Medical Care and Sickness Benefits Convention, 1969 (No. 130) - Bolivia (Plurinational State of) (RATIFICATION: 1977)

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The Committee requests the Government to refer to the comments concerning the application of the Social Security (Minimum Standards) Convention, 1952 (No. 102).

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In reply to the Committee’s previous observation concerning Conventions Nos 102, 121, 128 and 130, the Government explained, in its report received in August 2010, that the new Political Constitution of the State has established a new hierarchy of legal standards. This new hierarchy gives precedence over national law to international instruments including the Conventions of the International Labour Organization (ILO) ratified by the Plurinational State of Bolivia, a hierarchy that differs from the one existing under the Political Constitution of the State of 1967. The Government also stated that the Plurinational State of Bolivia must adopt new legislation as soon as possible (acts, supreme decrees and other legal instruments), reflecting the new spirit of the Constitution in force. Accordingly, the State and the Bolivian Workers’ Federation (COB) signed a framework agreement for the reform of Bolivian social security legislation, and it was agreed to amend the parameters concerning retirement in terms that would imply greater solidarity for affiliated workers. The abovementioned plans for social security reform maintain the financial system of individual capitalization and establish a solidarity component. Referring to its 2011 General Survey Social security and the rule of law (paras 451–452), the Committee welcomes the reinforcement of the involvement of the Bolivarian State and the reconstruction of solidarity mechanisms based on the principle of collective financing as major components of national social security systems. The Committee considers that the principles of collective financing and social solidarity are a powerful weapon against poverty and an effective instrument for making societies more equal and just. Besides improving social security administration, management and supervision, public systems more readily abide by the governance principles set out in ILO social security instruments. The Committee therefore expresses the firm hope that all future reforms of the social security system, such as the reform of the pensions system currently under way, will be based on the principles of solidarity and collective financing established in the new Political Constitution and by the ILO Conventions ratified by Bolivia. Moreover, the Committee notes that the Government has not replied to its observations concerning the extension and restructuring of the social security scheme and the creation of a national strategy for the development of social security. The Committee trusts that the Government, in its next detailed report which it is due to present before 1 September 2012, will reply to the questions raised in its previous observation, which read as follows:

Extension and restructuring of the social security scheme

The level of coverage of the social security scheme currently remains one of the lowest in the region. However, a number of recent measures have resulted in progress being made, with regard to health protection, through the introduction of universal insurance for mothers and children (SUMI) and free old-age medical insurance (SMVG). However, the health system remains very fragmented between the public assistance targeting the most vulnerable, the social security scheme directed at the employed population and their beneficiaries, and the private actors focusing on the higher income brackets. A rational restructuring would allow efforts to increase membership of the system to be coordinated, a series of basic health benefits to be defined giving effect in practice to the right to health protection for all and major economies of scale to be made with regard to both administrative management costs and the financing of care facilities.

Membership of the pension scheme also remains very low despite the introduction in 1997 of the new funded pension scheme which replaced the pay-as-you-go scheme based on solidarity. In order to remedy that situation, the Government recently established a universal non-contributory pension paid to all persons over 65 years of age, which has produced tangible results. A reform of the pension system is currently under way and a bill has already been approved by the Chamber of Deputies and is to be submitted to the Senate. The bill establishes a mixed pension scheme comprising a contributory and semi-contributory scheme and a non-contributory system. It also creates an invalidity and survivors’ scheme for common and occupational risks, as well as a specific invalidity and survivors’ insurance scheme for self-employed workers.

According to the 2009 ILO study, the weak coverage of the social security system with regard to health protection and pensions is largely due to the structure of the labour market and the fact that the social security scheme is essentially focused on covering the employed population benefiting from a relatively stable formal employment relationship and working essentially in large urban enterprises. However, given that this workforce accounts for only 25 per cent of the total workforce, the large majority of the economically active population, which comprises self-employed, domestic and rural workers, is excluded from the compulsory social security scheme, even though they represent more than two thirds of the country’s population. This situation is compounded by considerable evasion of contributions even within the formal economy. The combination of these two factors leads to a very low overall rate of health coverage of the economically active population (13.5 per cent in 2003). Access to health services in rural areas remains very limited with only 6 per cent of the rural population being covered. Furthermore, the high number of actors and the lack of coordination constitute yet more factors which contribute to keeping the coverage of the population at a very low level and perpetuating the lack of a comprehensive strategy in this regard. As regards old-age, invalidity and survivors’ risks, the Government indicated in its report that only 38 per cent of employees of large enterprises employing over 20 persons are covered. The economically active persons affiliated to the old-age, invalidity and survivors’ scheme represented only 5 per cent of the total number of residents. The problem of poor coverage is particularly pronounced with regard to self-employed workers and in agriculture, with only 4 per cent of Bolivian self-employed workers being affiliated to a pension fund administrator in 2007. In view of these factors, there is a need to adjust the Bolivian social security model in line with the economic and social reality of predominantly self-employed informal employment. The gradual compulsory membership of self-employed workers is a possible means of ensuring coverage of a large proportion of the population not yet benefiting from any social security coverage. State support in the form of social contribution subsidies would be an important component to ensure the success of such an initiative. The Committee would be grateful if the Government would provide information in its next report on the solutions found to increase the rates of membership and coverage and indicate the progress made with regard to reforming both the pension scheme and the health scheme.

The separation, since 1987, of the management of the short-term benefits scheme and the basic long-term scheme has resulted in each of these schemes devoting a significant proportion of their resources to the performance of administrative and operational functions, particularly those relating to membership and the collection of social contributions. Studies show that the establishment of centralized management with regard to the collection of benefits and supervision of compliance with the obligation to join the social security scheme would allow significant results to be achieved in terms of coverage and would ensure better coordination, planning and linking of strategic activities regarded as priorities from the point of view of the entire system. The creation of an independent specialized body responsible solely for supervising and controlling the social security system, without participating in the management of the system’s programmes, is another necessary component for the proper operation and viability of social security systems. The Committee requests the Government to provide information on the structural measures taken or envisaged with a view to optimizing the structure of the social security system.

