The former president of the ANJE, the National Association of Young Entrepreneurs, Marisol Vicens Bello gives El Caribe readers an insight into the Dominican Institute for Social Security (IDSS). Currently, the IDSS is fighting to increase the maximum salary for workers covered under the IDSS provisions. At the present time the maximum is a little over RD$4000, and the IDSS wants to have it raised to RD$8,883. This would mean that all workers earning less would have to become part of the IDSS medical scheme. According to Vicens Bello, advocates of this measure seem to think that the increased cash flow would cure the ills affecting the system. Vicens Bello says that these people forget that the IDSS’s real problem is not financial, but a question of very poor management. Responding to criticism that the maximum salary has not been increased since 1997, the lawyer points out that the Social Security Law went into effect in 2001. This resulted in a steep increase in employer contributions to the system as well as a complete reform of the IDSS itself. The latter has not happened because of a lack of political will. The IDSS problem is not a new one, and the restructuring of the system has been discussed by the governing board for years. In particular, the representatives of the employers have presented proposals for the reduction of the huge amount of superfluous employees and the improvement of the services offered. These steps would make the IDSS system competitive within the health services marketplace. As Vicens Bello sees things, this has created a “This or That” situation: the difficult but necessary decisions are not taken, either because nobody wants to take on the political cost, or affect certain interests. Therefore, they have chosen to defend the indefensible, or increase the contributions to the system. In a short time, any increase will be exhausted and new demands will be made. Marisol Vicens asks her readers in the El Caribe, is it not time to look at the real causes of the problem and face up to them? The key issue is that the Social Security Law includes a proviso, article 168, that requires a government subsidy for the IDSS system as the transition takes place and a “more efficient, productive and sustainable” entity is created. And the article speaks of a five-year time frame. The essay rejects further make-shift solutions for the IDSS, since the proposed increase in funding or any other step will not fix the problems of quality and sustainability of the IDSS.
In response to this position and the attitude shown by the employers and their representatives on the IDSS board, Vice-President Rafael Alburquerque called for renewed dialogue to discuss the issues. He defended the increase in the maximum salary, pointing out that the system’s monthly deficit was over RD$50 million. Both Alburquerque and the IDSS chief of Worker’s Health and Risks, Dr. Bernardo Defillo, said it would be impossible for workers to receive adequate treatments at current income levels.