Economic security in case of illness and disability

Clara Aranda (SD)

Madam Speaker! Today we are debating expenditure area 10 Economic security in case of illness and disability, and I would first and foremost like to take the opportunity to move for the approval of the committee's proposal.

Let me begin with what the committee also notes, namely that women's sick leave due to mental ill health is still high compared to how it looks for men. Psychiatric diagnoses in turn involve a clearly higher duration than other diagnoses, that is to say, longer periods of illness.

The continued high rate of sick leave among women due to psychiatric diagnoses is an important issue, and we need to work for measures aimed at preventing the occurrence of illness. At the same time, we need to work specifically on shortening sick leave with the help of an effective and accurate rehabilitation.

It is also important to create incentives for returning to work. And this is fundamentally about whether we have the right tools and the right knowledge and the opportunity to use these in a purposeful way.

Behind the high sickness rates, there is great human suffering and high costs for society. The costs for lost work due to sick leave amounted to, for example, 71 billion kronor for 2022.

When it comes to the total societal cost of mental ill-health, we have been able to see a gradual increase in Sweden over time, from 29.2 billion kronor in 2015 to 32.6 billion kronor during 2022. There are therefore good human but also socio-economic arguments for prioritizing the development work to strengthen mental health in society. And it is a very pressing issue when it comes to managing the high prevalence of sick leave due to psychiatric diagnoses.

Madam Speaker! The issue of mental health cannot be limited to a single area. It requires an overarching effort where we take a long-term holistic approach.

For this reason, I am also very pleased with the fact that the Sweden Democrats, together with the government, have chosen to work both strategically and long-term with mental health and suicide prevention.

In order to prioritize mental health and find a common direction, a new national strategy for mental health and suicide prevention has been developed. This strategy is intended to function as a common platform for the entire society's work in the area for a period of ten years. The new strategy is broader than previous initiatives in the area and will take a much-needed cross-sectoral holistic approach, while a larger health-promoting and preventive perspective is well-integrated into the strategy.

The question of a long-term national strategy is something that the Sverigedemokraterna have actively pushed during the last parliamentary term, an issue that was negotiated into the Tidö Agreement and which is now becoming a reality.

Trying to find quick solutions that yield short-term results has never been something that our party has strived for. Our will has always been to move away from the driven quarterly politics, especially within the area of mental health where initiatives are often dismantled and the appropriations are changed. We do not believe that is particularly sustainable if the goal is to change something fundamentally.

The goal of a lower sickness absence due to psychiatric diagnoses requires the cross-sectoral holistic approach that the Sweden Democrats, together with the government, are now taking. And it is an important step to manage the high prevalence of sickness absence in precisely psychiatric diagnoses.

Madam Speaker! The sickness insurance shall provide financial security to those who are ill and who cannot work. Basic security is something that the Sweden Democrats value and defend. With that said, we do not want a regulatory framework that contributes to lock-in effects that can lead to unnecessarily many and unnecessarily long sick leaves. Therefore, it is also important that we value rehabilitation and set clear requirements for all involved actors.

We also need to ensure that every tax krona is handled in a responsible manner. The Sweden Democrats and the government are therefore working with force to stop welfare crime. On January 1, for example, the important operations of the new payment authority will commence.

We also ensure that the Swedish welfare shall go to those who contribute to our country and who pay tax, while at the same time we counteract benefit dependency and exclusion. There must be incentives to create one's own livelihood, and therefore it must also always pay to work.

Madam Speaker! There is currently a great deal being prepared and handled within this important area. The Sweden Democrats will work to develop our policy in the area and at the same time push forward to ensure a secure and humane health insurance. There is very much left to do, and our important work continues.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Jessica Rodén (S)

Madam Speaker! I should have started working again after the holidays, but the panic anxiety attacks followed one another and took over everything. I was totally stressed out, and even though I realized that I needed to take sick leave, I felt like a bad employee when I did. It felt like I was betraying. But it was society and our so-called welfare that would bear the greatest betrayal.

These words come from Mari, who has written about her experience on the website 116omdagen.

Sickness insurance is a central part of the welfare state and constitutes an important social contract between society and the individual. The insurance shall provide security in the event of loss of income or when one lacks capacity to work.

For me as a Social Democrat, a secure and solidary society is of fundamental value. It is through a robust health insurance that we show that no one is left behind when facing illness or disability and that we jointly take responsibility and bear the burden together.

Illness can affect anyone at any time. Having a strong sickness insurance is not only a guarantee of financial security for the individual, but it is also an expression of our collective sense of responsibility. An improved sickness insurance is an investment in strengthening our social safety net and giving people the opportunity to focus on recovery instead of on financial worries in difficult times.

During the previous parliamentary term, several important changes were implemented to strengthen the sickness insurance. The purpose was to increase the economic security and flexibility in the insurance, but also to increase the understanding of the regulatory framework. And today, more people are able to retain their sickness benefit to complete care and rehabilitation, and that is good.

