Today, the matter of significant national importance “How to cope when you are elderly – the establishment of long-term care insurance?” was deliberated at the plenary sitting of the Riigikogu, with a focus on the problems of and solutions for the coping of the elderly.
In her report, the Chairman of the Social Affairs Committee Helmen Kütt gave an overview of the discussions on that topic that had been held in the Committee so far. She pointed out that the discussion had started from the idea of the establishment of long-term care insurance that had been submitted to the People’s Assembly of the New Old Age and then to the Riigikogu, and from an overview of the work of the burden care task force, and thereafter the committee had decided to propose a motion to discuss the issue as a matter of significant national importance in the plenary assembly.
Kai Saks, representative of the collective proposal “The Establishment of Long-Term Care Insurance”, Doctor, Associate Professor of Geriatrics, noted in her report that, in the funding of the care sector, Estonia ranked among the lowest among both European Union and OECD countries, and care was largely the responsibility of people with caring responsibilities. In Saks’s opinion, the state should contribute more to the care sector. She said that, at present, the nursing care service was much used. It is the most affordable for people but it is actually a very expensive service.
When presenting the idea of long-term care insurance, Saks said that in the event of long-term care insurance a person who needs assistance receives necessary care services or compensation in connection with costs arising from caring under the conditions and to the extent agreed upon, without an additional application and on uniform bases. Saks suggested considering the example of Germany as a model, where long-term care insurance must also be entered into when entering into health insurance. She explained that in Germany the benefit could be withdrawn as money in the event of a care need, but also as services, and in that case services were available in a larger amount.
Rait Kuuse, Deputy Secretary General on Social Policy of the Ministry of Social Affairs, said that in 2016 there had been 32 500 people with care needs in Estonia, and with the ageing of the population the number of 65-year-olds or older people with care needs may grow by more than 10 000 people by 2023. Kuuse said that at present 0.6 per cent was spent on long-term care costs, while 2–2.5 could be a realistic target, and 4 per cent of GDP would be the level of Nordic countries.
Kuuse gave an overview of the work of the burden care task force, within the framework of which a study by the World Bank had been completed. In the study, a long-term care insurance based on a contribution similar to the social tax is not recommended to Estonia. At the same time Kuuse noted that there had been different approaches to the concept of long-term care insurance. He said that, as regarded funding, there was an option to raise labour taxes which would be a model of insurance, or to use a solidary solution where working people pay insurance premiums in order that services were provided to those who need care. In Kuuse’s words, there is also an option to contribute from the state budget, directing attention in particular to local government services and offering of such services.
When speaking of what was already being done to improve the situation, Kuuse said that several pilot projects were underway, for example the care coordination pilot project. It is also necessary to tackle the funding issues of local level, so that there were not so many different solutions for care burden. Additional rest opportunities have been offered to people with a caring burden, and soon a procurement will be announced to find organisations of volunteers.
Maarika Kurrikoff, Head of Social Welfare Service of Tartu City Government, gave an overview of the services and supports for elderly people in the city of Tartu. She said that up to 15 per cent of the elderly people had a care need in Tartu. “Spending on the general care home services is relatively large,” Kurrikoff stated. “And this is constantly growing because prices are rising,” she added. Kurrikoff suggested to consider the integration of various services, for example the home service and the home nursing service, all over Estonia, in order that everyone could enjoy a homely atmosphere for as long as possible.
Kurrikoff made various recommendations to improve the situation. Her proposals included for example the establishment of a base funding system for caring for family members, the splitting of the obligation to provide maintenance to a family member, arising from the Family Law Act, equally between the state and the local government, and an allowance depending on the level of care need. She said that minimum standards for the services and recommendational guidelines for every service could also be in place.
During the debate after the discussion of the coping of elderly people, Viktor Vassiljev (Centre Party), Monika Haukanõmm (Free Party), Tiina Kangro (Pro Patria and Res Publica Union), Helmen Kütt (Social Democratic Party), Maris Lauri (Reform Party), Marika Tuus-Laul (Centre Party), Mart Helme (Estonian Conservative People’s Party) and Peeter Ernits (Centre Party) took the floor.
One Bill passed the first reading in the Riigikogu:
The Bill on Amendments to the Local Government Organisation Act and Amendments to Other Associated Acts (574 SE), initiated by the Constitutional Committee, will provide for additional measures to more effectively prevent corruption risks and to avoid conflicts of interest mainly in local authorities. The Bill will also specify the regulations that have raised questions in the application of the Local Government Organisation Act.
Under the Bill, the state or local government authorities will be responsible for ensuring that persons who perform public duties on their behalf do not have criminal records for crimes of corruption. The Bill will establish a restriction under which the chairman or deputy chairman of a municipal council and a member of an audit committee cannot be the manager or a member of the management board of a company, foundation or non-profit association under the dominant influence of the same rural municipality or city, or the head or deputy head of an authority administered by an administrative agency of the same rural municipality or city.
Under the Bill, the chairman of the rural municipality council or city council will decide the sending of the rural municipality mayor or city mayor on an official travel. The rural municipality mayor or city mayor will decide on the sending of members of the rural municipality government or city government on official travels. The Bill will give the prosecutor’s office the right to collect from the suspect, the accused or the defendant the patrimonial damage to the state, local authorities and other public authorities caused by a criminal offence.
Video recordings of the sittings of the Riigikogu can be viewed at: https://www.youtube.com/riigikogu
(NB! The recording will be uploaded with a delay.)
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