Vybrané problémy nemocenského zabezpečení

The study deals with selected basic health security questions. Health security is one of the social security fundamental organisational legal systems. Social security is not a codified branch of the law and the health security sphere is regulated by separate legislations (in the main independent of the other social security organisational legal systems). Health security is at present practically the only and last part of social security not regulated by uniform statute for the working population as a whole. Thus, the health security ruling is split in several separate statutes with their own implementing regulations governing the rights of the various groups of the working population separately. Unification of the regulations in a uniform working people’s health security statute is, therefore, one of the most pressing tasks of the social security legislation. However, in connection therewith considered and resolved would have to be obviously the existing differences between the various health security systems from the substantive, procedural and organisational aspects, including the provision of resources and financing of the health security funds. From the aspect of the overall system of health security allowances, of its complexity and compactness, despite the fact that the health security system of benefits had been in the past 30 years complemented by a single allowance – the pregnancy and maternity compensation contribution – it would appear that the existing system does not need to be extended by additional allowances. Future developments will concern, in my opinion, improvements in the existing system of benefits rather than its extension. To the contrary, the question may arise, whether some of the allowances should not be left out of the health security system. Among the conditions of the right to children allowances are, pursuant to Section 17, Par. 1 of the Act on the extension of maternity leave, on maternity allowances and on children allowances from the health insurance No. 88/1968 Coll., also that a worker shall have in his employment the prescribed hours of duty and that he had in the calender month worked the fixed time. Such conditions, mainly the condition of the time worked, have no connection with the purpose of the benefit and the health insurance substitutes in this instance functions otherwise appertaining to labour law. At the present development stage of this country’s society may arise the question, whether these conditions had not been surpassed. If one were to go further in these considerations, the question could be asked de lege ferenda, whether children allowances should in future be (generally) regulated as health insurance benefits or whether they could not be left out of the system. Children allowances could then be granted as state contribution and be subject to compliance with the condition that the citizen has not provided for children. Similar considerations apply to the allowance granted on the occasion of a child’s birth and to funeral charges relief. In the proposed conception would as health security benefits be retained money allowances replacing wages, i.e. sickness benefit, sick family member attendance relief, pregnancy and maternity compensation contribution, maternity money relief and health resort (spa) cure only. Other money allowances, i.e. children allowances, child birth relief and funeral charges relief could be governed by a separate statute or such benefits could be rather provided by a single statute together with the maternity statute, i.e. in a statute governing state contribution grants. Capacity to exercise rights and to discharge duties, legal capacity, capacity to sue and to be sued and capacity to commit lawless acts are not regulated by the health security, the same as by the whole social security law. In my opinion de lege ferenda should these fundamental questions be enacted in the health security statute. Limitation (negative prescription) ruling in health security is also one of the questions of principle to be considered de lege ferenda. In my opinion substantive changes would be in the future required by the regulation of terms, by which overpayments are recoverable from the working population or recipients of money benefits. The existing 10 years objective term appears to be inadequately long, moreover subjective term is unknown to the existing regulations. Adequate in my opinion would appear one year subjective and three years objective term of limitation with the proviso that for overpayments intentionally caused would be right to retain the 10 years objective term of limitation. Despite a continuing unification and substantive bringing together of health security ruling on the various categories of the working population, some differences in the conditions of origin of the right to benefits as well as in the facts affecting their amount of remain. Such differences are understood as differentiation in health security. A uniform working people’s health security statute should restrict health security differentiations, but could not eliminate them entirely. Some differentiations are justified with a view to the character of the work performed (e.g. jobbing workers), to the workplace (home workers) etc. Preference is on the other hand a narrower term than differentiation, in health security understood as advantaging certain groups of the working population, performing some difficult or risky work in a preferred branch of the national economy, in respect of the character of social events or of living conditions. In my opinion most debatable is the advantage granted to certain categories of the working population. In health security preference is applicable to workers with permanent workplace in underground mines, in open-cast mines and in overburden removal, such preference consisting in crediting higher daily net wage (180 Czechoslovak Crowns compared to 150 daily net wage in a five days working week generally credited) for the fixing health security money allowances replacing wages. The advantageous ruling applies also to professional members of the armed services who, in the first month of disablement, are entitled to their emoluments instead to sickness benefits. To my mind it is debatable, whether it would be fitting in future to transmit preferences, perfectly justified mainly in the sphere of wages, to the health security system. I think that the very unity is a virtue of the socialist health security system and in the interest of the unity preferences should be applied with particular care and only wherever it is fully justified and indispensable, so that their excessive application would not impair the social security unity. I consider that removed gradually from the health security system should be even the existing preferences, because they are not enough justified from the theoretical aspect.