Response to interpellation 2023/24:407 on the care deduction
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
M considers the deductible to be a fair insurance-related deductible that counteracts over-utilization 1 2. M argues that it is difficult to delineate specific occupational groups for exemptions due to complex boundaries 2. M wants to balance the need to protect vulnerable groups with the risk of over-utilization and the impact on the workload 3 4. M emphasizes that the deductible is crucial for counteracting errors and benefit fraud 5. M advocates for moving from ten to six deductions per year to provide greater protection for individuals with recurring sick leave 5. V considers the deductible to be a real obstacle to staying home when ill 6. V argues that it is unreasonable that people who pay into the sickness insurance lose wages when ill 7.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Statsrådet Anna Tenje (M)
Mr. Speaker! I have been asked why the original investigation regarding the parental leave deduction was discontinued and replaced with a review at the Ministry of Social Affairs. Isabell Mixter has also asked me whether I and the government intend to make any changes regarding the parental leave deduction.
The previous government appointed the Karensutredningen (S 2022:02) for the purpose of reviewing the karens deduction. The current government also considers it important to review the karens deduction but judged that the ongoing review of the karens deduction should be changed and clarified, as well as linked more closely to the Government Offices' other work. Karensutredningen was therefore replaced by a working group in the Government Offices. I have, among other things, commented on this in several media outlets and accounted for it in this chamber in an interpellation debate on 14 February 2023 regarding the answer to interpellation 2022/23:166. Furthermore, I participated in the Social Insurance Committee's meeting on 9 February 2023, where I accounted for this and answered the committee members' questions. I also believe that the interpellator asked many questions then that I also answered.
The working group was tasked with analyzing the appropriateness of the waiting period deduction and assessing whether there was any need for changes to the waiting period deduction. Through an additional assignment decided on 31 January 2023, the assignment was expanded to specifically analyze the conditions for changing the waiting period deduction to improve the conditions for specific occupational groups that are particularly exposed to close human contact in their professional roles and who find it difficult to work from home, for example certain employees within healthcare, school, and care, and to develop a model for this.
On 15 December 2023, the working group concluded its assignment. The working group's report is a comprehensive knowledge base on the consequences and expediency of the quarantine deduction.
The working group assesses that the period of absence deduction entails a more just and insurance-based deductible compared to the previous period of absence. The working group also assesses that the period of absence deduction counteracts over-utilization but that it can be burdensome for individuals with recurring sick leave and for individuals with small economic margins.
The working group submits proposals involving a uniform quarantine deduction as well as an expanded protection against loss of income resulting from quarantine deductions for groups with recurring sick leave. The working group also submits proposals for measures that shall make the administration of high-risk protection simpler and more efficient.
The working group's proposal is currently undergoing a referral process. I look forward to receiving the views of the referral bodies, which are to be submitted no later than 3 May 2024. The Government will subsequently take a position on any changes regarding the quarantine deduction.
Isabell Mixter (V)
Mr. Speaker! I experience a certain frustration in the Minister's answer regarding the fact that the question of why the investigation was discontinued is being revisited. I only want to clarify that I do not in any way want to frustrate anyone by revisiting the question, but I simply think it is important to discuss the issue. I also did not note any actual reason in the answer as to why the investigation was discontinued and turned into a desk product at the Ministry of Social Affairs.
As Anna Tenje very correctly stated, the government decided to shut down the Karensutredningen and replace it with a working group at the Socialdepartementet. When the investigation was first presented, it was clear that there was a purpose to investigate an additional day of sick leave. That was quickly backed down from, and it was stated that it was not relevant to investigate. But it was clear when the working group was to be appointed that there was another purpose than what the original investigation had, namely that the deductible should be more distributionally just depending on what work one has, if one can work from home, or if one is in a risky occupation. Furthermore, the risk of sickness absence should decrease.
The working group at the Ministry of Social Affairs has now submitted its product, and the proposed changes are modest. A change is proposed which means that those who have more than six instances of illness per year, compared to today's ten instances of illness per year, shall be covered by a high-risk protection, as it is called today. The vast majority of employees who need to be at home due to a cold or similar will not reach either six or ten instances of illness. The economic loss that it entails with the quarantine deduction will therefore remain.
The period of absence from work due to illness hits very differently for different occupational groups. Civil servants who can work from home can continue to do so in case of minor illness and therefore do not need to take any period of absence. In healthcare and care professions and in school and preschool, where the rates of sick leave are higher, they cannot work from home, and they suffer a loss of wages when they become ill.
In a report from the trade union Handels, seven out of ten state that they have at some point during the past year gone to work despite illness. Four out of ten state as a reason that they cannot afford to stay home.