Creation of a national strategy for the development of social security

In 2001, the International Labour Conference (ILC) reaffirmed the central role of social security and reiterated that it was a challenge which all member States had to tackle as a matter of urgency. The resolution adopted by the ILC in 2001 recognizes that “the highest priority should be given to policies and initiatives that bring social security to those who are not covered by existing systems”. To achieve that objective, the Conference urged every country to devise a national strategy closely linked to other social policies. States such as Bolivia which are party to the International Covenant on Economic, Social and Cultural Rights (ICESCR) are also required, according to the general observations made in 2007 by the United Nations Committee on Economic, Social and Cultural Rights (CESCR), to devise a national strategy for the comprehensive implementation of the right to social security and to allocate sufficient budgetary and other resources at the national level. The Committee considers that the need to devise a national strategy arises from the general responsibility of the State, established by Convention No. 102, to ensure the continuity and proper operation of the social security system. The launch of a national strategy designed to ensure the strengthening and sustainable development of the social security scheme, taking into account the above concerns, would allow the State to exploit to the full all the potential offered by international social security standards with a view to ensuring the proper administration of schemes and enabling the gradual extension of coverage to the entire population. The Committee draws the Government’s attention to the possibility of making greater use of technical assistance from the ILO with a view to devising, together with the social partners, a national strategy for the sustainable development of social security.

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The Committee asks the Government to refer to the comments made under the Social Security (Minimum Standards) Convention, 1952 (No. 102).

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The Committee notes that the Government’s report has not been received. It recalls that the ILO Subregional Office for Andean Countries had carried out a diagnosis of the Bolivian social security system in the framework of the Decent Work Country Programme for 2007–10, which was subsequently submitted to tripartite consultations. The Committee asks the Government to supply a detailed report for examination at its next session as well as to provide information on the progress achieved as regards the overall reform of the social security system.

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The Committee notes the report supplied by the Government. It also observes that the ILO Subregional Office for Andean countries is currently carrying out a diagnosis of the Bolivian social security system in the framework of the Decent Work Country Programme (project BOL/06/50M/NET). This diagnosis is being submitted to tripartite consultations and could serve as a basis for an overall reform of the Bolivian social security system. With reference to the numerous questions raised in its previous comments, the Committee hopes that, with the technical assistance of the ILO, the Government will be able to make progress in finding solutions to the previously identified problems of application. It will therefore undertake an in-depth analysis of the detailed information supplied by the Government at its next session, together with the relevant information from the above diagnosis, once it is adopted.

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The Committee notes with regret that the Government’s report has not been received. It must therefore repeat its previous observation which read as follows:

In reply to the comments that the Committee has been making for a number of years, the Government cites section 10 of the new Act on Pensions No. 1732 of 1996, covering benefits for invalidity as a result of occupational accidents, stating that all provisions contrary to this Act have been repealed. The Committee draws the Government’s attention to the fact that benefits for employment injury and occupational diseases are considered under the Employment Injury Benefits Convention, 1964 (No. 121), and that the matters raised by the Committee in connection with Convention No. 130 relate solely to medical treatment and medical benefits of ordinary origin. In this regard, the Committee requests the Government to confirm that the legal provisions applicable to these branches of social security to which it referred in its previous reports (Legislative Decree No. 10173 of 1972, No. 13214 of 1975 and No. 14643 of 1977) are still in force. In addition, it trusts once again that the Government’s next report will contain detailed information on the following matters raised in the Committee’s previous comments.

1. Part II (Medical care), Article 16, paragraph 1, of the Convention. The Committee once again requests the Government to adopt the necessary measures to ensure that medical care is provided throughout the contingency, in accordance with this provision of the Convention.

Article 16, paragraph 3. The Committee recalls that, under section 23 of Legislative Decree No. 13214 of 1975, in the event of sickness certified by the responsible physician before the insured person is given sick leave, entitlement to the corresponding medical care for this sickness shall not be interrupted and may continue up to the legal limit of 26 weeks, or less if the medical treatment is terminated. The Committee trusts that the Government will indicate in its next report the measures that have been adopted to extend, in the case of beneficiaries who lose their status as insured persons, the duration of medical care for prescribed diseases recognized as entailing prolonged care, as required by this provision of the Convention.

2. Part III (Sickness benefit), Article 21, in conjunction with Article 22. The Committee once again draws the Government’s attention to the fact that, in accordance with Articles 21 to 23, the rate of the sickness benefit shall be such as to attain a minimum level (60 per cent) for a standard beneficiary (a man with a wife and two children). Articles 22 to 24 offer the Government various formulae that can be adapted to national practice for the determination of this minimum level. The formula envisaged in Article 22 is intended to take into account systems of protection which, as is the case of the Bolivian social security system, provide benefits calculated on the basis of the beneficiary’s former earnings. The Committee recalls in this respect that, in view of the fact that Legislative Decree No. 13214 of 1975, and section 81 of the Social Security Code, as amended, envisage a maximum amount for the rate of benefit and for the earnings taken into account for its calculation, the percentage of 60 per cent provided for in the Convention must be calculated with reference to a standard beneficiary whose earnings are equal to the wage of a skilled manual male employee (Article 22, paragraph 3). The information requested under the terms of Article 22 of the Convention and, in particular, relating to the wage of a skilled manual male employee, is merely intended to permit comparison of the rate of benefit paid under the national legislation with the minimum rate established by the Convention. In these conditions, the Committee once again hopes that the Government will be able to take the necessary measures to provide the information required in the report form adopted by the Governing Body on Convention No. 130, and particularly the information on the wage of a skilled manual male employee, determined in accordance with paragraph 6 or 7 of Article 22, the amount of the sickness benefit paid to such a skilled worker, and the maximum level of wages subject to contributions.

