Panel 3: Social security and Health Ladies and gentlemen, chair, moderator, My name is Kasia Jurczak and I am a Policy Analyst at the European Commission's Directorate General for Employment, Social Affairs and Inclusion in Brussels. It is my great pleasure to participate in this panel on social security and health. In this presentation I would like to share with you the policy approach to social protection and social policy more widely that the European Commission is promoting. In this short presentation I intend to give you an introduction to the social investment approach. I will first explain why the social investment approach, secondly what it consists of, especially in the context of long term care and health issues and lastly I will show how it links to human rights issues; Why a social investment approach As the distinguished speakers from all regions of the world reported yesterday, populations are ageing at the unprecedented phase. In Europe, we are experiencing not only demographic ageing but also shrinking financial resources due to economic crisis. It means that per capita we have lower resources, and perhaps challenges are greater. Greater demand for long ‐ term care and health care services, question of pensions sustainability, less younger people to pay into the pensions to contribute to the pension schemes who also have more difficulties in finding a job. 1
There will be a huge gap between the LTC needs and the ability of social protection systems to meet them. What it leaves us with is do more with less in order to maintain access to high quality care, which are the objective of the EU's social protection policy. The European Commission launched the Social Investment Package in February this year. It provides the guides to the Member States on how to adapt the social models to adapt their social models to the challenges resulting from demographic ageing and budgetary pressure on social policies with the view of maintaining accessible, quality and adequate but also sustainable social protection. Let me just highlight here that the way social protection systems are financed and organised is a competence of EU member states but the challenges are similar and social investment can be a way to effectively address it in the medium to long ‐ term perspective. Social investment is a policy framework that enables people to remain active and healthy and to live independent lives for longer. Simply speaking, the main aim of the social investment is to prepare people to manage life's risks rather than "repairing" the consequences of these risks. It focuses on investing early to prevent hardship and from compounding later in life. However, the social investment package does acknowledge the crucial role of social protection as provider of a safety net for those in need. 2
Within this approach we also advocate not to focus on vulnerable groups, but rather people in vulnerable situations over their life ‐ course. The social investment approach advocates supporting individuals in various stages of life – in childhood, during adolescence, when making transition from school to work, in parenthood, as the end of career approaches, and in retirement and old age. Let me give you a few examples. Social investment in health Investing in health means investing in health systems, investing in people's health, and investing in reducing inequalities in health. Here an important part is health promotion and disease prevention and extending healthy life expectancy. Although the life expectancy has gone up, how much of this life is not always spent in good health. Social investment in long term care In the area of long ‐ term care, in line with the social investment approach we need to prevent or delay the need of long term care. It is based on 3 pillars: 3
1. Prevention and rehabilitation, including promotion of health and active ageing strategies; fall prevention; quick rehabilitation; 2. Empowering people to manage with functional limitations 3. Promoting independent living through the use of new technologies and home adaptations – age friendly environments; Human rights issues: privacy, autonomy may arise; Link to human rights Although we speak of investment from the socio ‐ economic perspective, I will show how concern for promotion and protection of human rights is at the core of the social investment approach. Social investment approach puts emphasis of empowerment of older people, holders of rights, who are empowered and enabled to take their lives in control. It puts emphasis on enabling people to live independently for as long as possible a healthy and dignified life. Accessibility, assistive devices, personal assistance are at the heart of this approach regarding long ‐ term care. 4
Shifting resources to where they are most needed, focus on long ‐ term care 24/7 live ‐ > this is an area where grave human rights abuses can take place; Role of carers The social investment approach recognises the important role of informal carers. Data from Europe shows that 80% of care is provided by family members. Model in which we rely on family care is no longer possible (shrinking number of people of old age) and it may also not be desirable for many older people. As for the informal carers, recognise their rights as well. As already mentioned in the ILO intervention yesterday, informal carers, who are often women, pay high price in terms of their own employment, foregone income. But as the working age population is shrinking and the number of informal carers will shrink as well. Social investment approach puts focus on professionalization of care – recognising the value of care, paying decent wage to the carers. Give older people choice of providers, but also for this choice to be real. Productivity increases in health and personal social services, connected to use of modern technologies. 5
Elder abuse This brings me to my next point on elder abuse, which most often occurs in informal settings. Recent conference with OHCHR on preventing elder abuse. Mainstreaming of human rights into delivery of social policy; How to operationalize human rights – make them a reality on the ground . It may seem that we speak different languages, the objectives are the same: adequate pensions, accessible environments, access to quality care; To ensure that until the very end of their lives people live in dignity, their voice is heard and their wishes respected, regardless of their health status or economic background. Work together across sectors, in a joint ‐ up governance way; (horizontal and vertical). Monitoring of quality of care, often only possible in public institutions. Cross ‐ cutting issues When addressing the issue of ageing, we cannot forget about the inter ‐ generational perspective. Inter ‐ generational perspective: addressing the ageing question in a way that does not create an inter ‐ generational conflict. Playing the devil's advocate – why do we focus so much on older people's issues if there is a crisis of young people. 6
In Europe, 1 in 4 and in some countries almost half younger people cannot find a job, education or training. In some countries it is almost 50%. Young people of today are older people of tomorrow that need to be equipped how to deal with life's challenges. This is very important for the sustainability of the social protection systems and pensions in particular. Intra ‐ generational perspective: how the experience of ageing differs between men and women, people of various ethnicities, sexual orientation, religion or belief or disability. While we reflect on these health or long ‐ term care services and innovate the way they are delivered, we need to take into account a variety of individual experiences of ageing. Use the UPR process to bring the visibility to older persons rights. Invitation to the side ‐ event Lastly, ageing is a challenge but it is also an opportunity that can be seized. This is an idea behind the European Year for Active Ageing which was run in the EU in 2012. Combatting negative sterotypes and highlight the potential and contribution older people make. This is why, I would also like to take this opportunity to invite you to our side event, which will take place tomorrow at lunchtime. The event looks at "mobilising stakeholders" in which we will hear examples from the European Year 2012, involving our partners 7
AGE Platform Europe who led the NGO coalition, presenting Active Ageing Index – how to track progress on the commitments made and also to compare the approach to ageing between Europe and Canada – learn from our colleagues there. We will have lots of time for discussion and I would like to sincerely invite you to this interactive side ‐ event. Highlight the need to address these issues through a multi ‐ stakeholder approach with public authorities at all levels; especially at the local level by creating environments that enable and empower older people to live healthy and independent lives. Ladies and gentlemen, Thank you for your attention. 8
Side event • Give floor to the Lithuania, who now holds the rotating Presidency of the Council of the EU; expert will share ‐ > biographies; ‐ > Jelena to meet tomorrow; 6pm ‐ > Chinese speaker 9
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