6 July 2023
The Ombudsman Mrs Diana Kovacheva presented her opinions on the 2023 National State Budget bill, the social security budget, and the budget of the National Health Insurance Fund (NHIF) that were reviewed at first reading in the Budget and Finance; Labour, Social and Demographic Policy; and Economic Policy and Innovation Standing Parliamentary Committees.
Video 1 here: https://m.facebook.com/story.php?story_fbid=1004481790999007&id=100006039721203
Video 2 here: https://m.facebook.com/story.php?story_fbid=1651672908640048&id=100006039721203
Video 3 here: https://m.facebook.com/story.php?story_fbid=929996928072227&id=100006039721203
As regards 2023 Budget, the Ombudsman draws attention to several problems related to complaints filed to the Ombudsman institution. First, Mrs Kovacheva points out that no indexation is envisaged for the monthly allowances for raising children with lasting harms up to 18 years of age or by the time they graduate high school, but not longer than they turn 20 years old as regulated in Article 8e of the Family Allowances for Children Act.
“The problem is that these monthly allowances have not been updated since 2016, and there is no mechanism in place yet for the automatic update of their amount. Furthermore, some of the social allowances are bound to the poverty line, however those concerning children with disabilities are not among these. I suspect this is just an omission rather than a discriminatory treatment as it appears in practice that there is unequal treatment of people with disabilities and minor children with disabilities below the age of 18. The bottom line is that these people should benefit from an adequate and annually updated assistance from the state – it is essential for both children with disabilities and their families. I hope that this issue be included for consideration between the first and second reading of the bill”, Mrs Kovacheva underscores.
Second, she points to how tax incentives are determined for persons with disabilities of 50 and more pct reduced capacity for work under Article 18 of the Personal Income Tax Act. Pursuant to Article 17 of the Personal Income Tax Act, in cases annual tax bases have not been updated since 2008, these shall be reduced by BGN 7,920.
The Ombudsman underscores that at the moment the reduction was introduced, the minimum wage used to be BGN 220; however, it has increased more than thrice over the years, yet no update mechanism for the tax reduction has been introduced yet.
Another problem which the public defender points out to is that targeted assistance under Article 18 of the Disabled Ex-Service Men Act continues to be determined on the basis of the guaranteed minimum income. She insists that it be determined in accordance with the poverty line.
Prof. Kovacheva further insists on urgent increase of the financial means envisaged in the National State Budget bill for the effective implementation of the inclusive education policy for children with disabilities and children with special educational needs. She underscores that more than 10,000 children with disabilities or special educational needs remain outside the education system which cannot respond to their needs.
In her opinion on the bill of the Social Security System budget that MPs from the Budget and Social Affairs Standing Committee are reviewing, the public defender recommends increase of the minimum unemployment allowance which has been frozen to BGN 18 per day, or approximately BGN 360 per month.
She further brings attention to the terms and procedure for attribution of old-age pensions to permanently disabled persons, and in particular the reduction under Article 74, para 1 of the Social Insurance Code, namely that the length of service of permanently disabled persons acquired after the date of invalidity is not taken into account for the purpose of acquiring the right to a general sickness disability pension.
“The problem in this regard is that often the invalidity occurred prior to acquiring the required length of service for the purpose of acquiring the right to a general sickness disability pension. In such cases sometimes people continue working and regardless of that, in practice the social security contributions, even if significant in size, are not acknowledged at all”, Prof. Kovacheva reiterates.
She further added that persons with disabilities challenge Article 74, para 1, item 2 and Article 74, para 3 of the Social Insurance Code as regards the impossibility to acquire general sickness disability pension rights.
The Ombudsman points out that indeed the minimum old-age and retirement pensions have increased; however, no adequate update has been envisaged for the rest of the pensions, which in her words poses a problem as this state of play does not solve the problem with the lower size of the pensions attributed prior to 2008. Thus, she calls that the recalculation of the amount of all pensions be considered on the basis of the average insurance income for the previous year.
The Ombudsman presented to the MPs from the Budget and Finance Standing Committee her opinion on the bill on the 2023 National Health Insurance Fund budget. She points out that people (partially) pay considerable amounts for medical devices that in fact they cannot afford. She gave an example with the endoprosthesis (artificial joints), lenses, expensive implants etc. She underscored that medical devices guarantee quality of life.
“I believe that measures are required and funds should be earmarked to help people”, the public defender stated „.
She points to yet another problem, namely that not sufficient financial resources are envisaged for medication, medical devices, and diet foods for special medical purposes and home treatment, as well as for medication applied in hospital medical care.
“A major problem persisting for years now is the limited opportunities for palliative care for terminally ill patients. Another one is that payment of treatment of health-insured persons after hospital care is not ensured – continuous post-treatment, treatment, and medical rehabilitation”, the Ombudsman adds.
The Ombudsman points to other problems such as treatment options for health uninsured persons under Article 82, paras 1a, 3a and 6b of the Health Act have not been expanded; and allowances for medical devices for persons with disabilities which have not been increased beyond the compulsory health insurance. Kovacheva brings attention to the fact that the limit values have not been updated for a long time.
“For yet another year the practice persists to limit patients’ access to specialists and medical diagnostic analyses by capping the referrals issued by doctors, respectively the number of assigned medical diagnostics for outpatient medical care – a trend that is becoming stable now. These in brief are the issues that citizens raise in a series of complaints, for years now, and I was hopeful that at least this year a solution, even if a partial one, would be found in the budget”, the Ombudsman says at the end.