First Reading of the Draft Act on Amendments to the Health Insurance Act and Consequently Amendments to Other Acts (Prevention of Incapacity for Work) (Bill 377 SE)
Session: 15th Riigikogu, 3rd session, plenary session
Date: 2024-03-06 18:00
Participating Politicians:
Total Speeches: 37
Membership: 15
Agenda Duration: 42m
AI Summaries: 37/37 Speeches (100.0%)
Analysis: Structured Analysis
Politicians Speaking Time
Politicians
Analysis
Summary
The first reading of Draft Act 377, initiated by the Government of the Republic, concerning the amendment of the Health Insurance Act and related amendments to other acts (prevention of incapacity for work), took place in the Riigikogu. Minister of Health Riina Sikkut introduced the draft act, the main objective of which is to enable people on long-term sick leave (over 60 days) to continue partial employment in order to prevent permanent incapacity for work and withdrawal from the labor market. The scheme is voluntary and requires the consent of the employee, the employer, and the treating physician. In this case, the Health Insurance Fund would pay 50% of the benefit and the employer would pay 50% of the wages, ensuring the person receives their pre-illness income. The Minister noted that this measure should reduce the costs of the Health Insurance Fund by 6–7 million euros per year. In addition to preventing incapacity for work, the draft act extends the period for receiving the child care allowance to 60 calendar days for all severe childhood illnesses, and the supplementary medicinal products benefit scheme is automatically extended to medical devices. Õnne Pillak, Chairman of the Social Affairs Committee, confirmed the committee's support for the draft act, highlighting discussions regarding the start time of partial employment (the 61st day) and the need for cooperation between occupational health doctors and family doctors. Representatives of the parliamentary groups (Eesti 200, Social Democratic Party) supported the draft act, emphasizing its positive impact on people's subsistence and their ability to remain connected to the labor market.
Decisions Made 2
The first reading of Bill 377 was concluded.
The deadline for submitting amendments was set for March 20th at 5:15 PM.
Aseesimees Toomas Kivimägi
AI Summary
The Deputy Speaker announced that preparations would begin for the next item on the agenda, which is the first reading of Draft Bill 377, the Act on the Amendment of the Health Insurance Act and the Amendment of Other Acts Related Thereto (Prevention of Incapacity for Work), initiated by the Government of the Republic. He also announced that Minister of Health Stenbock would arrive shortly. To avoid confusion, there will be no recess, and the transfer of the chair to a good colleague will take place immediately.
Aseesimees Jüri Ratas
AI Summary
Chairman Jüri Ratas stated that they are currently addressing draft bill 377, will not delve into the substance of the matter, and stresses the separation of powers. He expressed pleasure regarding the arrival of Health Minister Riina Sikkut in the Riigikogu and requested the floor and composure.
Terviseminister Riina Sikkut
AI Summary
The amendments to the Health Insurance Act permit individuals to resume work with partial capacity or lighter duties after a two-month sick leave. In such cases, the employer and the Health Insurance Fund cover half of the salary, allowing the person to maintain their income and mitigate the risk of permanent incapacity for work. Concurrently, the care allowance is extended to up to 60 days, and a supplementary scheme for medicinal product reimbursement and medical device compensation is being added. Social tax exemption is also being expanded for temporary incapacity benefits. All these initiatives will be financed by European funds and the state budget and implemented via information days, training, and IT solutions aimed at improving collaboration.
Aseesimees Jüri Ratas
AI Summary
Jüri Ratas thanked the esteemed minister for the presentation and for being ready to answer questions, and then called upon Arvo Aller to speak.
Arvo Aller
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Arvo Aller stated that the draft bill is very reasonable and that the additional information is welcome. He emphasized the importance of involving general practitioners and occupational health specialists, as well as the usefulness of the two-day information sessions being held in four regions. He then asked whether these regions had been pre-selected and if employers were also welcome and included in these information events.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut said that information days have already taken place in Pärnu, and they are coming up in Tallinn. Ida-Virumaa and Southern Estonia are the regions where information days will still be held. Participation depends on the size and role of the organization (owner or CEO, HR specialist, or accountant), but the doors are open to everyone.
Aseesimees Jüri Ratas
AI Summary
Deputy Speaker Jüri Ratas asks Eero Merilind to come forward.
