JSIS: act to preserve solidarity !

JSIS, Special Report
Joint Sickness Insurance Scheme

Solidarity scheme

The JSIS is a solidarity scheme and must remain so:

Everyone contributes according to their means (percentage of income);
Everyone is served according to their needs;
The employer bears 2/3 of the cost.

It is essential to preserve these characteristics. The resulting solidarity has three dimensions:

  • high wages with low wages;
  • young people with the old;
  • members with dependants with single people.

Trends in the scheme

The population covered by the scheme is growing steadily, currently at an annual rate of 3.5%. In 8 years, population growth has reached almost 60%. The average age of members has been increasing since 2009, most recently by six months a year. It is now 50.6 years old. Plan expenditure is developing in a very normal way, keeping pace with population and prices. The scheme’s revenues are growing at a slower rate than the population, even in nominal terms. The wage freeze since 2009 is responsible for this. This produces a sustainable operating deficit. The real rate of reimbursement – the ratio between total benefits under the scheme and the costs actually incurred by beneficiaries – is declining. Prices actually paid increasingly exceed the scheme ceilings, which have remained unchanged since 2008. This undermines the solidarity principles of the scheme and puts an increasing proportion of the costs on the backs of staff, to the benefit of employers. BLs are under-staffed. In order to maintain a constant quality of services, this staff should grow in proportion to the number of beneficiaries. However, it is constant and will be decreasing (5% cut in staff).

The result of these trends is an underfunding of the scheme. For the time being, it is still limited and is likely to increase rapidly. The BLs are reacting by tightening the screw, on the fringes of the regulations: Refusal of reimbursements under various pretexts (e.g. lack of tax receipts), refusal of psychological treatment, refusal to recognise serious illnesses, cuts in preventive medicine, etc.


The average age will continue to grow. This increase will be further amplified by the non-replacement of retiring workers as part of the reduction in 5 %. As a result, spending per affiliate will increase faster than inflation. The continuous wage freeze – 2013, 2014 – will amplify the annual deficit, which is unrecoverable without changing the parameters of the system.

In the medium term, the reduction in the average speed of promotions (freezes in AST9, AD12; reduced speed of the AST/SC career) will widen the deficit. The average contribution of members will tend to decrease: The average salary of secretaries and clerks will be much lower; recruitment in AST3 will be replaced by AST1; future pensions will be 25% lower than at present.

USF’s political orientation

The only way to rebalance the finances of the scheme that respects the basic principles (solidarity scheme) is to increase contributions. The Staff Regulations allow an increase of up to 2 + 4%, to be fixed by the heads of administration in the Common Regulations. This would give about €50 million more per year to the scheme. The €30 million or so per year that would fall on the Community budget is a negligible amount compared to the billions of savings made by the 2014 reform. It would also provide the margins needed to correct the current bad reimbursement practices. All in all, the JSIS would still be incomparably cheap compared to any national social security fund. The number of BL staff should increase in proportion to the number of beneficiaries. The ceilings must be increased by 10% and then indexed annually. The arbitrary restrictions implemented by the BLs must cease. In particular, there must be a return to a humane definition of serious illness: All vital treatment must be reimbursed at 100%.

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