The possibilities for Introduction of Economic Incentives in Slovenia

1. The possibilities for Introduction of Economic Incentives in Slovenia Insurance for Injuries at Work and Occupational Diseases Brdo at Kranj, November 2008 MA Rosvita Svenšek

2. International Labour Organization (ILO) • (Constitution of the Organization in 1944 – Los Angeles): • measures for safe and healthy work must be provided by the employer; • safe and healthy work is one of the basic human rights and employees’ rights. • European Foundation for the Improvement of Living and Working Condition • neglecting safety and health at work measures has consequences for the employee, employer and the entire economy; • the main responsibility for this area lies in the hands of the employers; • the situation in this area reflects the conditions in the state, the activity itself, and with the employer.

3. The Position and Views of the EU regarding safety and health at work: • investing in safety and health at work means investing in greater productivity, better overallfeelings of employees and thus the quality of life; • the system of safety and health at work must encourage increased concern for the health of workers and thus reduce the number and consequences of injuries at work and professional diseases; • the state of health absenteeism and frequency and consequences of injuries at work and professional diseases reflect the conditions of individual employees.

4. Why are changes in Slovenia necessary? • The first reason is humanity– for European conditions neglecting safety and health at work is unacceptable, irresponsible and in contradiction with human rights; • The second reason is of an economic nature – the transfer of financing the consequences of inadequate safety and health at work from public funds to employers in compliance with European practice; • The third reason:the demand for respect of European standards regarding requisite or acceptable levels of safety and health at work

5. Financing of safety and health at work in Slovenia now • part of the responsibility and liability is covered by employees themselves, and part by obligatory health and disability or pension insurance. • None of these insurances manages separately incomes and the costs of insurance, nor is the special management of these foreseen. • The costs of injuries at work and professional diseases are not transparent, and they do not encourage an increased concern and responsibility for efforts to reduce the number and consequences of injuries at work and professional diseases.

6. In Europe, for arranging financing of safety and health at work we are familiar with: • state organized and financed forms of social • security; • mutual insurance based on the principles of social • insurance. • Slovenia has a substantial share of social security organized in the form of social insurance; therefore the arrangement in which the same way the insurance for injuries at work and professional diseases is organized, is closer to us. The examples of such arrangements are Germany, Austria, Swiss, France etc.

7. The characteristics of such insurances are as follows: • they are based on the principles of reciprocity and non profitability, • they are mandatory, • there primary focus is prevention, • they combine all the efforts and operators for holistic treatment of the safety and health at work area, • they are financed by contributions from employers, while the contributions are differentiated, • they assure a high level of safety to workers.

8. The incentive to introduce insurance for injuries at work and professional diseases in Slovenia • The proposal regarding this is included in the material of the National Programme of Safety and Health at Work • is an obligatory (public) and non-profitable and mutual insurance based on the principles of Bismarck’s model of social insurance • with a status of a legal person with own means and management bodies; • it would be financed by contributions of employers, for which an adequate amount of contributions for Pension and Disability Insurance Institute of the Republic of Slovenia (PDII) and Health Insurance Institute of Slovenia (HIIS) would be reduced.

9. Insurance for injuries at work and professional diseases: • Would take over coverage of the costs of safety and health at work from PDII, HIIS, and partly from employers (health prevention and consultation activity); • There should appear the reconstruction of the financial liabilities of the employers regarding these insurances; • Gradual change to differentiated contribution rates of employers

10. The magnitude of differentiated contribution rates will depend upon: • the level of risk by activities, or upon risks by professions (or working positions); • the costs caused by employers due to injuries at work or professional diseases, or due to the remedies or consequences of them; • employers with lower or below average costs would be entitled to bonuses. Theoretically, a system of maluses could be introduced.

11. Economic incentives Through such an approach, the contributions would mean a direct economic incentive to employers to more consistently implement the measures for safety and health at work, and reduce the costs of injuries and professional diseases at work.

12. Insurance for injuries at work and professional diseases would take over coverage for the following: • technical, safety and medical counselling for employers on measures for preventing injuries at work and diseases related to work, and also laic and educational activities in this area; • detecting and assessing reasons and causes of injuries at work and diseases related to work; • treatment of the injured at work and sick persons due to diseases related to work; • medical, professional and social rehabilitation of persons injured at work, and persons sick due to diseases related to work, including rehabilitation instruments;

13. Insurance for injuries at work and professional diseases would take over coverage for the following (2): • wages compensation for period of temporary absence from work for medical treatment and rehabilitation (after certain period, which would be covered by the employer); the costs of retraining a person insured who is no longer able to perform his former work; • claim for permanently reduced working and profitable capability; • disability pension, attendance and care allowance in cases of permanent working inability or permanently reduced working capability • pension or claims of relatives in cases of the death of insured persons due to injuries at work or disease related to work

14. Insurance for injuries at work and professional diseases (3): • Should be performed by an existing public institution in the area of social insurance – probably HIIS; • The introduction of such insurance is only possible through the adoption of a special act that has to regulate the entire area of insurance, insured persons, their rights and obligations, and all other conditions for its functioning.

15. Working draft law was written more than 5 years ago It was not realized due to social and political reasons The introduction of insurance would mean redistribution of obligations to pay contribution rates, namely: • firstly between employers and employees, • and then between employers themselves For such changes there is neither willingness nor will

16. Unwillingness to change is also a reason for provisions of already adopted laws not being established: The introduction of differentiated rates is being discussed in the Health Protection Act and also in the Pension and Disability Insurance Act. HIIS and in PDII should introduce differentiated rates for employers in relation to the amount of costs for an employee due to injuries at work and professional diseases compared to the average in Slovenia or for the activity.

17. A suggestion to implement these definitions • was postponed by the Economic and Social Council and also by the Government • The implementation of these provisions was postponed until (?) • Almost certainly such a system will be introduced in Slovenia sooner or later.

18. The project of HIIS on health strengthening in collectives (1) • In its Strategic Development Programme, the HIIS is planning a new approachby whichthe prevention, improvement of health and early rehabilitation should prevail. • We are discussing here a conscious directive from “pathogenesis to salutogenesis,” to the encouragement of the health determinants and changes of the circumstances in collectives. • In so doing, one should bear in mind not only safety and health at work, but also the activities for improving health in collectives (in kindergartens , schools, companies, interest groups).

19. The project of HIIS on health strengthening in collectives(2) • At first, there will be multiple “pilots”; the cooperation of collectives will be voluntary. • Specific programmes of prevention, improving health, and rehabilitation (specific and individual programmes) will be prepared . • The results of the changes will be measured and monitored on an active and comparative group for a longer period of time . • Later on, particular novelties should be included in the regular programme of obligatory insurance.

20. The project of HIIS on health strengthening in collectives(3) In the project there should be cooperation and concerted action by employers, members of collectives, the medical service, the HIIS, ministries etc. with the goal of achieving the ? conditions and health. The financial investments and incentives for employers and members of the collectives are also foreseen. Among them there is also the possibility reducing employers’ obligations according to their results (improving health, reducing Health insurance costs, absenteeism etc)

21. The project of HIIS on health strengthening in collectives (4) • In this way HIIS introduces a novelty known elsewhere already for 15 years or even more. It will try to summarise the examples of good practise from around the world. • These measures and activities might contribute to the stronger motivation of employers for better health, greater security and health at work and for the realization of the goals stated in the National programme for Safety and Health at Work which are not adequately realized.