3. Article 26, paragraph 1. The Government states in its report that sickness insurance benefit is provided for 52 weeks and, for chronic illnesses, this period may be extended by the Ministry of Health. With regard to cash benefit, the subsidy for temporary incapacity is provided for 52 weeks at a rate that is equivalent to 75 per cent of the wage that is subject to contributions. The Committee once again emphasizes that section 30 of Legislative Decree No. 13214, of 1975, establishes that the common sickness subsidy commences from the fourth day of incapacity, with a maximum duration of 26 weeks, which can be extended for another 26 weeks if by doing so it is possible to avoid the status of invalidity. The Committee recalls that this requirement is not authorized by Article 26 of the Convention, which provides that sickness benefit shall be granted throughout the contingency, provided that the grant of benefit may be limited to not less than 52 weeks in each case of incapacity. In these conditions, the Committee once again reminds the Government of the need to harmonize the provisions of the legislation that is in force with those of the Convention.

4. In previous comments, the Committee had referred to the possibility of having recourse to the technical assistance of the Office to resolve difficulties arising out of the application of the Convention. In addition, the Government had referred to a structural reform of social security in Bolivia. As so many years have passed since these matters were first raised concerning the application of the Convention, the Committee trusts that the Government will provide a detailed report in which it will take fully into account the matters that have been raised in order to give full effect to the Convention and that it will not hesitate to have recourse to the technical assistance that can be provided by the Office to assist its efforts to apply the Convention.

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The Committee notes with regret that the Government’s report has not been received. It must therefore repeat its previous observation which read as follows:

In reply to the comments that the Committee has been making for a number of years, the Government cites section 10 of the new Act on Pensions No. 1732 of 1996, covering benefits for invalidity as a result of occupational accidents, stating that all provisions contrary to this Act have been repealed. The Committee draws the Government’s attention to the fact that benefits for employment injury and occupational diseases are considered under the Employment Injury Benefits Convention, 1964 (No. 121), and that the matters raised by the Committee in connection with Convention No. 130 relate solely to medical treatment and medical benefits of ordinary origin. In this regard, the Committee requests the Government to confirm that the legal provisions applicable to these branches of social security to which it referred in its previous reports (Legislative Decree No. 10173 of 1972, No. 13214 of 1975 and No. 14643 of 1977) are still in force. In addition, it trusts once again that the Government’s next report will contain detailed information on the following matters raised in the Committee’s previous comments.

1. Part II (Medical care), Article 16, paragraph 1, of the Convention. The Committee once again requests the Government to adopt the necessary measures to ensure that medical care is provided throughout the contingency, in accordance with this provision of the Convention.

Article 16, paragraph 3. The Committee recalls that, under section 23 of Legislative Decree No. 13214 of 1975, in the event of sickness certified by the responsible physician before the insured person is given sick leave, entitlement to the corresponding medical care for this sickness shall not be interrupted and may continue up to the legal limit of 26 weeks, or less if the medical treatment is terminated. The Committee trusts that the Government will indicate in its next report the measures that have been adopted to extend, in the case of beneficiaries who lose their status as insured persons, the duration of medical care for prescribed diseases recognized as entailing prolonged care, as required by this provision of the Convention.

2. Part III (Sickness benefit), Article 21, in conjunction with Article 22. The Committee once again draws the Government’s attention to the fact that, in accordance with Articles 21 to 23, the rate of the sickness benefit shall be such as to attain a minimum level (60 per cent) for a standard beneficiary (a man with a wife and two children). Articles 22 to 24 offer the Government various formulae that can be adapted to national practice for the determination of this minimum level. The formula envisaged in Article 22 is intended to take into account systems of protection which, as is the case of the Bolivian social security system, provide benefits calculated on the basis of the beneficiary’s former earnings. The Committee recalls in this respect that, in view of the fact that Legislative Decree No. 13214 of 1975, and section 81 of the Social Security Code, as amended, envisage a maximum amount for the rate of benefit and for the earnings taken into account for its calculation, the percentage of 60 per cent provided for in the Convention must be calculated with reference to a standard beneficiary whose earnings are equal to the wage of a skilled manual male employee (Article 22, paragraph 3). The information requested under the terms of Article 22 of the Convention and, in particular, relating to the wage of a skilled manual male employee, is merely intended to permit comparison of the rate of benefit paid under the national legislation with the minimum rate established by the Convention. In these conditions, the Committee once again hopes that the Government will be able to take the necessary measures to provide the information required in the report form adopted by the Governing Body on Convention No. 130, and particularly the information on the wage of a skilled manual male employee, determined in accordance with paragraph 6 or 7 of Article 22, the amount of the sickness benefit paid to such a skilled worker, and the maximum level of wages subject to contributions.

3. Article 26, paragraph 1. The Government states in its report that sickness insurance benefit is provided for 52 weeks and, for chronic illnesses, this period may be extended by the Ministry of Health. With regard to cash benefit, the subsidy for temporary incapacity is provided for 52 weeks at a rate that is equivalent to 75 per cent of the wage that is subject to contributions. The Committee once again emphasizes that section 30 of Legislative Decree No. 13214, of 1975, establishes that the common sickness subsidy commences from the fourth day of incapacity, with a maximum duration of 26 weeks, which can be extended for another 26 weeks if by doing so it is possible to avoid the status of invalidity. The Committee recalls that this requirement is not authorized by Article 26 of the Convention, which provides that sickness benefit shall be granted throughout the contingency, provided that the grant of benefit may be limited to not less than 52 weeks in each case of incapacity. In these conditions, the Committee once again reminds the Government of the need to harmonize the provisions of the legislation that is in force with those of the Convention.

