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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

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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

Marbachstrasse15 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. contingency/social riskProvision of formal LTC in the EU Member States

Different solutions:

the LTC insurance model

Germany

Luxembourg

Spain

Belgium / Flemish Community

(Japan, Korea)

Dr. Bernd Schulte, wiss. Referent/Consultant, München


the tax-financed model contingency/social risk

Austria

the public-service model

the Nordic countries

the residual model

the United Kingdom(England, Scotland)

Dr. Bernd Schulte, wiss. Referent/Consultant, München


  • 3. The German case contingency/social risk

  • 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


dual system consisting of a contingency/social riskpublic 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


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 benefitsand 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


4. EU and night care coordinationlaw

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


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


Thank you very much 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 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


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