Madam Speaker! Politics is about will. And we Social Democrats want the work of strengthening the sickness insurance to continue. We believe an important step is to let the same labor market concepts apply to the sickness and activity allowance as for the sickness benefit.

According to the report *A Sickness Insurance with Prevention, Rehabilitation and Security*, the introduction of the same labor market concept would reduce the risk of people remaining in the sickness benefit system despite there being no further measures to take to improve these individuals' work capacity.

According to today's rules, work capacity shall be assessed against gainful employment on the labor market. This includes adapted jobs and wage subsidies. But no assessment is made as to whether such a job actually exists. One is therefore to be assessed against an imagined job that is specially adapted and which one thinks should be able to exist, and not against what actually exists.

Both LO and TCO argue that the requirements for receiving sickness benefits are all too high and that a changed concept of the labor market would be a step in the right direction.

Madam Speaker! There is one thing that surprises me. The Sweden Democrats, who have a great influence on the government, seem to have forgotten what they said here in the spring. At that time, they stood in this rostrum and said exactly what I cited, that the right to sickness and activity compensation shall be tested against the same labor market concept as the sickness benefit. But these words were apparently worth nothing.

The economic security for individuals with sickness and activity compensation must be strengthened. We Social Democrats believe that it is urgent to review the indexing of the guarantee compensation. The current model, where the guarantee level is linked to the price base amount, causes income inequalities in society to increase. The Inspectorate for Social Insurance states that the income development in households lacking connection to the labor market and primarily supporting themselves on guarantee compensations has fallen behind the average income development. Increased income gaps lead to an increase in relative poverty.

In the report From risk factors to health factors, which TCO has written, it appears that mental ill-health is the most common cause of sick leave within all of TCO's sectors. As risk factors, they mention high workload, lack of influence over the work, sleep difficulties, and lack of support from their manager.

Kommunal also testifies that stress-related issues are causes of long-term sick leave within the female-dominated occupations. Risk factors that Kommunal, like TCO, highlight are a lack of influence but also understaffing, which leads to psychological pressure and a feeling of inadequacy.

Sickness absence is higher among women than among men, and it is higher for workers than for white-collar workers. Women are overrepresented in occupations with high demands and low influence over working hours and how the work is to be performed. Such working conditions are closely associated with health risks. No one, least of all those who are ill or have reduced work capacity, becomes more employable by being made poorer.

Mental ill-health is high and has increased noticeably in recent years. Our workplaces must become more sustainable. Preventive health work in the workplaces must be prioritized.

I want to say a few words about the occupational injury insurance. The number of decisions that Försäkringskassan makes to approve an occupational injury and grant a life annuity has decreased dramatically since 2005, from about 7,300 to about 900. Unfortunately, this cannot be attributed to major improvements in the working environment or fewer occupational injuries, but it is simply due to the fact that it has become harder to receive compensation from the insurance.

That is why the Social Democratic government appointed an inquiry. In September, the report *A Purposeful Workers' Compensation Insurance* was submitted to the Minister for Elderly and Social Insurance. Now the report is out for consultation. We Social Democrats consider the inquiry's proposals to be important in order to be able to re-establish the workers' compensation insurance. We hope that the government will soon submit a government bill to the Riksdag.

We Social Democrats have a specific statement in the report.

I wish the Speaker, the members, and the audience a Merry Lucia and a Merry Christmas.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Ulrika Heindorff (M)

Madam Speaker! The healthy person has a thousand wishes, but the sick person only one. This proverb resonates quite a bit with much of what we are debating here today, namely expenditure area 10 Economic security in case of illness and disability. This is a large and important expenditure area covering a total of 116.9 billion kronor, which is almost 10 billion more than last year.

We have a goal for this expenditure area: "Absence from work due to illness shall be at a long-term stable and low level". The Tidö parties believe that the sickness insurance should provide financial security for those who cannot work. We simultaneously need to strengthen the preventive and rehabilitative measures. The design shall be such that it counteracts unnecessary sick leaves, especially the long ones. This is done through the well-defined check-in points - the so-called rehabilitation chain.

Madam Speaker! It has been just over a year since the Moderate-led government took office, and a fair amount has happened within this area. I want to give four examples here today.

Firstly, the compensation for the insurance-medical investigations that the regions carry out is increased. These are investigations of people's capacity to work. The Government announced this this spring, and from January 1, 2024, the compensations to the regions will be increased. Thus, the actual costs that the regions have for the investigations will be covered in a better way. The purpose is that Försäkringskassan shall be able to make correct decisions in particularly difficult-to-assess sickness insurance cases.

Secondly, the Försäkringskassan's regulatory letter for 2023 emphasizes the very goal of the sickness insurance, including that long-term sickness absence shall be countered. The needs for rehabilitation shall be mapped out early, and efforts shall be made to ensure that measures are taken for effective rehabilitation.