4. In previous comments, the Committee had referred to the possibility of having recourse to the technical assistance of the Office to resolve difficulties arising out of the application of the Convention. In addition, the Government had referred to a structural reform of social security in Bolivia. As so many years have passed since these matters were first raised concerning the application of the Convention, the Committee trusts that the Government will provide a detailed report in which it will take fully into account the matters that have been raised in order to give full effect to the Convention and that it will not hesitate to have recourse to the technical assistance that can be provided by the Office to assist its efforts to apply the Convention.

The Committee hopes that the Government will make every effort to take the necessary action in the very near future.

CMNT_TITLE

The Committee notes with regret that the Government’s report has not been received. It must therefore repeat its previous observation which read as follows:

In reply to the comments that the Committee has been making for a number of years, the Government cites section 10 of the new Act on Pensions No. 1732 of 1996, covering benefits for invalidity as a result of occupational accidents, stating that all provisions contrary to this Act have been repealed. The Committee draws the Government’s attention to the fact that benefits for employment injury and occupational diseases are considered under the Employment Injury Benefits Convention, 1964 (No. 121), and that the matters raised by the Committee in connection with Convention No. 130 relate solely to medical treatment and medical benefits of ordinary origin. In this regard, the Committee requests the Government to confirm that the legal provisions applicable to these branches of social security to which it referred in its previous reports (Legislative Decree No. 10173 of 1972, No. 13214 of 1975 and No. 14643 of 1977) are still in force. In addition, it trusts once again that the Government’s next report will contain detailed information on the following matters raised in the Committee’s previous comments.

1. Part II (Medical care), Article 16, paragraph 1, of the Convention. The Committee once again requests the Government to adopt the necessary measures to ensure that medical care is provided throughout the contingency, in accordance with this provision of the Convention.

Article 16, paragraph 3. The Committee recalls that, under section 23 of Legislative Decree No. 13214 of 1975, in the event of sickness certified by the responsible physician before the insured person is given sick leave, entitlement to the corresponding medical care for this sickness shall not be interrupted and may continue up to the legal limit of 26 weeks, or less if the medical treatment is terminated. The Committee trusts that the Government will indicate in its next report the measures that have been adopted to extend, in the case of beneficiaries who lose their status as insured persons, the duration of medical care for prescribed diseases recognized as entailing prolonged care, as required by this provision of the Convention.

2. Part III (Sickness benefit), Article 21, in conjunction with Article 22. The Committee once again draws the Government’s attention to the fact that, in accordance with Articles 21 to 23, the rate of the sickness benefit shall be such as to attain a minimum level (60 per cent) for a standard beneficiary (a man with a wife and two children). Articles 22 to 24 offer the Government various formulae that can be adapted to national practice for the determination of this minimum level. The formula envisaged in Article 22 is intended to take into account systems of protection which, as is the case of the Bolivian social security system, provide benefits calculated on the basis of the beneficiary’s former earnings. The Committee recalls in this respect that, in view of the fact that Legislative Decree No. 13214 of 1975, and section 81 of the Social Security Code, as amended, envisage a maximum amount for the rate of benefit and for the earnings taken into account for its calculation, the percentage of 60 per cent provided for in the Convention must be calculated with reference to a standard beneficiary whose earnings are equal to the wage of a skilled manual male employee (Article 22, paragraph 3). The information requested under the terms of Article 22 of the Convention and, in particular, relating to the wage of a skilled manual male employee, is merely intended to permit comparison of the rate of benefit paid under the national legislation with the minimum rate established by the Convention. In these conditions, the Committee once again hopes that the Government will be able to take the necessary measures to provide the information required in the report form adopted by the Governing Body on Convention No. 130, and particularly the information on the wage of a skilled manual male employee, determined in accordance with paragraph 6 or 7 of Article 22, the amount of the sickness benefit paid to such a skilled worker, and the maximum level of wages subject to contributions.

3. Article 26, paragraph 1. The Government states in its report that sickness insurance benefit is provided for 52 weeks and, for chronic illnesses, this period may be extended by the Ministry of Health. With regard to cash benefit, the subsidy for temporary incapacity is provided for 52 weeks at a rate that is equivalent to 75 per cent of the wage that is subject to contributions. The Committee once again emphasizes that section 30 of Legislative Decree No. 13214, of 1975, establishes that the common sickness subsidy commences from the fourth day of incapacity, with a maximum duration of 26 weeks, which can be extended for another 26 weeks if by doing so it is possible to avoid the status of invalidity. The Committee recalls that this requirement is not authorized by Article 26 of the Convention, which provides that sickness benefit shall be granted throughout the contingency, provided that the grant of benefit may be limited to not less than 52 weeks in each case of incapacity. In these conditions, the Committee once again reminds the Government of the need to harmonize the provisions of the legislation that is in force with those of the Convention.

4. In previous comments, the Committee had referred to the possibility of having recourse to the technical assistance of the Office to resolve difficulties arising out of the application of the Convention. In addition, the Government had referred to a structural reform of social security in Bolivia. As so many years have passed since these matters were first raised concerning the application of the Convention, the Committee trusts that the Government will provide a detailed report in which it will take fully into account the matters that have been raised in order to give full effect to the Convention and that it will not hesitate to have recourse to the technical assistance that can be provided by the Office to assist its efforts to apply the Convention.

The Committee hopes that the Government will make every effort to take the necessary action in the very near future.