Eero Merilind
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Eero Merilind voiced his support for the draft legislation and inquired whether the supplementary reimbursement for medicines and medical devices would become more complicated or remain as straightforward as it is currently.
Terviseminister Riina Sikkut
AI Summary
Following the update, the same automatic compensation rules now apply to both medicines and medical devices: if the total co-payment paid during the year exceeds 100 euros, the Health Insurance Fund (Tervisekassa) covers 50% of the amount over that limit, and if that total reaches 300 euros, it covers 90%. This process works automatically and also applies to purchases of test strips and needles intended for people with diabetes, without the need to apply for separate reimbursement.
Aseesimees Jüri Ratas
AI Summary
The speech begins with a request to call Helmen Kütt.
Helmen Kütt
Profiling Sotsiaaldemokraatliku Erakonna fraktsioonAI Summary
Helmen Kütt thanks for the thorough overview and asks how a child’s severe condition is determined within the scope of the 60-day extension of the sickness benefit—is it diagnosis-based or condition-based, and who makes that decision (usually the treating physician), and does it depend on the diagnosis, as is currently the case with oncological diseases.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut stated that the current very strict limitation regarding oncological diseases will henceforth be extended to include all children's diagnoses, and neurological diseases will also be added; if a child’s health condition requires care and the doctor finds the care leave justified, the parent may take care leave for up to 60 days.
Aseesimees Jüri Ratas
AI Summary
Deputy Speaker Jüri Ratas invited Aleksei Jevgrafov to speak.
Aleksei Jevgrafov
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Aleksei Jevgrafov asks whether participation in the measure is voluntary and if people cannot be forced to join, as well as what the role and involvement of local authorities is, what kind of assistance is expected from city governments, and how to collaborate with them.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut emphasized that under the new scheme, people do not have to stay home for half a year, and if a doctor says that it is possible to work either remotely or do lighter duties in the office, they can continue working. Furthermore, the role of sharing information and offering assistance is extremely important for local governments.
Aseesimees Jüri Ratas
AI Summary
Deputy Speaker Jüri Ratas invited Rain Epler to take the floor.
Rain Epler
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Rain Epler thanked the chair of the session and the minister, and raised the possibility that the need for information days could decrease if the minister provided a comprehensive presentation and the information was shared via a specific channel. He also asked whether the figure presented for the Health Insurance Fund (Tervisekassa) represented a cost or a revenue, and what the exact amount was.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut stated that allowing people to continue working while on long-term sick leave could save the Health Insurance Fund 6–7 million euros annually, with a positive net impact of approximately 4.5–5 million euros. This saving would enable longer care periods for parents and fund an additional medicine reimbursement scheme. The key observations noted were a change in behavior and the significant benefit derived from information days, where large employers, doctors, and other interested parties could meet to discuss specific issues (including ethical questions, such as whether an employer is permitted to ask an employee to continue working).
Aseesimees Jüri Ratas
AI Summary
Deputy Speaker Jüri Ratas called upon Õnne Pillak to take the floor.
Õnne Pillak
Profiling Eesti Reformierakonna fraktsioonAI Summary
Õnne Pillak said that the partial sickness benefit is the core and a significant change in the draft bill, and that the extended care benefit now applies to all parents whose children are ill. She then asked if this truly doesn't depend on the diagnosis and whether, for instance, in the case of pneumonia, a parent would be able to stay home longer.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut stated that care leave is a medical decision that allows a parent to stay home during a child's period of illness, and a longer care allowance for parents of children with various diagnoses is something the Social Affairs Committee has been advocating for for a long time.
Aseesimees Jüri Ratas
AI Summary
Deputy Speaker Jüri Ratas invited Rain Epler to speak.
Rain Epler
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Rain Epler noted that, in addition to the soft effects, approximately 3–4 million has been financially projected for the Health Insurance Fund, and asked whether an analysis had been conducted regarding the impact of the darker sides of human nature, the system where the employer and the Health Insurance Fund share the salary when working while on sick leave, and the risk of potential salary optimization.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut said that the compensation for the wage difference will be paid after two months of sick leave, as most bone fractures heal precisely within this timeframe, and following a medical decision, the benefit will either continue or cease depending on the recovery; if the bone has fused and the cast has been removed, there is no basis for paying the compensation, but during monitoring, shifting the limits or allowing an earlier return to work will be considered, provided no fraudulent activity has been detected.
