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Disabilities for work are becoming increasingly important in our country. Policy in this area needs to be thoroughly reviewed
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The figures make you dizzy: we estimate nearly half a million the number of people who will, at the end of 2021, be unable to work for more than a year, that is to say under the status of disabled.
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The number of disabled people in Belgium increased by more than 71% between 2010 and 2020, and they are now 1.5 times more numerous than the unemployed. In terms of public expenditure, 12% of the overall social security budget, or nearly 9 billion euros, is now devoted to incapacity for work.
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The numbers are known; the reasons too. Let us quote in particular the communicating vessels between the various branches of social security, the reduction in the number of unemployed people having led to an increase in the number of disabled people; the aging of the working population; the raising of the pension age for the female public; the growth in the number of patients and the duration of incapacity linked to their illness, etc.
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Act upstream
That the system of incapacity for work has become a societal “bomb” is a fact recognized by all experts; the main thing now is to speak in terms of “solutions”.
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It is no longer tolerable that, apart from the health crisis, Belgium limits itself to investing the equivalent of 2.1% of its resources in health care, while the European average stands at 3%.
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A first solution is undoubtedly toact upstream: prevention and health promotion remain a necessity, not only in speeches, but also in actions. In this area, it is no longer tolerable that, apart from the health crisis, Belgium and its federated entities limit themselves to investments equivalent to 2.1% of the resources allocated to health care, while the European average stands at 3%. We underline: we speak of “investments” and not of “expenses”, each euro invested in prevention can bring in 4.
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Reintegration path to review
A second solution is to reform the very system of incapacity for work. In truth, this system was revisited less than 5 years ago, but without consultation and without extensive reflection on its implementation. Result: the project, initially attractive on paper, turned out to be complex in practice. Reintegration routes have proven to be inflexible; their formalization led to additional administrative procedures for the holder, the employer and the doctors concerned; in many cases, reinstatement delays have lengthened.
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However, at a time when professional and medical careers differ from one person to another, it is necessary to make the system more agile, more flexible, so that it can simultaneously take into account the needs related to recovery and the possibilities of returning to work. While the rest necessary for remission should not be neglected, the suffering and difficulties that may be caused by stopping professional activity should not be overlooked either.
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Strengthening the pool of medical advisers would be relevant, since there are only 260 for a disabled population of over 500,000 people.
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To make this system more agile and more efficient, the authorities are considering the recruitment of “return to work coordinators” in the offices of medical consultants. While the idea is excellent in principle, it will be necessary to ensure that these new actors will be able to act on the one hand without excessive formalism, and on the other hand in good understanding with the other professionals concerned. In this regard, strengthening the pool of medical advisers would be relevant, since there are only 260 for a disabled population of over 500,000 people. In addition, new tools could bring significant added value, such as a digital communication platform allowing the instantaneous exchange of information between the many players concerned, while ensuring compliance with GDPR legislation.
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Simplify the calculation of indemnities
A third solution consists in reviewing and simplifying the calculation of indemnities. The level of these should be between the at-risk-of-poverty threshold and the minimum wage, so that the incapacitated person benefits from the means necessary for his subsistence and his recovery, but that he is encouraged to return to employment after having regained sufficient and medically certified capacities.
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In the specific case of resuming part-time work, the accumulation of benefits and income should be lower than the original full-time salary in order to reduce the possible “employment trap”.
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©doc
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Prevention, flexibility of reintegration routes and revision of the calculation of indemnities: the Free Mutualities are calling, not for expenditure, but for investment in work incapacity policies. Changing the situation will not happen without investing in prevention and well-being at work, without strengthening the workforce to support people with incapacity for work and without reviewing the compensation scales. Changing the situation involves perceiving that each euro well invested will facilitate the return of people (sufficiently) healed in a healthy professional environment. Changing the situation involves remembering that investing in incapacity for work means, in the long run, curb the growth of spending in this sector, promote a return to employment and therefore increase State revenues through social contributions. To change the situation, it is finally to have a global political vision, within the framework of the reform of the incapacity for work, but also of that, to come, of pensions and end of career.
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This would be a healthy and sustainable public policy, guaranteeing at the same time the good management of public funds and the maximization of the well-being of the citizens.
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Through Xavier Brenez, Managing Director of Mutualités Libres
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