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Social Security System is 13 years old with eight key points pending solution

SANTO DOMINGO. The Social Security law constitutes the most important social conquest in the country over the last decade, but the stagnation of eight transcendental points limits its development.

“In spite of its deficiencies, nobody would want to return to a dark past when limited, restrictive and without social solidarity regimes were the order of the day,” said Arismendi Diaz Santana, an expert on the issue and a former manager of the CNSS.

So he is in agreement with others who drew up this document which today reaches 13 years of its publication, that the law requires modification.

The government, business, union and medical commissions have spent these years talking about these issues which are the strategy for the First Level of Attention (primary care), as the entrance to the national health network, the National Fund for Medical Attentions for Traffic Accidents (Fonomat Definitivo), the expansion of the coverage of the PBS, and the extension of coverage, including new procedures and an increase in the RD$3,000 peso yearly limit of medicines.

Also they need to work on the plan for the restructuring of the Dominican Social Security Institute (IDSS), the Children’s Shelters, the Family Health Insurance for the pensioners, and the Contribution-subsidized Regime, which is called upon to benefit 1,255,000 independent professionals and technicians, as well as self-employed workers, are among the key points and pending modification.

The limits of coverage of the PBS are reflected in the daughter that receives the diagnosis that her mother has cancer and needs to undergo chemotherapy treatment in order to prolong her life. Impotence and desperation overcome her because this requires medicines that are outside of the coverage, a situation that is repeated for hundreds of Dominicans each day.

The Directorate for Information and Defense of Social Security Affiliates (DIDA) delivered last year more than 1,500 letter of no-coverage for high cost medications to affiliates of the system who request them as a support of seeking help at the Ministry of Public Health or in other institutions.

This confirms that 13 years after Law 87-01, which created the Dominican Social Security System, went into effect, the universal, obligatory, solidarity, plural and complete character of the measure is still pending.

Diaz Santana adds to the list the substitution of the PDSS, the establishment of protocols of attention in order to standardize and rationalize the provision of services, the creation of a unified public network, joining the IDSS health centers and those of Public Health, the reform of the Ministry of Public Health in order to separate the functions governance, leadership and supervision of the delivery of health services in order to save out of pocket expenses for health.

These reforms are designed to guarantee the sustainability and the balance of the SDSS.

As of February of this year, there were 4,130,356 persons without regular health care service, among these, communities where even primary care attention is difficult to find.

The CNSS has registered 5,688,982 affiliates to the system out of a population of 9,819,338 for coverage of 58%. Of those, 2,908,347 belong to the payroll deduction regime of the Family Health Insurance program (SFS).

The former manager of the CNSS said that he felt the fact that hundreds of thousands of families that never had health insurance today enjoy this service was a great achievement. Now they can be tranquil about not having to pawn something or spend their savings is they have a health problem.

Nevertheless, others have to pay a complementary insurance policy in order to have a better access to the private health services that the system offers through the Health Risk Administrators (ARS, which are similar to HMOs)which handle the business of private medicine, a situation that Diaz Santana feels should also be modified.

Affiliates of the Subsidized Regime have guaranteed coverage and do not have medical co-payments or differences for consultations, specialized medical tests or for surgical procedures.

The limited provision of medications includes coverage of RD$1.0 million for high cost illnesses, such as cancer, which forces thousands of patients to go home with prescriptions instead of medicines.

The situation is worse for the pensioners that have to spend nearly all of the RD$5,000 the state provides for having dedicated more than20 years of labor on medicines.

“In spite of the deficiencies, nobody would want to return to the dark past when systems that were limited, restrictive and without social solidarity predominated,” said Diaz Santana.

The veto is questioned

The president of the Dominican Medical College (CMD), Pedro Sing, and the former superintendent of Labor Risks, Bernardo Defillo, critize the veto because this was annuls important decisions in the CNSS which benefit the system.


The implementation of the Dominican System of Social Security (SDSS) will be evaluated by the authorities of the sector within the framework of the “Social Security Week” that begins today and ends on the 15th of this month.

The activity will start with a Te Deum Mass at the San Judas Tadeo Church in Naco.

The principle activity is programmed for Thursday 15 May with the panel called “Situation and Perspectives of Social Security” which will be under the leadership of the Minister of Labor and the president of the CNSS, Maritza Hernandez, who will present an analysis of the system. The activity is set to start at 9:00 o’clock in the morning.

During the panel, the ministry will release the SDSS Strategic Plan 2014-2018, a document that lays out a better functioning of the system and its institutions. It also presents aligns the institutions in one direction and has them developing common objectives, according to the general manager of the CNSS, Rafael Perez Modesto.

The Executive Branch declared 9 May to be the “National Social Security Day” due to its importance as the pillar of protection of a the Dominicans and legal residents in the country.

For Wednesday, 14 May, at 10:00 in the morning, they will release the document titled “Complete Attention First Infancy in the Dominican Republic”, at the IDSS headquarters.

Pensions, another issue to be evaluated

With assets of RD$264.7 billion, the issue of pensions is so prickly as well as of great interest in the IDSS.

The Statistical Summary of the Social Security System up to 15 April 2014 of the Superintendent of Pensions showed 2.9 million affiliates, of whom only 1.4 million contribute to the plan.

From the start of the pension system in this country, more than 50% of the affiliates do not contribute, and this means that more than half of those that are supposedly protected by the social security system do not receive pensions when they retire or receive a minimum pension.

Up until now, 3,666 disability pensions and 4,095 survivors’ pensions have been paid.

“In the field of pensions, the reduction of the commissions paid to the Pension Fund Administrators (AFPs), the indexing of the pensions according to the Consumer Price Index, the increase in contributions to accelerate the growth of the pension fund and avoid miserable pensions at the moment of retirement by the workers, cannot be put off any longer,” indicates Arismendi Diaz Santana.

He suggests the design of different types of affiliation, collection and payment according to the work and economic characteristics of the small and micro-businesses, as well as theindependent professional and technical personnel.
Source: DiarioLibre

Category: DR News |

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Last updated March 23, 2017 at 1:16 AM
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