Каталог статей из сборников научных конференций и научных журналов- The structure of the polish system of support for people with disabilities

Marcin Garbat, Ph.D.

University of Zielona Góra,

Zielona Góra, Poland

Introduction

System of the social security is particularly important tool in implementation of a social – economic policy. Its task is to provide benefits for the human individual to ensure safety in many different practical circumstances, e.g. threat or losses of health, fortuitous incidents, involuntary financial deterioration, loss of revenue, disability. Sense of security is regarded as one of basic human needs, as the essential human right.

Social security system of persons with disabilities includes: social insurance, health insurance (including medical care and medical rehabilitation), social rehabilitation, professional rehabilitation along with employment of persons with disabilities, social assistance.

All the above components have their own specificities. Include more uniform and precise than the entire system, collection of incidents and situations creating circumstances as well as conditions to justify the claim or efforts of person with disabilities, directed to the institutions implementing benefits provided in their specific life situation. However, all components in spite of the generic diversity combine common objectives: it’s to provide the sense of security understood as the singleness of state free from threats in many circumstances and life situations for people less efficient, as well as leveling chances of achieving full personal and professional development.

Social insurance

The social insurance assures a certain social security level by direct satisfying needs appearing in all different social groups and professional categories. It’s connected with protection of man from the fortuitous incidents. These incidents are included in categories of risk, appearing during performing the paid work. Therefore this insurance includes the protection of employees due to illness or injury, temporary inability to work, reduced professional competence or permanent inability to work.

Disability, which limits or makes impossible to fulfill social roles and ability to perform professional work, correlates with the social insurance institution at the most. For persons with disabilities it has particular importance, because the loss of certain abilities is compensated by determined benefits.

Polish social insurance model is defined as the system of three pillars (three source of finances benefits), because pension and disability pension are composed of two or three components, from different sources.

The first pillar is a pension from the reformed system handled by the Social Insurance Institution (ZUS/FUZ). The second pillar is a pension from the capital system, created from the part of superannuation in a registered account of every person, which belongs to the fund. The third pillar is a pension from resources collected by the insured person or individually through purchase of pension insurance policy, or in employee retirement programs created by the employer [5].

Health insurance

Discussing the system of health insurance one should be aware that reduction of disability degree and enabling person with disabilities to perform social roles is the basic civil right of a human being. This right is being guaranteed by the Constitution.

The following purposes of health benefits are listed in the Act on common insurance with the National Health Fund – NFZ [4]: preservation of health as well as prevention of disease and injury, early detection of diseases, treatment, prevention of disability and its limitation [1, p. 305].

Implementation of benefits as part of this insurance in relation to persons with disabilities are supposed to serve the tasks, activities and medical procedures of different character, including medical, therapeutically – protective and rehabilitation. They are: medical examinations, clinical and hospital treatment as well as supply of medicines and medical materials. In case of persons with disabilities the scope of these procedures is widened to supply with the orthopedic objects, aids and healing technical means, palliative care as well as benefits in the area of teaching and upbringing. The most important is the treatment process and medical rehabilitation of these people.

Social rehabilitation

It is a strong case to exclude the social and professional rehabilitation as one of the social security subsystems for persons with disabilities. Firstly, this system is regulated by Act of professional and social rehabilitation as well as employment of persons with disabilities (the Act of the social assistance 2004, art. 24), therefore it has the legal basis. Secondly, this system is financed from extra-budgetary centers, from special created fund which is National Fund for Rehabilitation of Persons with Disabilities (PFRON). Thanks to that it is possible to implement the tasks from social and professional rehabilitation scope for persons with disabilities, within the part of social security system, not involving the budgetary resources.

The main entity responsible for tasks implementation from the scope of social rehabilitation is regional self-government, although some tasks are also assigned for municipal authorities, provincial and government administration. Programs of the social rehabilitation involve also unprofessional social forces.

Professional rehabilitation and employment of persons with disabilities

The professional rehabilitation is a form allowing the person with disabilities to bring back the active and creative life which as a result of illness or injury was lost or never possible due to inborn defects.

The following can be distinguished in the professional rehabilitation system: career consulting, determining the capacity to work, adaptation to work in protected conditions, supporting employers of persons with disabilities on the open labor market (financial assistance to adapt workstation, equipment in appropriate technical assistances) and self-employment support of persons with disabilities.