CMNT_TITLE

The Committee notes that the Government’s report has not been received. It must therefore repeat its previous observation which reads as follows:

In reply to the comments that the Committee has been making for a number of years, the Government cites section 10 of the new Act on Pensions No. 1732 of 1996, covering benefits for invalidity as a result of occupational accidents, stating that all provisions contrary to this Act have been repealed. The Committee draws the Government’s attention to the fact that benefits for employment injury and occupational diseases are considered under the Employment Injury Benefits Convention, 1964 (No. 121), and that the matters raised by the Committee in connection with Convention No. 130 relate solely to medical treatment and medical benefits of ordinary origin. In this regard, the Committee requests the Government to confirm that the legal provisions applicable to these branches of social security to which it referred in its previous reports (Legislative Decree No. 10173 of 1972, No. 13214 of 1975 and No. 14643 of 1977) are still in force. In addition, it trusts once again that the Government’s next report will contain detailed information on the following matters raised in the Committee’s previous comments.

1.  Part II (Medical care), Article 16, paragraph 1, of the Convention.  The Committee once again requests the Government to adopt the necessary measures to ensure that medical care is provided throughout the contingency, in accordance with this provision of the Convention.

  Article 16, paragraph 3.  The Committee recalls that, under section 23 of Legislative Decree No. 13214 of 1975, in the event of sickness certified by the responsible physician before the insured person is given sick leave, entitlement to the corresponding medical care for this sickness shall not be interrupted and may continue up to the legal limit of 26 weeks, or less if the medical treatment is terminated. The Committee trusts that the Government will indicate in its next report the measures that have been adopted to extend, in the case of beneficiaries who lose their status as insured persons, the duration of medical care for prescribed diseases recognized as entailing prolonged care, as required by this provision of the Convention.

2.  Part III (Sickness benefit), Article 21, in conjunction with Article 22.  The Committee once again draws the Government’s attention to the fact that, in accordance with Articles 21 to 23, the rate of the sickness benefit shall be such as to attain a minimum level (60 per cent) for a standard beneficiary (a man with a wife and two children). Articles 22 to 24 offer the Government various formulae that can be adapted to national practice for the determination of this minimum level. The formula envisaged in Article 22 is intended to take into account systems of protection which, as is the case of the Bolivian social security system, provide benefits calculated on the basis of the beneficiary’s former earnings. The Committee recalls in this respect that, in view of the fact that Legislative Decree No. 13214 of 1975, and section 81 of the Social Security Code, as amended, envisage a maximum amount for the rate of benefit and for the earnings taken into account for its calculation, the percentage of 60 per cent provided for in the Convention must be calculated with reference to a standard beneficiary whose earnings are equal to the wage of a skilled manual male employee (Article 22, paragraph 3). The information requested under the terms of Article 22 of the Convention and, in particular, relating to the wage of a skilled manual male employee, is merely intended to permit comparison of the rate of benefit paid under the national legislation with the minimum rate established by the Convention. In these conditions, the Committee once again hopes that the Government will be able to take the necessary measures to provide the information required in the report form adopted by the Governing Body on Convention No. 130, and particularly the information on the wage of a skilled manual male employee, determined in accordance with paragraph 6 or 7 of Article 22, the amount of the sickness benefit paid to such a skilled worker, and the maximum level of wages subject to contributions.

3.  Article 26, paragraph 1.  The Government states in its report that sickness insurance benefit is provided for 52 weeks and, for chronic illnesses, this period may be extended by the Ministry of Health. With regard to cash benefit, the subsidy for temporary incapacity is provided for 52 weeks at a rate that is equivalent to 75 per cent of the wage that is subject to contributions. The Committee once again emphasizes that section 30 of Legislative Decree No. 13214, of 1975, establishes that the common sickness subsidy commences from the fourth day of incapacity, with a maximum duration of 26 weeks, which can be extended for another 26 weeks if by doing so it is possible to avoid the status of invalidity. The Committee recalls that this requirement is not authorized by Article 26 of the Convention, which provides that sickness benefit shall be granted throughout the contingency, provided that the grant of benefit may be limited to not less than 52 weeks in each case of incapacity. In these conditions, the Committee once again reminds the Government of the need to harmonize the provisions of the legislation that is in force with those of the Convention.

4.  In previous comments, the Committee had referred to the possibility of having recourse to the technical assistance of the Office to resolve difficulties arising out of the application of the Convention. In addition, the Government had referred to a structural reform of social security in Bolivia. As so many years have passed since these matters were first raised concerning the application of the Convention, the Committee trusts that the Government will provide a detailed report in which it will take fully into account the matters that have been raised in order to give full effect to the Convention and that it will not hesitate to have recourse to the technical assistance that can be provided by the Office to assist its efforts to apply the Convention.

The Committee hopes that the Government will make every effort to take the necessary action in the very near future.

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In reply to the comments that the Committee has been making for a number of years, the Government cites section 10 of the new Act on Pensions No. 1732 of 1996, covering benefits for invalidity as a result of occupational accidents, stating that all provisions contrary to this Act have been repealed. The Committee draws the Government's attention to the fact that benefits for employment injury and occupational diseases are considered under the Employment Injury Benefits Convention, 1964 (No. 121), and that the matters raised by the Committee in connection with Convention No. 130 relate solely to medical treatment and medical benefits of ordinary origin. In this regard, the Committee requests the Government to confirm that the legal provisions applicable to these branches of social security to which it referred in its previous reports (Legislative Decree No. 10173 of 1972, No. 13214 of 1975 and No. 14643 of 1977) are still in force. In addition, it trusts once again that the Government's next report will contain detailed information on the following matters raised in the Committee's previous comments.

1. Part II (Medical care), Article 16, paragraph 1, of the Convention. The Committee once again requests the Government to adopt the necessary measures to ensure that medical care is provided throughout the contingency, in accordance with this provision of the Convention.

