ppt - trESS

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
Marbachstrasse 15 A, D-81369 Munich (Germany); T: +49 (0)89-760 57 91; M: +49 (0)179-593 85 96;
E: [email protected]
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
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. Provision of formal LTC in the EU Member States
Different solutions:
a) the LTC insurance model
Belgium / Flemish Community
(Japan, Korea)
Dr. Bernd Schulte, wiss. Referent/Consultant, München
b) the tax-financed model
c) the public-service model
the Nordic countries
d) the residual model
the United Kingdom
(England, Scotland)
Dr. Bernd Schulte, wiss. Referent/Consultant, München
3. The German case
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 public 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 benefits
and 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 coordination law
a) case-law of the European Court of Justice:
“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
b) 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
for your attention!
Dr. Bernd Schulte
Marbachstrasse 15 A
D-81369 Munich (Germany)
T: ++49 (0) 89-760 57 91
M: ++49 (0) 179-593 85 96
E: [email protected]

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