Observation (CEACR) - adopted 2019, published 109th ILC session (2021)

Chile

Sickness Insurance (Industry) Convention, 1927 (No. 24) (Ratification: 1931)
Sickness Insurance (Agriculture) Convention, 1927 (No. 25) (Ratification: 1931)

In order to provide a comprehensive view of the issues relating to the application of the ratified Conventions on social security, the Committee considers it appropriate to examine Conventions Nos 24 (sickness insurance, industry) and 25 (sickness insurance, agriculture) together.

Article 7(1) of the Conventions. Contribution to the establishment of the sickness insurance fund. With regard to its previous comments, the Committee notes from the Government’s report that, in accordance with sections 158 and 184 and following. of Legislative Decree No. 1 of 2006, the public health system and the private health scheme are financed with a 7 per cent contribution from workers’ pay or income, besides additional contributions by workers in the private scheme. The Committee notes that the State contributes to both schemes in certain circumstances. One of the circumstances in which the State shall contribute is established by Act No. 20850 of 2015, which envisages a financial protection system for high cost diagnoses and treatment. Another circumstance is provided for by Act No. 21010 of 2017, which has created a fund to finance the Insurance to Support Children (SANNA), which benefits working parents of children under the ages of 15 or 18 years with serious health conditions. In addition, the Committee notes that the SANNA also receives the monthly contributions paid by the employer or the self-employed worker, the amount of which is 0.03 per cent of taxable income. While noting the employers’ contribution to the establishment of the sickness insurance fund in respect of compensation to support children with serious health conditions, the Committee observes that the sickness insurance, which includes medical care and sickness benefits, is mainly financed by insured persons, with the State’s participation in certain circumstances. In this regard, the Committee recalls the importance of fulfilling the basic principle provided for in Article 7(1) of the Conventions, under which workers and employers shall share in providing the financial resources of the sickness insurance fund. The Committee requests the Government, in consultation with the social partners, to ensure the full application of the principle provided for in these Articles of the Conventions and to provide information in this respect.

The Committee has been informed that, based on the recommendations of the Standards Review Mechanism Tripartite Working Group (SRM tripartite working group), the Governing Body decided that member States for which Conventions Nos 24 and 25 are in force should be encouraged to ratify the more recent Medical Care and Sickness Benefits Convention, 1969 (No. 130), or the Social Security (Minimum Standards) Convention, 1952 (No. 102), accepting Parts II and III (see GB.328/LILS/2/1). Conventions Nos 130 and 102 reflect the more modern approach to medical care and sickness benefits. The Committee therefore encourages the Government to follow up the Governing Body decision at its 328th Session (October–November 2016) approving the recommendations of the SRM tripartite working group and to consider ratifying Convention No. 130 or No. 102 (Parts II and III), as the most up-to-date instruments in this subject area. The Committee reminds the Government of the possibility to avail itself of the technical assistance of the Office in this regard.