CMNT_TITLE

Repetition

The Committee notes the first reports on the application of the Convention and of the European Code of Social Security and would like to receive additional information on the following points.

Part II (Medical care). Persons protected. According to the Government, health insurance in Romania is mandatory and operates as a universal, equitable and non-discriminatory system. The report indicates however that 1,775,717 persons could not provide proof of health insurance coverage and did not benefit from the types of medical care guaranteed by Article 10(1) of the Convention. In view of the high number of persons who escape mandatory coverage, the Committee would like the Government to explain the reasons leading to this situation, the categories of persons concerned, and the measures taken to extend full medical coverage to the whole of the population.

Reduction of medical care. Article 10(1) of the Convention in conjunction with Article 69. According to section 210(1)(e) of Act No. 95/2006 on Health Reform, when insured persons cannot make proof of the payment of contributions their medical care benefits are reduced to a minimum package limited to emergency aid, care in potentially epidemic diseases and in case of pregnancy, child birth and family planning. The Committee recalls that Article 69 of the Convention does not mention the lack of proof of payment of contributions as a permitted ground for the suspension of benefits. Noting that health insurance contributions in Romania are paid to the National Health Insurance Fund (CNAS) by employees (5.5 per cent) and their employers (5.2 per cent), the Committee would like the Government to clarify who is responsible for transferring these payments to the CNAS and how insured employees obtain proof of the payment of the insurance contributions on their behalf by their employers.

Part III (Sickness benefit). Article 18. According to sections 13 and 14 of the Emergency Ordinance No. 158/2005 on leave and social health insurance benefits, sickness benefit is granted for an initial period of 90 days (approximately 13 weeks) and may be extended for a full duration of 26 weeks (183 days) subject to the approval by a social security medical expert. The Committee asks the Government to explain the procedure regulating such extension of sickness benefit.

Part VII (Family benefits). Article 44 in conjunction with Article 66. Statistical information regarding the total value of benefits granted. According to the report, the total number of children of all persons protected reported under Part VII amounted to 3,892,407, while the records of the CNAS reported under Part II contained 4,220,018 children. The Committee further notes that the report calculates the total value of family benefits on the basis of the national gross monthly minimum wage, which would be lower than the reference wage of a person deemed typical of unskilled labour determined under Article 66 of the Convention. In view of these incompatibilities, the Committee invites the Government to review in its next report the statistical data and the calculation made under Article 44 of the Convention.

Part VIII (Maternity benefit). Article 49. Cost sharing. Sections 210 and 213 of Act No. 95/2006 on Health Reform provide for cost sharing of medical care offered under the basic package of services in accordance with the framework agreements. With respect to medical care in case of pregnancy and child birth and their consequences, women are not required to participate in the cost of medical care when they are covered by health insurance and when the medical services provided are those reimbursed by the CNAS. The Committee would like to know whether all types of medical services mentioned in Article 49 are covered by the framework agreements and are fully reimbursed by the CNAS. Please also explain the structure and parties to such framework agreements. Furthermore, according to sections 213 and 223 of Act No. 95/2006, the monitoring and progress of pregnancy and post-natal care are provided regardless of the insurance status of women; pregnant women and those who have recently given birth who have no income, or income below the minimum wage, are exempt from paying insurance contributions. The Committee would be grateful if the Government would confirm these statements and clarify the circumstances in which uninsured women could be required to participate in the cost of medical care related to prenatal, childbirth and post-natal care.

Part XI (Standards to be complied with by periodical payments). Article 65. Replacement rate of the sickness, old age and maternity benefits. The report on the Convention indicates under Part III that the monthly earnings of the person deemed typical of skilled labour in 2010 were 1,724 Romanian New Leu (RON), while under Part V the monthly salary of a skilled manual labourer employed in the major group of economic activities attained only RON1,531, which was the amount of the national monthly average wage. In contrast, the report on the application of the European Code of Social Security determined the reference wage under Part V at the level of RON1,931 as the wage of a person whose earnings were equal to 125 per cent of the average earnings of all persons protected, i.e. RON1,531. However, according to the National Institute of Statistics, the national monthly average wage in 2010 was RON1,910 and not RON1,531. In view of these incompatibilities, the Committee asks the Government to clarify how the skilled manual male employee is selected, what is his reference wage, and what national monthly average wage should be used in the formula for the calculation of old-age pension. Please make the calculations requested by the report form on the basis of the updated statistics.

Review of the rates of long-term benefits. Noting that old-age pensions and the minimum pension value appear to be reviewed annually through a legislative process in line with the inflation rate and the real growth of earnings, the Committee would like the Government to indicate in its next report the relevant legal provisions and to provide statistical information requested in Title VI of Article 65 for the period since 2010.

Article 70. Right of Appeal. The Government is invited to indicate whether the complaint and appeal procedures mentioned in the report on the European Code of Social Security relate to all ratified Parts of the Convention and to explain the rules for lodging claims before the competent public bodies at all levels