The Superintendent of Health and Occupational Risks, Miguel Ceara Hattonstated that the recent decision of the National Social Security Council (CNSS) to approve the proposal for a differentiated capita by age and sex for the Contributory Regime represents a transcendental step towards sustainability and equity of the Dominican Social Security System (SDSS).
Ceara Hatton pointed out that this provision It does not affect members or imply changes in medical care and much less on the contributions of the insured, but rather seeks a fairer redistribution of the economic allocation received by the Health Risk Administrators (ARS) within the system.
He explained during an interview on the morning program El Despertador that the measure consists of allocating a greater amount of resources to the ARS that have a population affiliated with advanced age or women in the reproductive stage that require more medical attention, compared to ARS that concentrate a portfolio of young and male users who demand less health services, eliminating discriminatory barriers in the affiliation processes.
“Health services will not change nor will the member pay more. What changes is the way in which the State distributes resources to the ARSdepending on the consumption of the affiliate structure you have. For example, a 20-year-old young person practically does not consume medical services, but a person between 50 and 64 years old consumes 41% more than the per capita value,” the superintendent explained.
He highlighted that, with the new distribution schemethe funds will adjust to that reality in a fair manner, guaranteeing equitable distribution and ensuring the financial sustainability of the system.
The superintendent warned that the country faces an accelerated process of population agingwhich will increase the demand for health services in the coming years.
“In the Dominican Republic is aging very fast. If we do not adjust the distribution of resources now, the system will become unsustainable. “This change ensures that funds are used where they are truly needed,” he said.
Fairness instead of distortion
Ceara Hatton pointed out that the previous model (a per capita of 1,683.22 pesos the same for all ARS) generated distortions that affected the stability of the systemsince the ARS with the greatest number of older adults registered an increase in the levels of consumption of health services, while others benefited from concentrating young members with low consumption.
“Over the years a distortion was generated that has had a very high cost. No system can work if all resources are concentrated on a 20-year-old population,” he said.
He recalled that Law 87-01, which creates the SDSS, contemplates the implementation of a differentiated per capita. Furthermore, the technical and actuarial studies to support the measure were carried out with data updated until 2024.
“We did the studies, calculations and projections with all the information available. We heard from all the actors and ARS in public hearings and in work meetings on this issue, that the law establishes it and it was necessary to apply it to protect the financial balance of the system,” explained Ceara Hatton.
“Don’t fall for it”
Ceara Hatton said that some ARS maintained irregular practices to attract young members through deception or false promises.
Faced with this situation, the Superintendency of Health and Occupational Risks (Sisalril) undertook a targeting campaign to alert citizens called “Don’t fall for the hook.”