Thirdly, it appears in Försäkringskassan's regulation letter that the agency shall prioritize countering benefit fraud and incorrect payments. A new assignment has been given to achieve an efficient and purposeful recovery and claims activity. As recently as last Monday, I read an article about a pair of siblings who had cheated Försäkringskassan out of 9.6 million kronor. I do not believe I am alone in being very upset when I read this type of article. Now, they have at least been convicted of aggravated fraud. They were employed as assistants for a relative and had made incorrect time reports. Among other things, they had requested compensation when they themselves were abroad on vacation. Crimes of this type are completely unacceptable and make one incredibly irritated and angry. They must be detected much earlier and must be countered with full force.

For the fourth, the National Board of Health and Welfare has a responsibility to support the healthcare system's work with sick leave. The Government has now allocated permanent funds for this important work. This has already resulted in a national knowledge support that arrived in November. It is intended to support health and medical care in achieving good quality, patient safety, and equality in the work with sick leave and rehabilitation.

Madam Speaker! Of the longer cases of sick leave, mental ill-health accounts for a high proportion, over half. Above all, it is linked to stress-related diagnoses such as exhaustion syndrome. As you all know in this chamber, women risk being affected by this long-term absence from work to twice the extent as men. Compared to somatic diseases, that is, the bodily ones, it is more often difficult to limit stress-related ill-health to a single isolated thing. The so-called life puzzle, as is known, has many dimensions and consists of many parts. Being signed off sick does not automatically mean that the stress disappears and that one suddenly feels well again. Getting some respite is sometimes completely necessary, but it must always be weighed against the fact that one is taken away from the context that work with colleagues entails.

Madam Speaker! A month ago, I attended a seminar here in the Riksdag where the Ica Foundation and Glada Hudik-teatern participated. In the invitation, it stated that one of the insights is that it is better to be a king at putting cans straight on a shelf than to not be a king at anything at all. In the project Vi kan mer, over 2,000 people with disabilities participate. They work in stores and central warehouses. I can say that not a single eye was dry at this seminar. You all know Ica-Jerry, or Mats Melin as he is actually called. He is truly an idol and a role model for many people in Sweden with disabilities.

Many of those who work in this project in the country's stores have previously been receiving activity compensation or sickness compensation on a full-time basis. Getting the chance to contribute allows people to grow. Many can contribute with the right support and knowledge in the workplace. We shall give people the opportunity to contribute.

My final words in this speech shall be those that Pär Johansson, the founder of Glada Hudik, said during the seminar: I believe in a society that utilizes the power that exists in the human being. Everyone deserves their place.

(Applause)

In this speech, Magnus Resare (M) agreed.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Isabell Mixter (V)

Madam Speaker! Households are being pressured by falling real incomes, high food prices, and sharply rising mortgage interest rates. At the same time, banking and food giants are making record profits at the consumers' expense. It is the government's and the Sweden Democrats' responsibility to ensure that we get through the crisis together and that the burdens of the crisis are distributed fairly, but that responsibility has been ignored.

Madam Speaker! The Left Party presents in its budget motion a completely different direction than the government and the Sweden Democrats – a new course for a safer Sweden. The economic policy shall be directed towards full employment and economic equality. The burdens of the rapid price increases must be distributed fairly, with special consideration for households with small margins. The banks' and the food giants' excess profits need to be choked. They shall not be able to make profits at the expense of households.

The welfare sector has been underfunded for a long time and is now crumbling. In order for welfare to continue to be one of the foundations of society, it needs to be provided with resources so that those who need care receive it in time, those who are heading towards gang criminality can be stopped, and those who are older can receive the support they need in everyday life. Those who work in preschool and school, in healthcare or in elderly care need a good working environment and good working conditions. This is created through investments, not cuts.

Madam Speaker! The Left Party's budget alternative for expenditure area 10, which is the expenditure area we are discussing here today, implies that the care deduction is abolished and that the state instead bears the costs that arise as a result of it. When it comes to the sickness benefit, the ceiling for the compensation is raised. Sickness benefit at continuation level is abolished while the sickness benefit for job seekers is raised and indexed. Furthermore, the calculation basis for SGI is changed.

The compensation level within the activity and sickness benefit is increased. The budget option also implies that the right to these benefits shall be assessed against the same concept of work-related injury as applies to the right to sickness benefit. In the area of work-related injury insurance, changes are proposed with the aim that more people should be entitled to a life annuity. These changes lead to lower expenditures for sickness benefit. The Försäkringskassan's appropriation is increased to reduce processing times and as a consequence of the proposal regarding work-related injury insurance.

The general savings proposed by the government regarding the administrative appropriations are rejected. In total, we allocate 18 billion kronor more than the government to expenditure area 10 for 2024.

