
For better coordination of care benefits see trESS Thematic Report (“Think Tank”) on this issue: Jorens, Y./Igl, G./Fillon, J.-C./Strban, G.
, Legal impact assessment for the revision of Regulation 883/2004 with regard to the coordination of long-term care benefits, Analytical study, Gent 2012
Dr. Bernd Schulte, wiss. Referent/Consultant, München 9
Thank you very much for your attention!
************
Dr. Bernd Schulte
Consultant
Marbachstrasse 15 A
D-81369 Munich (Germany)
T: ++49 (0) 89-760 57 91
M: ++49 (0) 179-593 85 96
E: dr.bernd.schulte@t-online.de