Article 16, paragraph 3. The Committee recalls that, under section 23 of Legislative Decree No. 13214 of 1975, in the event of sickness certified by the responsible physician before the insured person is given sick leave, entitlement to the corresponding medical care for this sickness shall not be interrupted and may continue up to the legal limit of 26 weeks, or less if the medical treatment is terminated. The Committee trusts that the Government will indicate in its next report the measures that have been adopted to extend, in the case of beneficiaries who lose their status as insured persons, the duration of medical care for prescribed diseases recognized as entailing prolonged care, as required by this provision of the Convention.

2. Part III (Sickness benefit), Article 21, in conjunction with Article 22. The Committee once again draws the Government's attention to the fact that, in accordance with Articles 21 to 23, the rate of the sickness benefit shall be such as to attain a minimum level (60 per cent) for a standard beneficiary (a man with a wife and two children). Articles 22 to 24 offer the Government various formulae that can be adapted to national practice for the determination of this minimum level. The formula envisaged in Article 22 is intended to take into account systems of protection which, as is the case of the Bolivian social security system, provide benefits calculated on the basis of the beneficiary's former earnings. The Committee recalls in this respect that, in view of the fact that Legislative Decree No. 13214 of 1975, and section 81 of the Social Security Code, as amended, envisage a maximum amount for the rate of benefit and for the earnings taken into account for its calculation, the percentage of 60 per cent provided for in the Convention must be calculated with reference to a standard beneficiary whose earnings are equal to the wage of a skilled manual male employee (Article 22, paragraph 3). The information requested under the terms of Article 22 of the Convention and, in particular, relating to the wage of a skilled manual male employee, is merely intended to permit comparison of the rate of benefit paid under the national legislation with the minimum rate established by the Convention. In these conditions, the Committee once again hopes that the Government will be able to take the necessary measures to provide the information required in the report form adopted by the Governing Body on Convention No. 130, and particularly the information on the wage of a skilled manual male employee, determined in accordance with paragraph 6 or 7 of Article 22, the amount of the sickness benefit paid to such a skilled worker, and the maximum level of wages subject to contributions.

3. Article 26, paragraph 1. The Government states in its report that sickness insurance benefit is provided for 52 weeks and, for chronic illnesses, this period may be extended by the Ministry of Health. With regard to cash benefit, the subsidy for temporary incapacity is provided for 52 weeks at a rate that is equivalent to 75 per cent of the wage that is subject to contributions. The Committee once again emphasizes that section 30 of Legislative Decree No. 13214, of 1975, establishes that the common sickness subsidy commences from the fourth day of incapacity, with a maximum duration of 26 weeks, which can be extended for another 26 weeks if by doing so it is possible to avoid the status of invalidity. The Committee recalls that this requirement is not authorized by Article 26 of the Convention, which provides that sickness benefit shall be granted throughout the contingency, provided that the grant of benefit may be limited to not less than 52 weeks in each case of incapacity. In these conditions, the Committee once again reminds the Government of the need to harmonize the provisions of the legislation that is in force with those of the Convention.

4. In previous comments, the Committee had referred to the possibility of having recourse to the technical assistance of the Office to resolve difficulties arising out of the application of the Convention. In addition, the Government had referred to a structural reform of social security in Bolivia. As so many years have passed since these matters were first raised concerning the application of the Convention, the Committee trusts that the Government will provide a detailed report in which it will take fully into account the matters that have been raised in order to give full effect to the Convention and that it will not hesitate to have recourse to the technical assistance that can be provided by the Office to assist its efforts to apply the Convention.

[The Government is asked to report in detail in 2000.]

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I. The Committee notes the Government's report, in which it states that the applicable legal provisions (Legislative Decrees Nos. 10173 of 1972; 13214 of 1975; and 14643 of 1977) are compatible with the provisions of the Convention. The Committee notes that the Government's report does not contain information on the matters raised in its previous comments. The Committee hopes that in its next report the Government will include detailed information on the following matters:

1. Part II (Medical care), Article 16, paragraph 1, of the Convention. The Committee once again requests the Government to adopt the necessary measures to ensure that medical care is provided throughout the contingency, in accordance with this provision of the Convention.

Article 16, paragraph 3. The Committee recalls that, under section 23 of Legislative Decree No. 13214 of 1975, in the event of sickness certified by the responsible physician before the insured person is given sick leave, entitlement to the corresponding medical care for this sickness shall not be interrupted and may continue up to the legal limit of 26 weeks, or less if the medical treatment is terminated. The Committee trusts that the Government will indicate in its next report the measures that have been adopted to extend, in the case of beneficiaries who lose their status as insured persons, the duration of medical care for prescribed diseases recognized as entailing prolonged care, as required by this provision of the Convention.

2. Part III (Sickness benefit), Article 21, in conjunction with Article 22. The Committee once again draws the Government's attention to the fact that, in accordance with Articles 21 to 23, the rate of the sickness benefit shall be such as to attain a minimum level (60 per cent) for a standard beneficiary (a man with a wife and two children). Articles 22 to 24 offer the Government various formulae that can be adapted to national practice for the determination of this minimum level. The formula envisaged in Article 22 is intended to take into account systems of protection which, as is the case of the Bolivian social security system, provide benefits calculated on the basis of the beneficiary's former earnings. The Committee recalls in this respect that, in view of the fact that Legislative Decree No. 13214 of 1975, and section 81 of the Social Security Code, as amended, envisage a maximum amount for the rate of benefit and for the earnings taken into account for its calculation, the percentage of 60 per cent provided for in the Convention must be calculated with reference to a standard beneficiary whose earnings are equal to the wage of a skilled manual male employee (Article 22, paragraph 3). The information requested under the terms of Article 22 of the Convention and, in particular, relating to the wage of a skilled manual male employee, is merely intended to permit comparison of the rate of benefit paid under the national legislation with the minimum rate established by the Convention. In these conditions, the Committee once again hopes that the Government will be able to take the necessary measures to provide the information required in the report form adopted by the Governing Body on Convention No. 130, and particularly the information on the wage of a skilled manual male employee, determined in accordance with paragraph 6 or 7 of Article 22, the amount of the sickness benefit paid to such a skilled worker, and the maximum level of wages subject to contributions.