Madam Speaker! In order for the sickness insurance to function as intended, it must be need-based. The sickness insurance shall provide financial security to those who are too ill to work and opportunities for rehabilitation to return to work. For far too long, other ambitions and objectives, for example pressing down sickness rates, have come to govern the function of the sickness insurance. The absurdity of this order became clear during the pandemic.

The Government should therefore return with proposals for changes to the objective for expenditure area 10 to "provide economic security in the event of illness and effective support so that the individual can regain their capacity to work and return to work" and let that guide Försäkringskassan's regulation letter. Today, only Vänsterpartiet is voting to remove the wording about low sickness rates in the budget. I regret that.

At the same time, the government has changed the directives for the existing investigation of the sickness insurance. The goal has been changed to look at unjustifiably long sick leaves, which for me is code for that we are to get more people out of work. It is a policy I do not stand behind.

Madam Speaker! When the Left Party's mandates were needed to govern Sweden during the previous term, we used them to push through improvements in the health insurance. The Sweden Democrats have previously spoken about having good compensation and security when one becomes ill, but when their mandates are needed, these values are no longer particularly important.

When we were given the opportunity to decide, more people received compensation when they were ill, and elderly people who had endured a long working life were granted so-called security pension. Now we want to take new steps: More people should receive sickness and activity compensation regardless of age, the security pension should be broadened and include more people, the waiting period deduction should be abolished, and those who have been insured against for years should receive redress.

Unfortunately, we see how the Sweden Democrats are backing down on issue after issue. Before the election, they promised improvements in the health insurance and that the karen deduction would be abolished, and now they are letting the Moderates push through deteriorations after investigation after investigation. The Left Party will never accept this.

With that, I move for approval of the Left Party's reservation.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Camilla Rinaldo Miller (KD)

Madam Speaker! I would like to begin by moving to approve the committee's proposal for a decision.

Madam Speaker! We Christian Democrats base our politics on the inviolable value of all people and on solidarity defined as humanity. The pursuit of social justice, that is, an ambition to level structural injustices and create a fair distribution of society's goods, is the foundation for a good society. Since everyone has the same human value, we have a responsibility to ensure that others' human value is not infringed upon and that they are allowed to live a dignified life. It is in these Christian Democratic basic principles that I take my starting point in this debate.

Madam Speaker! If you are affected by illness or have a disability, it is important that we as a society ensure that you can feel economically secure. You should not have to feel anxiety about being able to pay rent, food, or other life-essential expenses. If you yourself are physically unable to work full-time, you should have the opportunity to work 100 percent of your ability and still be able to feel economic security through various welfare systems. It is to respect all people's inviolable value and dignity.

We should not consider this group as homogeneous. Every person has their own special ability, and every individual human being should also be treated based on this. We know that every human being fares better by having a job and by being part of a community where one can feel needed and in demand. Everyone should live with the security that the collective carries when one is unable to carry everything alone.

Madam Speaker! The goal for the expenditure area is that the absence from work due to illness should be at a long-term stable and low level. Looking back, we see that the development has not gone in the right direction. The work to reach the goal becomes even more important now in economically difficult times.

As early as 2022, sick leave increased sharply, and the trend towards rising sickness rates has continued. The latest figure we have is from August 2023, and at that time there were 183,600 ongoing cases of illness. That was 12,700 more than in August 2022. Women's sick leave is somewhat higher than men's, which is something that we need to highlight and work extra hard on.

The previous government appointed the inquiry Sjukförsäkringen i förändring, which is to conduct an evaluation of the changes that have been made in the sickness insurance, primarily during the years 2021 and 2022. Since the inquiry is not complete and the current government considered the development to be very worrying - because it was seen that the development creates a risk that people are hidden and forgotten again in the sickness insurance without receiving the support and interventions that can enable a return to work - the inquiry Sjukförsäkringen i förändring was given an additional mandate.

The investigation shall also elaborate a legislative proposal if the evaluation shows that the sick leaves are not concluded as intended but become unjustifiably long, or if other negative consequences arise for society and, of course, for the individual. To ensure a high quality in the evaluations, the investigation is furthermore reinforced with solid competence in evaluation methodology.

The investigation will submit its considerations on March 1, 2024. After that, the report will be referred for consultation in the usual order. Only after that will I take a position on the proposals or, alternatively, the preparation that the department will then commence.

Madam Speaker! The most common reason for sick leave is mental ill-health. This applies to both women and men. Once again, it becomes clear that we need to find new ways to help people towards better health and a healthier life.

Here we can all participate and contribute by showing care for colleagues, friends and family members. Asking how a fellow human being is doing costs nothing but can contribute to, for example, a better work environment. There, you and I can participate and make a difference.