The quarantine deduction therefore constitutes a real obstacle today for many people to stay home from work due to illness. During the pandemic, there was a system that meant the state took over the compensation for the quarantine deduction to facilitate for people to stay home and avoid the spread of infection. This shows that the system with the quarantine deduction is not static but possible to change. Even though the pandemic is over, I would like to remind the Minister for Pensions and Social Insurance that the spread of infection within, for example, elderly care needs to be avoided. Of course, the spread of infection generally in society also decreases if people stay home when they are sick.
But if one is to be able to stay home when one is ill, it also needs to be financially possible to do so, and the deduction for sick pay is today an obstacle for many people to stay home. I would like to ask the Minister which people she thinks should go to work even though they are ill.
Caroline Högström (M)
Mr. Speaker! The Minister represents the entire government and has, for I do not know the umpteenth time, had to stand here in the chamber of the Riksdag, sit in the committee, and appear in the media to explain why it was chosen to conduct a letter investigation instead of the previous quarantine investigation. That very question from the left side is starting to become quite tiresome.
Funny enough, I still experience that the parliamentary parties, including Vänsterpartiet, have gained greater insight into this working group's work in the letter investigation than compared to many other investigations. All directives, investigations, and investigators are of course different, but to still be upset about that change is actually starting to become a bit strange. The insight that has existed here is not seen in many other investigations, and that includes even Vänsterpartiet.
Mr. Speaker! I also want to take the opportunity to nuance the picture that the Left Party is painting. Yes, there are groups where the sick pay deduction hits somewhat harder than others, for example, my own professional group of preschool teachers and pedagogical staff. But there is also not the same problem with what we can somewhat sloppily call Monday sickness, as we can see in other parts. It is also not an entirely unreasonable thought that one should bear a part of the cost responsibility.
The balancing act is difficult, but here I personally and as a Moderate believe that we must keep both perspectives in mind at the same time. This concerns how we can help and protect those groups in the contact-Turks who cannot work from home but who need to be at home, but also how we can curb an over-exploitation of the welfare systems. Both perspectives are important to take with us into the upcoming work.
Statsrådet Anna Tenje (M)
Mr. Speaker! Let me begin by stating that the report submitted by the working group is anything but a desk product. It constitutes a comprehensive knowledge base on the consequences and purposefulness of the care deduction and provides a good basis for continuing the discussion and making various considerations.
The working group assesses that the quarantine deduction entails a more equitable and insurance-related deductible compared to the previous quarantine day, and the quarantine deduction simultaneously counteracts over-utilization. The working group has analyzed the conditions for changing the quarantine deduction to improve the terms for specific occupational groups that are particularly exposed to close human contact surfaces in the professional role and who have difficulty working from home, as we were touching upon earlier. The working group assesses that it is not appropriate to introduce a differentiated quarantine deduction based on an occupation since there is no simple or, for that matter, comprehensive way to define which occupational groups employees should be covered within. This boundary-setting problem is very extensive and complicated, and it was raised in the working group during conversations with the parties in the labor market.
Two proposals are primarily being submitted, which the member touched upon earlier, which provide an extended protection against loss of income as a result of quarantine for groups with recurring sick leave. It concerns those who are ill many times, those with chronic illness, and those who are extra vulnerable.
Firstly, the working group proposes that the current general high-risk protection be replaced with a cap, which means that the pension deduction shall not be made if such a deduction has been made for the individual on at least six occasions during the last twelve months.
The proposal would reduce the loss of income resulting from the fact that carens deductions for persons with recurring sick leave are not made. It would be of particularly great importance for individuals with the lowest incomes and for employees in particularly female-dominated occupations such as healthcare assistants, nursing assistants, childcare workers and preschool teachers, who also have a higher rate of sick leave. These are groups that have limited opportunities to work from home.
Secondly, the working group proposes changed administration and an expanded high-risk protection for individuals with diseases that entail a risk of recurring sick leave.
The government has, as stated, not taken a position. There is time until March 3 to submit various referral statements, and I look forward to the compilation that is made then. After that, we will land on whether we want to change or improve something or simply conclude that things are good as they are. I cannot take a position on that here today.
Isabell Mixter (V)
Mr. Speaker! Anna Tenje pointed out that the proposed changes agreed upon in the working group will facilitate things for those who are particularly vulnerable, for example, healthcare staff. But if one looks at the average regarding the number of sick days, one sees that it lies at approximately two sick days a year, so the vast majority who work in, for example, health and medical care – or for that matter, preschool, as Caroline pointed out here – will not be covered. One will still suffer a large loss of income in the event that one catches a cold and needs to stay home from work.
Anna Tenje describes in her response that the period of absence deduction counteracts over-utilization. But the period of absence deduction also leads to under-utilization, meaning that people refrain from taking sick leave despite illness.
