Solicitud directa (CEACR) - Adopción: 1993, Publicación: 80ª reunión CIT (1993)

The Committee notes the information supplied by the Government in its report concerning the scope of individual coverage of medical care and sickness benefits. The Committee wishes to draw the Government's attention to the following points:

1. Part II of the Convention (medical care). (a) Article 10 (protection of the members of the beneficiary's family). In its previous comments, the Committee asked the Government to take the necessary measures to ensure that the spouses and children of insured persons enjoy compulsory protection under the existing sickness insurance scheme, in accordance with this provision of the Convention. In its report, the Government indicates that spouses and children of insured persons are not specifically covered in their capacity as dependents, but that if they are not covered by any of the existing private medical schemes, they are protected by the State Health Services Administration (ASSE) which is responsible for organizing first-level medical care for its beneficiaries. The Committee again asks the Government to provide information, in accordance with Articles 13, 15, 16(1) and 17 of the Convention, on the working of the above Administration in practice and on the nature and scope of the medical care referred to in section 270 of Act No. 15903 of 1987, and to state whether the regulations envisaged in section 270 have been adopted and, if so, to provide a copy of them. It also asks the Government to indicate to what extent benefits are granted irrespective of the level of the beneficiaries' resources.

2. Article 12 (protection of beneficiaries and members of their families). In its previous comments, the Committee asked the Government to take the necessary measures to guarantee, in accordance with this provision of the Convention, that persons who are in receipt of a social security benefit for invalidity, old age, death of the breadwinner or unemployment and, where appropriate, the wives and children of such persons, shall continue to be protected in respect of medical care of a curative and a preventive nature. In its report, the Government states that effect is given to this provision of the Convention in the case of persons receiving social security benefit for temporary invalidity or unemployment. However, persons receiving benefits for total and permanent invalidity, old age and death of the breadwinner, and, where appropriate, their wives and children, have access to medical care under the ASSE. In these circumstances, the Committee asks the Government to provide information on the nature and scope of such medical care (see under Article 10 of the Convention).

3. Article 16, paragraph 2 (maintenance of the entitlement to medical care). With regard to beneficiaries who cease to belong to the category of persons protected, the Committee notes that they continue to be entitled to medical care for as long as they receive sickness benefit, which can be extended for up to ten years. The Committee asks the Government to indicate which provisions establish this entitlement and whether provision is made for the maintenance of the entitlement to medical care in respect of persons not receiving sickness benefit.

4. Article 16, paragraph 3 (sicknesses requiring prolonged treatment). The Committee again asks the Government to indicate whether any provision is made for the duration of medical care to be extended for diseases recognized as entailing prolonged care and, if so, to state under which laws or regulations.

5. Article 22 (amount of sickness benefits). With regard to its previous comments, the Committee notes the statistical information on the wage of the skilled manual male employee. However, it observes that the Government has not provided the information required by the report form, and the Committee is therefore unable to assess to what extent effect is given to this provision of the Convention. It requests the Government to provide the following information in respect of the same period: (a) the wage of a skilled manual male employee, determined in conformity with paragraphs 6 or 7 of this provision of the Convention; (b) the maximum amount of sickness benefits (three times the amount of the national minimum wage); and (c) the amount of family allowances payable to two children, during employment and during the contingency.