Madam Speaker! Sweden has a well-functioning welfare system. It is a welfare system that we should be proud of and safeguard. Unfortunately, this does not mean that people cannot get caught in the middle or fall between the cracks, as we usually say. It is never okay. We must have security in our welfare systems, and of course also controls that prevent people from being encouraged to cheat. Those in need of different interventions should never feel that the help is far away.

As I said earlier: Everyone should live with the security that the collective carries when you are unable to carry everything yourself. It is a policy built on all people's inviolable value and human solidarity.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Annika Hirvonen (MP)

Madam Speaker! The Member spoke in his speech about how wrong it is that people fall between the cracks. I have spoken with many who have been bounced back and forth. Försäkringskassan says that they are healthy enough to work. When they arrive at Arbetsförmedlingen, the caseworker sighs and says: No, no one will hire you when you are this sick. This can go on for a while in several rounds.

We in Miljöpartiet would like to replace the chairs with a bench without gaps to fall through. We want to see that we have a job security that ensures you know that the insurance works regardless of whether it is illness or unemployment that lies behind it, and regardless of what assessment the authorities make of your capacity to work. If you do not have a job, the insurance should still ensure that you receive compensation.

I wonder what the Christian Democrats' solution is so that people do not fall through the cracks. As it is today, it hits many people hard. Feeling anxiety about one's finances is truly the worst for people who are trying to recover from, for example, burnout. In that case, economic stress is a recipe for illness.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Camilla Rinaldo Miller (KD)

Madam Speaker! Thank you, Annika Hirvonen, for the question!

The Christian Democrats' answer to the question you raise is quite clear. We have long said that people should be allowed to work 100 percent of their ability. That means that for you, perhaps 100 percent is to work 60 percent, and 40 percent you are unable to work. But you are allowed to work 100 percent of your ability.

We are completely convinced that people who are given the opportunity to have a job to go to and who feel like part of a community in the long run feel better. It prevents mental ill-health and involuntary loneliness.

It is about being met by a hand or a smile when you arrive at work and feeling that you are needed and in demand, and above all that if you do not show up, someone will get in touch and wonder: Where are you? We miss you. You were not here today. We therefore believe that it is important that one should be able to have the opportunity to work 100 percent of one's ability.

Another alternative that the Christian Democrats have also highlighted many times is that the steps are sometimes too large. The member speaks of burnout. You are to go back and work either 25, 50, 75 or 100 percent.

The Christian Democrats have long said that we should soften those boundaries because they are too large steps, and then you have to start over again. The person who is on sick leave has to start over again.

There we see an opportunity to help people to be able to return to work step by step in order to ultimately be able to work 100 percent of their capacity.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Annika Hirvonen (MP)

Madam Speaker! I fully and completely agree. The health insurance must become more flexible and be adapted to the people. People do not always fit into the mold that the politicians have drawn up. The Christian Democrats are now in the government. There is a finished proposal on exactly this. When are you going to present it to the Riksdag?

I have another question. When I speak about falling between the cracks, I see it more broadly than just within the health insurance itself. We have unemployment insurance and health insurance. Exactly where the line is drawn for a person having regained their capacity for work, case officers can make completely different assessments of.

Försäkringskassan says: You are too healthy, you are not allowed to be on sick leave. At the same time, Arbetsförmedlingen says: No, you are too sick to work. Then people fall between the chairs. Therefore, we in Miljöpartiet propose a coherent safety system so that there are no gaps to fall through. If you do not have the possibility to work, the insurance shall kick in.

My second question is whether the Christian Democrats are prepared to consider that. Again: It is not the people who should adapt to the systems. The systems should be flexible and be based on the people.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Camilla Rinaldo Miller (KD)

Madam Speaker! I am a bit surprised that this time it feels like we are in very much agreement. We must help each other in letting people work based on what they are capable of. It should be 100 percent of their ability. I also wish that the chairs should disappear, or that they should be built together or stand so close that no one should fall between them.

I do not want to stand here today and say which path we should take to remove the chairs and have benches instead where no one gets caught in the middle. But I am completely convinced that the government we have today has no other goal in sight than to help those people who need help in order to be able to work.

We know that having a job to go to and being part of a community lifts people out of loneliness and mental ill-health. That is something that must be taken step by step. As an employer, I think myself that most employers truly want the best for their staff. They are the most important thing one has. Without staff, the workplace does not function. There, even employers can do small things.

In our family, it is about me and my husband and our children working on Christmas Eve so that our employees can have time off and be together with their families.

There are many other ways to make people feel better. Here, we can help each other as fellow human beings, a little bit every day. So I believe that we can make a difference.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Martina Johansson (C)

Madam Speaker! The area of economic security in the event of illness, injury, or disability involves many crowns and affects very many people.

The goal is that absence from work due to illness should be long-term stable and at a low level. This means that we should not have large differences during the year unless it is seasonal and during influenza periods.