3. Article 26, paragraph 1. The Government states in its report that sickness insurance benefit is extended for 52 weeks and for chronic illnesses, and that after this period it comes under the responsibility of the Ministry of Health. With regard to cash benefit, the subsidy for temporary incapacity is provided for 52 weeks at a rate that is equivalent to 75 per cent of the wage that is subject to contributions. The Committee once again emphasizes that section 30 of Legislative Decree No. 13214, of 1975, establishes that the common sickness subsidy commences from the fourth day of incapacity, with a maximum duration of 26 weeks, which can be extended for another 26 weeks if by doing so it is possible to avoid the status of invalidity. The Committee recalls that this requirement is not authorized by Article 26 of the Convention, which provides that sickness benefit shall be granted throughout the contingency, provided that the grant of benefit may be limited to not less than 52 weeks in each case of incapacity. In these conditions, the Committee once again reminds the Government of the need to harmonize the provisions of the legislation that is in force with those of the Convention.

II. In previous comments, the Committee had referred to the possibility of having recourse to the technical assistance of the Office to resolve difficulties arising out of the application of the Convention. In addition, the Government had referred to a structural reform of social security in Bolivia. As so many years have passed since these matters were first raised concerning the application of the Convention, the Committee trusts that the Government will provide a detailed report in which it will take fully into account the matters that have been raised in order to give full effect to the Convention and that it will not hesitate to have recourse to the technical assistance that can be provided by the Office to assist its efforts to apply the Convention.

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The Committee takes note of the information supplied by the Government in its report.

1. Part II (Medical care), Article 16, paragraphs 1 and 3 of the Convention. In reply to the Committee's previous comments, the Government indicates that in the restructuring of the Bolivian social security, careful account has been taken of the Committee's recommendation that medical care should be provided throughout the contingency. In accordance with the Convention, this care should be extended for prescribed diseases recognised as entailing prolonged care when the beneficiary ceases to belong to a category of protected persons. The Committee notes this statement with interest. It hopes that the above-mentioned structural reform will shortly be completed and that it will give full effect to the Convention as regards this point.

2. Part III (Sickness benefit), Article 21 (in conjunction with Article 22). The Committee notes with interest the information supplied by the Government. It notes in particular that the Government will request technical assistance from the ILO. The Committee hopes that, with the help of the ILO Regional Adviser on social security, in its next report the Government will be able to provide the statistical information required by the report form adopted by the Governing Body under Article 22, so that the Committee can determine whether the amount of sickness benefit prescribed by the Convention for a standard beneficiary is attained.

3. Article 26, paragraph 1. In reply to the Committee's previous comments, the Government indicates that section 30 of Legislative Decree No. 13214 of 24 December 1975 does not impose any conditions for the extension of the payment of sickness benefit by a further 26 weeks. However it states that, should the Committee maintain its position, it would be grateful to receive assistance from the Regional Adviser.

The Committee notes this statement with interest. It considers that, to avert any risk of confusion, it would be advisable to harmonise section 30 of Legislative Decree No. 13214 with this provision of the Convention which prescribes that sickness benefits must be granted throughout the contingency, although the grant of the benefit may be limited to 52 weeks in each case of incapacity.

The Committee expresses the hope that, with technical assistance from the Office, the Government will gradually be able to overcome its difficulties in applying the Convention.

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The Committee notes that the Government's report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which read as follows:

Article 16, paragraphs 1 and 3, of the Convention. In its previous comments, the Committee, while noting the statement of the Government that it will take into account the Committee's comments when formulating the new Social Security Code, had requested the Government to adopt, without prejudice to the announced reforms, the necessary measures to give full effect to Article 16, paragraphs 1 and 3. In accordance with these provisions, medical care should be provided throughout the contingency (paragraph 1 of Article 16) and this period should be extended for prescribed diseases recognised as entailing prolonged care, in the prescribed circumstances (paragraph 3 of Article 16) when the beneficiary ceases to belong to a category of protected persons. No information to this effect being contained in the Government's report, the Committee hopes that the Government will not fail to indicate in its next report any measures taken or envisaged to ensure the application of the Convention on the above-mentioned points.

Article 21 (in relation with Article 22). In response to the Committee's previous comments, the Government states that ordinary sickness benefits are calculated on the basis of the wage on which contribution is levied without considering whether the wage corresponds to that of a skilled employee or an ordinary labourer; for this reason, neither the Institute nor the social insurance management bodies keeps statistics on the question. The Committee wishes to draw the Government's attention to the fact that, according to Articles 21 to 23, the amount of sickness benefit must correspond for a standard beneficiary (a man having a wife and two children) to a minimum level (60 per cent). To determine this minimum level several formulas, intended to meet the practice of different countries, are offered to governments under Articles 22 to 24. The formula prescribed by Article 22 is precisely designed to take account of the system of protection which, like the Bolivian social security systems, provides for benefits calculated on the basis of previous earnings of the beneficiary. However, if, as in the case of Bolivia (see section 28 of Legislative Decree No. 13214 of 24 December 1975 and section 81 of the Social Security Code as amended), a maximum is prescribed for the amount of benefits or for the earnings taken into account for their calculation, the 60 per cent required by the Convention must be reached for a standard beneficiary whose earnings are equal to the wage of a skilled manual male employee (Article 22, paragraph 3). The information required by Article 22 and, in particular, that relating to the wage of a skilled manual male employee, has no other objective than to permit the comparison of the amount of benefits paid under national legislation with the minimum amount prescribed by the Convention. Under these circumstances, the Committee hopes that the Government will be able to take the necessary measures in order to provide the information on the wage of a skilled manual male employee, determined according to paragraphs 6 and 7 of Article 22, and that it will also be able to submit with its next report information on the amount of family benefits paid during the period under consideration, during employment as well as during the contingency, and the maximum limit of the wage on which contribution may be levied. In this regard, the Committee takes the opportunity to draw to the attention of the Government the possibility of seeking the technical assistance of the ILO regional adviser on social security for Latin America.

