Those ignored by social security
Pedro Castellanos believes it is not fair for the people that they continue postponing the start of the Subsidized Contributive Regime
While Tamara, five years old, runs around the halls of the Dr.Robert Reid Cabral Children's Hospital, Odennis Romano, her mother, tells a Diario Libre reporter about the odyssey she goes through to take care of her two young daughters in public hospitals and without insurance.
With the little girl, the pediatricians indicated a sonogram of her abdomen because of a possible hernia in the upper part of her navel, her appointment is set for within a month, and the doctor needs to see it the next day.
"It costs RD$650 to do it outside (in a private clinic), and it's like I told you, I'm not working and it's hard for me, because the father is also not working. Really I'd like to have insurance for the girls, because when I least expect it, they get sick, and normally I don't have money to cover it," noted the young 24-year-old.
Elderly without insurance
Within the 3,701,032 persons that do not receive the protection of the Family Health Insurance (SFS), there are also 54,575 pensioners and retirees of the State Fund of Pensions and Retirement, who by means of the decree 342 - 09, that created the Special Transitional Regime (RPT), in order to offer them health services.
This is a sector of the population which before the enactment of the Social Security System made their contributions corresponding to the old System of Distribution. Of 85,010 pensioners and retirees, as of January of this year, they have only affiliated 30,435 to the special regime, 35.8% of the target population.
The option proposed by the head of the Superintendency of Health and Labor Risks (Sisalril), Pedro Castellanos, in order to complete the universal coverage which is proposed by the Social Security Law, is to incorporate the rest of the persons, to the National Health Insurance (Senasa).
"They could perfectly well incorporate these persons with the payment of a quota that was equal to those costs that have been established by the public system, which would be pretty low, and with the option of being able to expand those services, if they wish, to the private level through purchasing a complimentary additional plan," argued the official.
Informal sector
As of October 2014, the country showed 4,910,524 persons among the economically active population, of which 1,876,459 belong to the formal sector and 2,341,117 to the informal sector, according to the statistics from the Dominican Central Bank.
The alternative which some who belong to the informal sector have adopted, is to enter Mutual Association of Solidarity Services (AMUSSOL-CASC).
"This entity came about in order to provide service to workers of the informal sector, especially in the transportation sector which is not receiving Social Security. At the end of 2014 we had 52,277 affiliates, including within them domestic workers, hairdressers and mechanics," reported the president Gabriel del Rio, who underlined that this entity functions only for those that have a job. "Those that did not have work and are interested in insurance, should look some other place in order to receive the service," he explained.
Unemployed
Carlos Rodriguez (not his real name) was let go while his wife was pregnant and unemployed. At three months he knew that he would not have the protection of the medical insurance, so that receiving his child in a clinic was "unthinkable." Two months after losing his job, the young 26-year-old was desperately looking for some place to work. He was without any savings, and his greatest worry was the medical insurance.
"I didn't want to take my wife to a hospital because of the deficiencies and unhealthy conditions that exist. I asked that my insurance company if it was possible to continue paying, taking on my part and the part paid by the company, but it was impossible. I felt trapped. Finally I got a job, and my wife could have a baby in a clinic," said the citizen who, as of last year, formed part of the 381,869 persons unemployed in the country.
No pension
The Old Age, Disability and Survivors Insurance should also favor the formal workers and their dependents and the employers, the independent workers and their rural and urban employers, through the Subsidized Contributive Regimen (payroll deduction), and the unemployed, disabled and indigent, through the Subsidized Regime, but many do not receive this protection. Don Francisco Duran, 60, for example.
"Life out in the country is sad, there is no money circulating, nor work, nothing. My children give me what they can, and with this my woman and I eat, and if we have to last the month with 300 (pesos), that is what we do," relates in his elderly resident of La Culata, Constanza.
In the meantime, the disabled have filed 7784 requests for pensions as of April of this year, of which the Superintendency of Pensions (SIPEN) granted 4482. The remaining persons are still without a pension.
The indigent and childcare centers
The indigent that are out on the streets, in spite of the support that they would receive from the system, also form part of those that are ignored, as well as the 255,543 children of up to four years of age, who should receive the benefits of childcare centers. As of this date, only 7907 have access, according to the Administrator of the Safe Health Childcare centers.
The solution is debated
The subsidized Contributive Regime, which should answer to this population segment, has still not gone into effect.
The Sisalril representative, confessed to Diario Libre that within his plans is to search together with the other representatives of the System, for a formula that will allow these persons to begin affiliation with the SDSS this year.
"Because it is not fair to the people that the start of the Subsidize Contributive Regime continues to be postponed, and it is a responsibility of the agencies of the system to find a solution," emphasized Castellanos.