There should be no regional differences in how large the sick leave is, and there should also be no difference between men and women. These two differences need to continue to decrease.

Madam Speaker! Today we have fairly low levels when it comes to sick leave, which is good. But for this to continue, it is required that we ensure there is support to return to work for those who become ill.

It is about being allowed to stay at home for the first period to heal, but in the long run, one must receive support to return as soon as possible because, in the long run, staying at home does more harm than good. We see that in research.

In order to maintain a low level, we must also understand what it is that makes there more people on sick leave in Värmland than in Norrbotten. Why do we have regional differences when it comes to sick leave? What is it they do well in Norrbotten that can be learned from in other parts of the country? It is something that we need to create more knowledge about.

It is the same thing when it comes to the difference in sick leave between men and women. There are more women than men who have a longer period of sick leave. In a previous speech, people spoke about mental ill-health, and we need more knowledge about this to know if that is the answer to why more women than men are on sick leave and, if so, how we work together to reduce that type of sick leave. It is about the employer but also about how society otherwise is structured and functions.

The same applies to the occupational injury insurance, where fewer women than men are granted compensation. It is said that women also receive a poorer investigation when it comes to occupational injury compensation. Even here, we need to increase knowledge.

Madam Speaker! The Centre Party wants to see a broad range of reforms and increased knowledge in order to be able to address the regional differences but also the differences between men and women.

We believe that coordination is required, especially for those with the most complex clinical picture, so that they can return to work. This requires that rehabilitation planning starts much faster than it does today, and here the government needs to put pressure on Försäkringskassan so that it steps up even more. That is where the responsibility for coordination lies, and then Försäkringskassan must take that responsibility.

It also concerns the preventive sickness benefit. It should be used much more so that we can prevent long-term sick leave. Again, Försäkringskassan needs to work on this.

There is an investigation here that the vast majority of parties stand behind. But nothing is happening. Why has the government not presented a bill in this area so that we actually move forward with the issues?

I miss the government's leadership and forward movement when it comes to helping the individual person in everyday life. The government has a focus on very many different things but not on that which is close to the human being.

I also wonder where the proposals are regarding the flexible sick leave - that it should not be fixed forms with 25, 50, 75, and 100 percent. I agree with several parties in the government that it should be so.

But what happens with the government when four parties come together? Well, it becomes a bit of a mess of everything. I am thinking about previous speeches today. The risk is that parties have to choose to de-prioritize some of their views. But I think it is good to have many different parties and different proposals. Otherwise, we could have a two-party system, which I do not believe in.

When it comes to small business ownership, it is actually there that four out of five jobs are created. But if one as a small business owner becomes ill, there is actually a risk that one will not manage to resume their company after the sick leave is over. If one is to follow today's regulations, one is not allowed to work with their company at all during the time one receives sickness benefit. But perhaps there is administration that needs to be done. Even if one cannot sell their goods and services, one might need to do things in their company for it to survive during the time one is away due to illness.

One can do this partially when it concerns parental leave for small business owners, but not when one is on sick leave. I wonder where the government's small business policy stands on this area.

Furthermore, the government has now abolished the compensation for high sick pay costs, which would also help the small business owner to be able to continue their business even if the employees have high sickness absence. Which entrepreneur dares to invest in the one who has a history of illness if we as a society cannot support and help with the high sick pay costs? At Svenskt Näringsliv, they are quite quick to criticize even this issue.

I wonder, then, where the government's corporate policy has gone in the government cooperation.

Madam Speaker! There are voices calling for loosening the rehabilitation chain. That is not good, because it is the prerequisite for being able to return to work. This is where Försäkringskassan must step up regarding coordination so that the focus becomes on planning for a return - at 10 percent, 35 percent, or 100 percent.

I believe that Centerpartiet and I think that placing more focus on coordination, rehabilitation, preventive work, knowledge of unreasonable differences and more flexibility is a way to get more healthy workers out onto the labor market.

I am proud that we in Centerpartiet drive our policy and talk about what we want to do to improve society. It is more important than wondering who will negotiate with whom after the next election, because that is why we are here - to drive the policy we want to see for Sweden moving forward.

With that, I wish to refer to the specific statement we have in the report and wish everyone here a Merry Christmas and a Happy New Year.

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Mauricio Rojas (L)

Madam Speaker! In the debate on the report Expenditure Area 12 Economic security for families and children, I showed that there are two types of opposition parties in this Riksdag.

On the one hand, there are two parties, the Social Democrats and the Centre Party, who in broad strokes follow the government's description of the problems and the desire to drive forward a tight fiscal policy that does not inflate the inflation.

On the other hand, there are two parties, Vänsterpartiet and Miljöpartiet, who seem to live on another planet and propose a very expansive fiscal policy with large deficits, enormous tax increases, and a rapidly growing indebtedness that will affect future generations.