Article 26, paragraph 1. The Government states in its report that, in accordance with Legislative Decree No. 10173 of 28 March 1972, the grant of medical benefits to persons suffering from tuberculosis can be extended up to a period of 26 extra weeks, in addition to the 52 recognised by the Social Security Code and that, according to section 36 of this Code, sickness benefit is paid throughout the period of medical care. While taking note of this information, the Committee must draw the attention of the Government to the fact that, according to section 30 of Legislative Decree No. 13214 of 24 December 1975 reforming the Bolivian system of social security, sickness benefit is payable for 26 weeks which may be extended for an equal period if this prolongation makes it possible to avoid permanent incapacity. The extension of the payment of the benefit to 52 weeks is therefore not assured in all cases but only in those cases where the extension makes it possible to avoid permanent incapacity. Such a condition is not authorised by Article 26 of the Convention, which prescribes that sickness benefits must be granted throughout the contingency, although the grant of the benefit may be limited to 52 weeks in each case of incapacity. The Committee would therefore be grateful if the Government would indicate the measures taken or envisaged to bring section 30 of Legislative Decree No. 13214 of 1975 into conformity with this provision of the Convention. The Committee also takes this opportunity to suggest resort to the technical assistance of the regional adviser for social security in order to find a suitable solution to this question.

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Article 16, paragraphs 1 and 3, of the Convention. In its previous comments, the Committee, while noting the statement of the Government that it will take into account the Committee's comments when formulating the new Social Security Code, had requested the Government to adopt, without prejudice to the announced reforms, the necessary measures to give full effect to Article 16, paragraphs 1 and 3. In accordance with these provisions, medical care should be provided throughout the contingency (paragraph 1 of Article 16) and this period should be extended for prescribed diseases recognised as entailing prolonged care, in the prescribed circumstances (paragraph 3 of Article 16) when the beneficiary ceases to belong to a category of protected persons. No information to this effect being contained in the Government's report, the Committee hopes that the Government will not fail to indicate in its next report any measures taken or envisaged to ensure the application of the Convention on the above-mentioned points.

Article 21 (in relation with Article 22). In response to the Committee's previous comments, the Government states that ordinary sickness benefits are calculated on the basis of the wage on which contribution is levied without considering whether the wage corresponds to that of a skilled employee or an ordinary labourer; for this reason, neither the Institute nor the social insurance management bodies keeps statistics on the question. The Committee wishes to draw the Government's attention to the fact that, according to Articles 21 to 23, the amount of sickness benefit must correspond for a standard beneficiary (a man having a wife and two children) to a minimum level (60 per cent). To determine this minimum level several formulas, intended to meet the practice of different countries, are offered to governments under Articles 22 to 24. The formula prescribed by Article 22 is precisely designed to take account of the system of protection which, like the Bolivian social security systems, provides for benefits calculated on the basis of previous earnings of the beneficiary. However, if, as in the case of Bolivia (see section 28 of Legislative Decree No. 13214 of 24 December 1975 and section 81 of the Social Security Code as amended), a maximum is prescribed for the amount of benefits or for the earnings taken into account for their calculation, the 60 per cent required by the Convention must be reached for a standard beneficiary whose earnings are equal to the wage of a skilled manual male employee (Article 22, paragraph 3). The information required by Article 22 and, in particular, that relating to the wage of a skilled manual male employee, has no other objective than to permit the comparison of the amount of benefits paid under national legislation with the minimum amount prescribed by the Convention. Under these circumstances, the Committee hopes that the Government will be able to take the necessary measures in order to provide the information on the wage of a skilled manual male employee, determined according to paragraphs 6 and 7 of Article 22, and that it will also be able to submit with its next report information on the amount of family benefits paid during the period under consideration, during employment as well as during the contingency, and the maximum limit of the wage on which contribution may be levied. In this regard, the Committee takes the opportunity to draw to the attention of the Government the possibility of seeking the technical assistance of the ILO regional adviser on social security for Latin America.

Article 26, paragraph 1. The Government states in its report that, in accordance with Legislative Decree No. 10173 of 28 March 1972, the grant of medical benefits to persons suffering from tuberculosis can be extended up to a period of 26 extra weeks, in addition to the 52 recognised by the Social Security Code and that, according to section 36 of this Code, sickness benefit is paid throughout the period of medical care. While taking note of this information, the Committee must draw the attention of the Government to the fact that, according to section 30 of Legislative Decree No. 13214 of 24 December 1975 reforming the Bolivian system of social security, sickness benefit is payable for 26 weeks which may be extended for an equal period if this prolongation makes it possible to avoid permanent incapacity. The extension of the payment of the benefit to 52 weeks is therefore not assured in all cases but only in those cases where the extension makes it possible to avoid permanent incapacity. Such a condition is not authorised by Article 26 of the Convention, which prescribes that sickness benefits must be granted throughout the contingency, although the grant of the benefit may be limited to 52 weeks in each case of incapacity. The Committee would therefore be grateful if the Government would indicate the measures taken or envisaged to bring section 30 of Legislative Decree No. 13214 of 1975 into conformity with this provision of the Convention. The Committee also takes this opportunity to suggest resort to the technical assistance of the regional adviser for social security in order to find a suitable solution to this question.