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The Former Yugoslav Republic of Macedonia” 01/12/08 RAP/Cha/FYROM/II(2008) EUROPEAN SOCIAL CHARTER 2nd report on the implementation of the European Social Charter submitted by THE GOVERNMENT OF “THE FORMER YUGOSLAV REPUBLIC OF MACEDONIA” (Articles 11, 12 and 13 for the period 01/01/2005 – 31/12/2007) _________ Report registered at the Secretariat on 29/11/2008 CYCLE 2009 REPUBLIC OF MACEDONIA MINISTRY OF LABOUR AND SOCIAL POLICY S E C O N D R E P O R T O N T H E I M P L E M E N T AT I O N O F T H E E U R O P E AN S O C I AL C H AR T E R Submitted by THE GOVERNMENT OF REPUBLIC OF MACEDONIA ( reference period: 2005-2007 ) ( for articles 11, 12 and 13 ) Skopje, October 2008 CONTENTS page PREFACE................................................................................................................................. 2 ARTICLE 11- The right to protection of health...................................................................... 3 Article 11§1 ............................................................................................................................................. 3 Article 11§2 ........................................................................................................................................... 15 Article 11§3 ........................................................................................................................................... 35 ARTICLE 12 - The right to social security ........................................................................... 52 Article 12§1 ........................................................................................................................................... 52 Article 12§2 ........................................................................................................................................... 64 Article 12§3 ........................................................................................................................................... 72 Article 12§4 ........................................................................................................................................... 79 ARTICLE 13 - The right to social and medical assistance.................................................. 83 Article 13§1 ........................................................................................................................................... 83 Article 13§2 ......................................................................................................................................... 101 Article 13§3 ......................................................................................................................................... 101 Article 13§4 ......................................................................................................................................... 104 1 PREFACE The Republic of Macedonia hereby submits its second Report on implementation of ratified provisions of the 1961 European Social Charter, in accordance with the Article 21 of the Charter. The Report has been prepared in compliance with the new reporting system, adopted by the Committee of Ministers and in effect since October 31, 2007. This Report covers the provisions of the Charter belonging to the second thematic group (Health, social security and social protection), concerning Articles 11, 12 and 13 accepted by the Republic of Macedonia, for the reference period 2005-2007. In accordance with the Article 23 of the European Social Charter, copies of this Report have been communicated to the relevant national organizations of employers and trade unions : - Confederation of free trade unions of Macedonia - Federation of trade unions of Macedonia - Union of independent and autonomous trade unions of Macedonia - Confederation of trade-union organizations of Macedonia - Organization of employers of Macedonia - Confederation of employers of Macedonia 2 ARTICLE 11- The right to protection of health With a view to ensuring the effective exercise of the right to protection of health, the Contracting Parties undertake, either directly or in co-operation with public or private organisations, to take appropriate measures designed inter alia: 1. to remove as far as possible the causes of ill-health; 2. to provide advisory and educational facilities for the promotion of health and the encouragement of individual responsibility in matters of health; 3. to prevent as far as possible epidemic, endemic and other diseases. Article 11§1 Law on health care protection and Law on health insurance provide equal access to health facilities, at the same time, respecting the right on equality of all citizens in the Republic. As in many countries in the world, the Republic of Macedonia has established health insurance with which the citizens, as healthy persons, set aside certain monthly amount of their incomes in corresponding institution - Health Insurance Fund; these financial means bound this Institution that in a case of disease or injury, it will cover all expenses for health care protection and for paying of all allowances in a case of temporary work disability due to sickness or injury The Law on health insurance determines two types of health care insurance: Mandatory and voluntary. By the mandatory health care insurance, every citizen of the Republic of Macedonia is mandatory provided with health care insurance, in order to ensafe social and material safety in a case of sickness or injury, in circumstances when citizens need health care services and allowances in case of sickness and injury on the base of the principles for compulsoriness, comprehensiveness, solidarity and efficiency, as generally accepted principles in all democratic countries where the mandatory health insurance has been introduced. According to the principle of compulsoriness, health insurance is mandatory for all citizens, stipulated as insured persons in the Law. According to the principle of comprehensiveness (universality), mandatory health insurance includes all citizens of the Republic of Macedonia, regardless of their working and legal status, including unemployed persons and all social categories. The principle of solidarity represents interconnected relation among all inured persons, which is realized trough the obligation for permanent contribution payment in certain percentage according to the amount of any insured person’s salary, i.e. according to the determined insurance base and insured persons having need of health care protection. According to the principle of equality, insured persons receive equal treatment regarding health insurance contribution payment obligation, as well as regarding equal right application in a case when insured persons have certain needs and under same conditions they have access to health care, regardless of the basis of their insurance, insurance category and paid contribution amount. 3 Health care services are provided trough three levels of health care: - family doctor, - specialist and consultative, and - hospital health care protection. Any insured person, in order to use health care protection in primary, should select doctor in the area of: - general medicine, - labor medicine, - pediatrics - school medicine, - gynecology, and - general dental medicine, depending on the place of residence, or place of work. The prevention and mouth cavity and teeth treatment in the primary health care protection includes: dental examination and other types of dental assistance in order to determine follow and verify health condition, as well as mouth cavity and teeth treatment. Dental examinations can be preventive or examination on request of the insured person. The insured person has access to home treatment, in a situation when no hospital treatment is necessary, in the cases of : disabled or persons with heavy disability; chronic disease in stage of deterioration or complications; following operations needing swathing and injury care; hospital treatment continuation on hospital health care institution proposal and in the case of ill persons in terminal sickness stage. The insured person has access to urgent medical assistance without referral from selected doctor, in the nearest health care institution providing primary health protection, or in the health care institution, that has urgent medical assistance service, depending on the place of residence, or the place where insured person is at the moment of the need for urgent medical assistance. Sanitary vehicle can be used in a non-urgent case, and ill or injured person due to disability or limited ability cannot use public transportation. Selected doctor, i.e. competent doctor from the adequate hospital health care institution, determines the need of sanitary vehicle transportation. Nursing visit represents provision of professional assistance and following of the condition of the insured person-parturient woman and of the newborn, after childbirth, in order to provide preservation and improvement of parturient women and child health condition, facing higher risk of disease manifestation. Nurses of chosen doctor-gynecologist team realize nursing visit. Any insured person has right to drugs on the basis of drug prescription. Doctor- medical doctor or doctor of dental medicine, having status of selected doctor in the primary health care protection, proscribes drug prescription. Specialist and consultative health care protection includes specialist examinations, diagnostic, therapeutic and rehabilitation procedures, depending on medical indications. Any insured has the right
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