Aseesimees Jüri Ratas
AI Summary
Jüri Ratas invites Aleksei Yevgrafov to talk.
Aleksei Jevgrafov
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
He/She thanks the honorable minister and asks how many people will benefit from this bill.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut stated that the draft bill divides the income during illness between the employer and the state in such a way that if a person stays home due to illness, they will receive 70% of their previous income. If they continue working, the Health Insurance Fund (Tervisekassa) covers 50% of the previous income and the employer covers the remaining 50%. This structure should ensure an income level equal to the pre-illness period, and in the long run, this will help keep people in the labor market longer, accelerate recovery, improve mental health, and increase long-term earnings.
Aseesimees Jüri Ratas
AI Summary
Deputy Speaker Jüri Ratas addresses Helle-Moonika Helme and says, "Please."
Helle-Moonika Helme
Profiling Eesti Konservatiivse Rahvaerakonna fraktsioonAI Summary
Helle-Moonika Helme commends the minister for their courtesy and clarity, and proceeds to ask whether the tax revenues intended to cover the bill's associated costs are actually secured, and what steps will be taken if those revenues do not materialize due to an economic slowdown.
Terviseminister Riina Sikkut
AI Summary
Riina Sikkut noted that the supplementary medicine compensation scheme and the costs associated with the 60-day care leave might launch slower than anticipated because there are many parties involved and obstacles may arise in the flow of information. However, she added that the costs are small (up to about 1.5 million) and can be covered if necessary. She also emphasized the importance of awareness campaigns and information days so that employees, employers, and doctors can get answers and the scheme can be implemented as smoothly as possible.
Aseesimees Jüri Ratas
AI Summary
Jüri Ratas thanked the minister, stated that there were no questions, and handed the floor over to Õnne Pillak, the Chair of the Social Affairs Committee.
Õnne Pillak
Profiling Eesti Reformierakonna fraktsioonAI Summary
Õnne Pillak introduced a draft bill aimed at allowing the use of partial incapacity for work starting from the 61st day (not the first day), addressing cooperation between occupational health physicians and family doctors, and tackling issues related to financing and ex-post evaluation. The committee subsequently decided to send the draft bill to the plenary session for its first reading on March 6th, concluding the first reading with 7 votes in favor and 1 vote against.
Aseesimees Jüri Ratas
AI Summary
The Presiding Officer thanks the previous speaker, opens the debate, and invites Irja Lutsar, the representative of the Eesti 200 party faction, to the Riigikogu rostrum for her presentation. She requests additional time, specifically eight minutes.
Irja Lutsar
Profiling Eesti 200 fraktsioonAI Summary
Irja Lutsar emphasizes that the law is a step in the right direction because, starting from the 61st day of sick leave, an individual would have the option to work partially in consultation with their treating physician and receive partial pay from the employer. However, the final decision rests with the individual and the doctor's assessment, and the nature of modern work, including the possibilities of hybrid and remote work, must be taken into account. She cites a fractured leg as an example, where continuing work with a partial workload could be beneficial to both the employee and the employer and would help prevent the impoverishment often associated with long-term illness. Crucially, the decision must always be based on the individual's wishes and the treating physician's professional judgment.
Aseesimees Jüri Ratas
AI Summary
Ratas offers his thanks and invites Helmen Kütt, the representative of the Social Democratic Party faction, to the Riigikogu podium.
Helmen Kütt
Profiling Sotsiaaldemokraatliku Erakonna fraktsioonAI Summary
Helmen Kütt stated that the Social Democrats welcome the fact that the draft bill allows working while on sick leave under adapted conditions and via remote work, expands the care benefit to caregivers of all children in serious condition, and adds supplementary compensation for medicines and medical devices starting January 1, 2025, urging the Riigikogu to adopt this law unanimously and quickly.
Aseesimees Jüri Ratas
AI Summary
Deputy Speaker Jüri Ratas announced that negotiations have concluded. The lead committee recommends concluding the first reading of Draft Act 377 SE. The deadline for submitting amendments is March 20th at 5:15 p.m., and the first reading, along with the consideration of the eighth item on the agenda, has been concluded.