Expenditure area 10 Economic security in case of illness and disability gives us an opportunity to delve a little deeper into this rift that splits the opposition between populist spending parties and more moderate ones.

Madam Speaker! Within expenditure area 10, promises are made generously from a Green Party perspective and, above all, a Left Party perspective, yet without simultaneously stating how and by whom the party shall be paid for. Nor does one state the inflation-driving effects of an expansive fiscal policy. Just over 9 billion kronor over three years is the price tag for the Green Party's promises within expenditure area 10. But here, the Left Party's generosity with others' money is truly outstanding. The bill lands at just over 54 billion kronor over three years. That corresponds to almost half of the entire appropriation for defense and the society's crisis preparedness.

This is pure fiscal populism. However, it is not so strange considering that it comes from the same party that proposes that the fiscal surplus target over ten years should be replaced by a deficit target of 1 percent of GDP and that the national debt should consequently grow by a total of 800 billion kronor.

In the Left Party's budget motion for 2024, one can read the following sentences:

Vänsterpartiet proposes that today's surplus target be replaced with a deficit target for the public finances.

Fiscal policy needs to be more expansive.

The Left Party's budget proposal increases aggregate demand which, all other things being equal, may be expected to increase inflationary pressure somewhat.

The latter does not, however, seem to concern Vänsterpartiet significantly, and for that part, neither does Miljöpartiet.

Madam Speaker! In comparison with these populist parties' inflation-driving and debt-financed generosity, the Social Democrats' spending increase within expenditure area 10 of barely 700 million kronor over three years is a very modest proposal, not to mention the Center Party's proposal for total savings of almost 9 billion kronor. Everything between plus 54 billion and minus 9 billion kronor over three years is thus what this new red-green mess offers solely within this expenditure area.

What one naturally wonders, given this enormous discrepancy between the opposition parties' different budget proposals, is how the parties in this red-green mess can ever be able to govern together. What policy would then apply—the one that promises gold and green forests with future generations' money, or the one that in all material respects follows the government's austerity? Is it our carefree populists who are to decide, or the more sensible parties who do not want to inflate the risk of inflation? It would be pleasant if the opposition parties, not least the Social Democrats and the Center Party, could explain this. The voters have every right to know what is hidden in the red-green mess's bag.

Madam Speaker! In conclusion, I would like to summarize the Liberals' basic positions regarding our social insurances.

A liberal social security is based on a few simple principles - that there is a connection between contributions and benefits, that the contribution is proportional to the income, that compensation is paid out against loss of income and, last but not least, that the insurance covers everyone. This should also apply to the unemployment insurance.

With this, I conclude my speech and move for the approval of the committee's proposal.

(Applause)

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Annika Hirvonen (MP)

Madam Speaker! Today, it is the case that if one is on sick leave and receives sickness allowance from Försäkringskassan, one can, after a period of time, receive a decision that one is no longer entitled to be on sick leave with sickness allowance. Försäkringskassan may consider that one has become sufficiently healthy. That decision can not only apply forward in time but also backward in time, for days before the decision was made, and for money that has already been paid out and used.

Do the Liberals consider it fair that people who are ill and apply for continued sick leave can be denied not only for the future but also for time that has already passed, and thus be required to pay money back to Försäkringskassan?

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Mauricio Rojas (L)

Madam Speaker! Försäkringskassan pays for the sick leave when it is correct. That is an assessment that the authority makes, of course. I cannot see anything wrong with authorities being able to conclude that it was not correct to pay anything and then demanding the money back. This applies to many other situations within the welfare state.

The principle that it must be correct when one pays out a grant, an insurance, or anything else is very important. Therefore, I do not see anything problematic in Försäkringskassan making this assessment.

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Annika Hirvonen (MP)

Madam Speaker! It is refreshing to receive straight answers and to be able to talk with the Liberals about the matters we actually have on the table and not just about the pressing issue of a red-green government formation, something that I, of course, look forward to very much in 2026.

We in Miljöpartiet think it is completely wrong that people who are ill, perhaps have been burnt out, can end up in debt to the state when they are assessed as healthy by Försäkringskassan. It is naturally reasonable that Försäkringskassan can make the assessment that you are now healthy enough to work. But if some time has already passed and you have received sickness benefit and thought that you were entitled to it - it has still been paid out to you - those funds that Försäkringskassan has paid out for time that has passed should not lead to you ending up in debt.

We from Miljöpartiet propose in our budget that the possibility of indebting people who have been ill in this way be removed. We think it would be fair but also important for health. Economic stress can risk making people stay ill longer. Stress-related illness is increasing enormously, and if one goes around being worried that they will also be indebted by Försäkringskassan, it can have negative effects on the individual's health and, in the long run, also for the goal that people should return to work as soon as possible.

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Mauricio Rojas (L)

Madam Speaker! If I understand the member correctly, she is saying that one can become ill because Försäkringskassan has judged that one is healthy. That is a very strange conclusion.

