"....The Constitution of the
Principality of Andorra recognizes the right to protection under a
State-guaranteed social security system.
The health system is mixed: it is
based on the social security system and consists of all facilities
and services relating to hygiene, public health and individual and
collective health care - these fall directly under the general
administration and are placed under its management. The funding and
the supply of services are mixed in the sense that the users
participate in the financing, and both independent professionals and
publicly employed professionals and public and private institutions
provide services in public and private establishments.
The health-care and hygiene
functions are assigned between the general administration and the
management bodies as follows:
(a) The Government is responsible
for developing and programming all health sectors and for
implementation in regard to public health and hygiene;
(b) The Caixa Andorrrana de
Seguritat Social (CASS) is responsible for collecting insured
persons' contributions and financing the health services used by beneficiaries;
(c)The Andorran Health Care Service
(SAAS) is responsible for running government-funded health services,
in addition to its duties as stipulated in the law creating SAAS.
Accordingly, the health system in
Andorra is run by the State and falls under the regulatory authority
of the Government, which guarantees the system so that all citizens
enjoy the best possible health facilities.
Membership in CASS
Membership in CASS is compulsory
for all wage earners. Other persons may become voluntary members.
Disabled persons may obtain health insurance through a disability
pension, and elderly persons not in receipt of other pensions may
obtain a non-contributory old age pension. These are granted and
financed by the Government, which pays the contributions to CASS in
proportion to the number of retirees. Approximately 80 per cent of
the population is now covered by insurance.
The sickness scheme is administered
by CASS as a single system, without any distinction between the
various groups of insured persons, regardless of occupation or type
of membership. The sickness scheme must ensure a financial balance
between revenue, exclusively from contributions, and payments for
health services and other benefits. Employers and workers contribute
a specific percentage of salary (10 per cent in 1998, i.e. 7 per cent
by the employer and 3 per cent by the wage earner). Voluntary
contributors pay CASS 10 per cent of their average declared salary.
The contribution for retirees is 3 per cent of their pension.
Health services are not provided
directly by the social security system. The system engages
professionals or institutions through general or special agreements.
In addition, the State has concluded or is in the process of
concluding international social security agreements with Spain,
France and Portugal. The sickness scheme plays an important role in
financing health care, but it covers only about a quarter of health
service expenditures. For this reason, many people need supplementary
insurance with private companies.
Supply of services
Services are supplied by
dispensaries and, in the case of hospitalization, by professionals at
public and private centres. All the professions involved are
regulated and may be exercised under the public or private system.
The private system is termed "liberal practice", and
comprises independent professionals. They can, as appropriate, work
in public establishments, such as hospitals. It may therefore be said
that the supply of health services is mixed, i.e. both public and
private.
Andorran Health Care Service (SAAS)
SAAS is a semi-public body
established under the General Health Act; it was created on 23
December 1986 by agreement with the Consell General. Its task is to
manage and administer all public health resources - human, material
and financial - both in the hospital and primary-care sectors.
The responsibilities of SAAS in the
health system are to develop and implement health promotion
activities and programmes....."
Updated: 20/11/02
Keywords: HEALTHCARE, SYSTEM,
HEALTH, ANDORRA
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