At present in Poland we have two ways of supporting employment of persons with disabilities: application of compulsory disabled persons employment indicator (so-called quota method), provision of grants and other benefits from public means to entities employing persons with disabilities [3, art. 25-27].

Social assistance

The aim of Social Assistance is to enable persons with disabilities and their families to overcome difficult situations, which they are not able overcome using their own means and possibilities [3, paragraph 1 and 2]. Therefore, it is addressed to these families of persons with disabilities which are in need, suffer from scarcity.

It is the local authorities that are obliged to provide the social assistance, the municipality and district in particular. Other levels of the self-government and government administration are guided by principle of subsidiarity, i.e. strictly interpret own tasks resulting from the Act of social assistance. Therefore the tasks of social assistance are divided into those carried by municipality, district, provincial government, province governor and delegated to non-governmental organizations by the central and local government administration.

The basic funds which finance the social assistance come from municipal and district budgets. These budgets are assisted by the state budget, but only with tasks assigned by the state to self-government units.

The right to benefits is subject to fulfillment of two basic conditions: income criterion and appearance of circumstance justifying granting the social assistance. The disability itself is such a conditions, because it is connected with low incomes and spendings for rehabilitation purposes.

Financing of the system

Each system requires a financial supply. In the case of the social security system for people with disabilities, financing may come from various sources (such as the state budget, local government budget, PFRON, NFZ, FUZ or employers).

The financing of the social security system for people with disabilities from the state budget has a twofold nature. On the one hand it comes from additional funds for social security and employment of persons with disabilities, on the other hand, it is financed by the statutory allowances and omissions which are granted to employers of people with disabilities who give up their potential revenue.

Statutory reductions and omissions are an internal source of funding for the system. These include the omission of tax collection. External source of funding is a grant from the budget. The budget also pays health insurance premiums for unemployed people with disabilities and provide funding through the provincial administration to local governments (provincial, district and municipal) and non-governmental organizations. A significant part of funds in the system are grants, subsidies and refunds from PFRON.

Broadly defined health care is paid for by contributions from citizens from all types of income. General formula assumes that the health insurance contribution is 7.75% of the base tax on individuals. This tax is collected by the tax authorities and discharged in the form of advances to the National Health Fund, which is the primary source of funding for medical services.

PFRON is the primary source of funding for employment and professional rehabilitation of persons with disabilities. It is supplied mainly from obligatory contributions from employers for not employing people with disabilities in an appropriate proportion (6%) and payments from supported employment enterprises. These funds are spent for subsidies to wages, the payment of social security contributions for people with disabilities doing business or involved in agriculture, loans for business or agriculture, or to contribute to the social cooperatives, creation of protected workplaces and other statutory tasks. The Fund has also targeted programs, for persons with disabilities and individuals engaged in social rehabilitation. It also funds medical and social rehabilitation of unemployed people with disabilities.

Local government is responsible for the financing of social rehabilitation and social assistance. The funds for this purpose are obtained from own revenues, grants from the state budget and PFRON. District family assistance centres and welfare centres perform tasks related to the liquidation of architectural barriers, urban planning and communication, as well as the organization of rehabilitation courses, occupational therapy workshops. Local government is also responsible for financing of social assistance.

Rehabilitation and support for people with disabilities is also financed from the Company Fund for Rehabilitation of Disabled Persons (ZFRON). This is an internal fund in companies with the status of protected plants. It is created with the resources of employers due to omission of collecting of taxes in the amount of 90% of those payments. A trustee of the fund is the employer.

However, it is important not to forget that PFRON funds are not the only ones that can be and should be used to support people with disabilities. Non-governmental organizations are doing well in this field and they are treated as reliable partners. All problems of the disabled cannot be solved centrally.  Good partnership between central government, local government and NGOs can only bring desired results. Non-governmental organizations are best prepared to perform specific functions, and thus, for example, to conduct therapy workshops. The financing of these tasks comes mainly from the Fund, but more and more is gained by NGOs themselves. In 2006, non-governmental organizations have allocated 4.6 million PLN for professional activation of people with disabilities. It was rather symbolic amount. But one has to remember that many of the tasks were carried out in the form of volunteering, which is difficult to be evaluated in money terms. In 2011, one can see a great improvement in the financial situation of this sector - from donations and their own activities NGOs collected more than 30 million PLN, the sum that later was spent on supporting people with disabilities.