Basically, it is a matter of paying the right amount to the people who are entitled to something. If it turns out that you were healthy - that is the authority's decision - it is right to demand the money back, in the same way as with other incorrect payments. This applies to everything, housing allowance and much more. It is important so that our welfare state does not collapse. It is important that it is correct when one is entitled to something.

I understand that Miljöpartiet is more generous and want to pay anyway. But then the members should say that you are borrowing money for it, that you have a deficit in your budget proposal and that those funds will cost and cost a lot. You should also say that.

It sounds very nice to say: We want to raise this and that and give more money to everyone and everything. But someone always pays. There are no free lunches. It is very important that we in this Riksdag understand this simple but so important sentence.

Madam Speaker! I would like to wish you a Merry Christmas.

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Annika Hirvonen (MP)

Madam Speaker! When one requests a reply, one cannot address that very last point. But I take the opportunity to do so now, in my speech.

Madam Speaker! No, we borrow for the climate transition to make the investments that Sweden needs to make and to reach our climate goals and live up to Sweden's commitments under the Paris Agreement without it coming at the expense of the welfare and the people who are having it toughest here and now. Investing in the climate transition is a profitable business in the long run. We believe that the state should be able to have an investment budget in the same way that municipalities have it.

Madam Speaker! A just transition is a prerequisite for our society to hold together through the challenges we now face. That people who are ill should not become poor is a central part of the Miljöpartiets view on how we organize a just and equal society.

We can all be affected by illness and disability. In a welfare state like Sweden, it should not be the same with poverty. Unfortunately, that is the case today. The government continues to tax people with a disability higher than people who work. It is terribly unfair. That is what we in Miljöpartiet say no to.

In our budget, we also propose that a part of the altogether too low level that applies in the health insurance be corrected. It must be raised.

Of course, the Försäkringskassan's decision for you who have been ill for a long time should be able to apply even if you are suddenly judged to be healthy. But it should not apply for the time that has passed, when you relied on the fact that Försäkringskassan's payments to you were correct. We know that people living on sickness benefits, sickness allowance, and activity compensation do not have large margins, but on the contrary. We should not make people indebted.

Madam Speaker! I am concerned that the costs for health insurance will increase in the future. I recently met with the chief economist of Sveriges Kommuner och Regioner, and she told me about the enormous deficits that healthcare across all of Sweden is now facing. We have already seen warnings out in the regions. It is worst in Region Sörmland. Healthcare staff are being laid off. In the wake of that, the healthcare queues will grow. People will be sick longer before they receive the help they need, and the risk that their health condition will deteriorate further because of it is imminent.

We also see cuts all around in the schools. It risks leading to even fewer children having time to meet the counselor. And when you cut back on student assistants, fewer children will have the prerequisites they need to complete their schooling. A successful schooling is actually the most important thing for having good chances at good health for the rest of life and, of course, for not ending up in unemployment.

Madam Speaker! Within expenditure area 10, which we are now discussing, cuts are also being made to preventive health work. Occupational health services have a key role in preventing people from becoming ill at work. Now the government is lowering the compensation for this important work.

While healthcare looks at every individual as a patient and is to address that specific person's problems, perhaps with the hip or the shoulders, occupational health can see if many at the same workplace perhaps have exactly the same ailments. One cannot just ensure that the individual receives care but also look at how it actually looks at the production in the workshop and if it is possible to change something so that the shoulders do not become so worn out. Preventive work is one of the smartest things we can spend money on, so that people do not become ill.

We in Miljöpartiet want to eventually merge the insurance systems into a single work-life security, so that one can base it on the individual's needs. Individuals should not fall through the cracks and be bounced back and forth between Arbetsförmedlingen and Försäkringskassan if they make different assessments. Unfortunately, different assessments are indeed made. It is people who assess whether someone is healthy enough to be able to work, and people sometimes do differently. This should not affect the individual people. They should still have an economic security.

Economic security in case of illness and disability

Madam Speaker! I have noted that many in the chamber have spoken in favor of us having a flexible level for how much one can be on sick leave. The individual's work capacity shall decide. If one can work 60 percent, one should also be able to be on sick leave 40 percent. That is not the case today.

There are very many important and good proposals that the government hopefully has on its table. I am waiting for those proposals to come to us here in the Riksdag. We have not received any announcements as to when that can happen. But fine words are not enough, Madam Speaker. Action is needed to repair the tears that exist in the health insurance.

Since we in Miljöpartiet want to invest more money in people who are ill and who have disabilities, and the government's lower proposal has already been voted through in the framework budget, I cannot move for approval of our proposal today. But I refer to our special statement and look forward to 2026, when we can form a red-green government that takes these issues seriously.

In this speech, Per Bolund (MP) agreed.

The deliberation was hereby concluded.

(Decisions were made under § 12.)

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