While Tamara, five years old, runs around the halls of the Dr.Robert Reid Cabral Children's Hospital, Odennis Romano, her mother, tells a Diario Libre reporter about the odyssey she goes through to take care of her two young daughters in public hospitals and without insurance.
With the little girl, the pediatricians indicated a sonogram of her abdomen because of a possible hernia in the upper part of her navel, her appointment is set for within a month, and the doctor needs to see it the next day.
"It costs RD$650 to do it outside (in a private clinic), and it's like I told you, I'm not working and it's hard for me, because the father is also not working. Really I'd like to have insurance for the girls, because when I least expect it, they get sick, and normally I don't have money to cover it," noted the young 24-year-old.
Elderly without insurance
Within the 3,701,032 persons that do not receive the protection of the Family Health Insurance (SFS), there are also 54,575 pensioners and retirees of the State Fund of Pensions and Retirement, who by means of the decree 342 - 09, that created the Special Transitional Regime (RPT), in order to offer them health services.
This is a sector of the population which before the enactment of the Social Security System made their contributions corresponding to the old System of Distribution. Of 85,010 pensioners and retirees, as of January of this year, they have only affiliated 30,435 to the special regime, 35.8% of the target population.
The option proposed by the head of the Superintendency of Health and Labor Risks (Sisalril), Pedro Castellanos, in order to complete the universal coverage which is proposed by the Social Security Law, is to incorporate the rest of the persons, to the National Health Insurance (Senasa).
"They could perfectly well incorporate these persons with the payment of a quota that was equal to those costs that have been established by the public system, which would be pretty low, and with the option of being able to expand those services, if they wish, to the private level through purchasing a complimentary additional plan," argued the official.
Informal sector
As of October 2014, the country showed 4,910,524 persons among the economically active population, of which 1,876,459 belong to the formal sector and 2,341,117 to the informal sector, according to the statistics from the Dominican Central Bank.
The alternative which some who belong to the informal sector have adopted, is to enter Mutual Association of Solidarity Services (AMUSSOL-CASC).
"This entity came about in order to provide service to workers of the informal sector, especially in the transportation sector which is not receiving Social Security. At the end of 2014 we had 52,277 affiliates, including within them domestic workers, hairdressers and mechanics," reported the president Gabriel del Rio, who underlined that this entity functions only for those that have a job. "Those that did not have work and are interested in insurance, should look some other place in order to receive the service," he explained.
Unemployed
Carlos Rodriguez (not his real name) was let go while his wife was pregnant and unemployed. At three months he knew that he would not have the protection of the medical insurance, so that receiving his child in a clinic was "unthinkable." Two months after losing his job, the young 26-year-old was desperately looking for some place to work. He was without any savings, and his greatest worry was the medical insurance.
"I didn't want to take my wife to a hospital because of the deficiencies and unhealthy conditions that exist. I asked that my insurance company if it was possible to continue paying, taking on my part and the part paid by the company, but it was impossible. I felt trapped. Finally I got a job, and my wife could have a baby in a clinic," said the citizen who, as of last year, formed part of the 381,869 persons unemployed in the country.
No pension
The Old Age, Disability and Survivors Insurance should also favor the formal workers and their dependents and the employers, the independent workers and their rural and urban employers, through the Subsidized Contributive Regimen (payroll deduction), and the unemployed, disabled and indigent, through the Subsidized Regime, but many do not receive this protection. Don Francisco Duran, 60, for example.
"Life out in the country is sad, there is no money circulating, nor work, nothing. My children give me what they can, and with this my woman and I eat, and if we have to last the month with 300 (pesos), that is what we do," relates in his elderly resident of La Culata, Constanza.
In the meantime, the disabled have filed 7784 requests for pensions as of April of this year, of which the Superintendency of Pensions (SIPEN) granted 4482. The remaining persons are still without a pension.
The indigent and childcare centers
The indigent that are out on the streets, in spite of the support that they would receive from the system, also form part of those that are ignored, as well as the 255,543 children of up to four years of age, who should receive the benefits of childcare centers. As of this date, only 7907 have access, according to the Administrator of the Safe Health Childcare centers.
The solution is debated
The subsidized Contributive Regime, which should answer to this population segment, has still not gone into effect.
The Sisalril representative, confessed to Diario Libre that within his plans is to search together with the other representatives of the System, for a formula that will allow these persons to begin affiliation with the SDSS this year.
"Because it is not fair to the people that the start of the Subsidize Contributive Regime continues to be postponed, and it is a responsibility of the agencies of the system to find a solution," emphasized Castellanos.
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