Among the key factors which reduce the labour supply of people with disabilities one can include: system of pensions and disability pensions and social assistance, which are often used as a substitute for early retirement. Benefits paid to the unemployed until they reach the standard retirement age are one of the examples of such type of social assistance. Economists point out that the amount and availability of all the benefits that can replace the income from work contribute significantly to the decline of labour activity of people who are close to retirement age. The higher the transfers, and the sooner one can use them, the more people are choosing to leave the labour market before reaching the official retirement age.

The decision to continue or terminate the activity are also affected by demand factors, such as the state of economic activity and the associated volume of demand for labour. The better the prospects of economic development end expected increase of demand for labour in the future, the weaker stimuli do older people experience to an early exit from the labour market.

Tensions related to the financing of pensions are largely due to early exit of people from the labour market. People who receive pensions from the Social Insurance Fund, worked an average of 27.6 years (including men 29.2 years and women 24.4 years). Less than every fifth of pensioner has completed 40 or more years, and only one in ten more than 45 years. By comparison, more than one in ten pensioner worked for less than 25 years. Very little has changed in this respect, so far. The average length of service of people who have retired in 2010, was 35.3 years. Although the percentage of pensioners with a very short period of employment decreased, unfortunately the percentage of pensioners with normal or long period of employment decreased in the same way. Every second person who received the benefit in 2010 worked less than 25 years.

In 2010, the annual cost of public sector related to the payment of allowances to enable leaving the labour market before reaching standard retirement age and at the same time not resulting from poor health (i.e. without disability benefits for work) amounted to 28.3 billion PLN. This means that in 2010 the average burden of employed persons for the payment of these benefits amounted to 230 PLN per month (year 2614 PLN). For an employee who receives the average salary, the additional burden amounted to 16% of total non-wage labour costs.

Since the beginning of this decade, the annual cost of these retirement benefits stood at 2.1%. GDP). Such amount consisted of early retirement from Social Security Fund (1.4-1.7% of GDP), and pre-retirement benefits (0.5-0.6%, early retirement of people in the area supervised my Ministry of Defence, Ministry of Interior and Ministry of Justice (0,4-0 , 5% of GDP) and early retirement pensions from KRUS (0,0-0,1% of GDP).

Conclusion

Financing of the social security system for persons with disabilities is exceptionally complicated in terms of finances source as well as legal – institutional regulations. Financial means, before they reach the persons with disabilities, go through many institutional levels: state budget, PFRON (National Fund for Rehabilitation of Persons with Disabilities), FUS (National Investment Fund) or ZUS (Social Insurance Institution), NFZ (National Health Fund), self-government budgets, district centers of the family assistance. In addition to that the system itself is very complicated having its source in the folded structure of entitlements and competence of many institutions as well as funds. Such shape of system causes its low legibility, problems with monitoring and controlling of expenses, and hence complicates rational action. It’s a cause of developed bureaucracy and duplication of competence (e.g. granting loans for the business activity and orthopedic supply). Many financial means provided by PFRON to social assistance centers – instead for the rehabilitation – are used as part of the social assistance.

Social effect of this situation is loss of abilities of optimal support activities associated with actual needs of the person with disabilities in rehabilitation, among others because many people due to complicated bureaucratic procedure give up participating in the system. This causes the lack of discernment as for actual needs and expectations of persons with disabilities in regard to the system (e.g. it isn't known, how many persons with disabilities needs support). It also leads to many negative stereotypes concerning the system failure and wasted public money.

Proper construction of the social security system causes that persons with disabilities bring something into the society, and is not regarded as the burden for it. Properly organized as well as conducted social and professional rehabilitation of persons with disabilities creates conditions for the economic self-dependence of these people. Achieving this they find appropriate place in the community and are regarded as its highly respect members. Treatment, social work, prevention and these aimed to support persons with disabilities in recovery for independent functioning.

Bibliography

1. Jończyk, J. Law of the social security. Cracow: Zakamycze, 2003.
2. Act from 27 August 1997 about the professional and social rehabilitation as well as employment of persons with disabilities, Journal of Laws 1997 yr., No. 123, pos. 776 with changes.
3. Act from 13 March 2004, about the social assistance, Journal of Laws 2004 yr., No. 64, pos. 593 with changes.
4. Act from 23 January 2003 about common insurance in the National Health Fund, Journal of Laws 2003 yr., No. 45, pos. 391.
5. Act from 17 December 1998 about the retirement and pensions from the Social Insurance Fund, Journal of Laws 1998 yr., No. 162, pos. 1118.