Of the people who refrain from taking sick leave despite being ill, six out of ten state that they work despite the illness. Many state as reasons that they do not want to burden colleagues and that there is no one else who can do the job. But a good number also answer that it is because they cannot afford to be absent from work due to illness.
The answers show that there is a great sense of duty among the working population. I think that believing that a removal of the care deduction or a more generous compensation from the first day would lead to a massive over-exploitation is to think very poorly of people who work. On the contrary, there are societal gains in people not going to work when they are sick, such as avoiding the spread of infection and longer sick leaves later.
I agree with the government that it is difficult to delimit specific professional groups that should be covered by reliefs in the quarantine deduction. The Left Party believes, however, that the quarantine deduction should be abolished.
In Anna Tenje's and the working group's communication, it sounds as if the sickness insurance is like any other insurance. That one has a deductible in an insurance is also reasonable to me if it concerns a car insurance or similar. But in general, people get colds or are affected by illness every now and then, and that one then every year should have to lose an average of 1,500 kronor in wages despite paying into the sickness insurance via waived wage space is actually quite unreasonable. It is also unreasonable that some are hit harder than others, including women in manual occupations.
That it should pay to work is usually a motto for the right-wing parties. But does the Minister not think it is then reasonable that the one who works hard, works, and foregoes wage space for the health insurance receives compensation when they become ill?
Caroline Högström (M)
Mr. Speaker! I would like to take this opportunity to maintain the need to keep both of these two perspectives alive.
The chairman Mixter describes the one perspective heartwarmingly, and it is clear that this is not something we should take lightly in any way. But a total abolition, which I understand is the Left Party's demand or wish, would have major consequences in workplaces but also in the financing of the welfare system. I believe there may be other, better ways to do it - for example, that which exists in the working group.
Now we have to wait for the work that is ongoing. The working group has done a solid job, and it will be very interesting to see what the referral bodies say. After that, we will have to take a position.
One has tried to remove the quarantine deduction previously, when there was a quarantine day in the 80s and 90s, but came back to introducing it again.
During the pandemic, it was not a total abolition; one still received a quarantine deduction and then, for the most part, compensation at a later time from Försäkringskassan, so we have not had this total abolition that Vänsterpartiet proposes and implies when they compare it with the pandemic. There was still a certain out-of-pocket aspect, albeit significantly less than the ordinary quarantine deduction.
I believe it is important that we keep both perspectives in mind at the same time. We need to look at the groups that are particularly vulnerable, but also look at the risk that exists when one removes it, linked to both the funding of the welfare and to the workplace and the workload.
Statsrådet Anna Tenje (M)
Mr. Speaker! The working group's conclusions indicate that the care deduction fulfills a function and counteracts over-utilization. It was therefore the working group's conclusions that I set out earlier in my response.
As said, we would all probably have wished that controls were not needed. But for me and the government, it is absolutely crucial to counteract all types of errors, over-utilization, and subsidy fraud. In this case, I agree with Member Högström that it is a matter of having balance and keeping both of these two things in mind at the same time. A certain degree of control is required. At the same time, we know that the big problem today is not whether one has a few days of absence, but that we need to focus on protecting those who have very many days of absence.
The proposal that the working group has now submitted, which concerns moving from ten to six times during a year over the last twelve months, becomes naturally more generous. But it also means that those who are most vulnerable are protected to a greater extent than before. It provides greater protection for more individuals with illnesses that entail a risk of recurring sick leave and the possibility for them to be exempted from a waiting period deduction. In this way, we can also better target the regulations to facilitate things for the groups that have the greatest need for this. These are groups that, for various reasons and repeatedly, are affected by different illnesses – for example, women working in healthcare, school, and care, whom Member Mixter spoke warmly about.
Simpler administration is the other thing the working group proposes. That employees with high-risk protection apply for sickness allowance from the beginning of the sickness period means that the employer is no longer obliged to pay out the sickness pay. This would simplify the protection for the individual and the administration and reduce the risk for the employer, which would play a major role for people with disabilities and persons with functional variations. It would reduce the risk-taking for the employer in employing persons with this type of disability.
It is important to have sense and balance in this issue. I understand that Vänsterpartiet and MP Mixter would prefer to abolish the karensavdrag entirely. This is nothing that the working group has proposed. Nor has a differentiation been proposed, precisely because the issue of drawing boundaries would be so difficult. It would make it impossible to set limits for which professions and in what way.
These two changes have been proposed while noting that the period of absence deduction has served us well and fulfilled its purpose, and that it meets the needs of many different professional groups significantly better than the period of absence day did.
Work is currently underway to compile the responses from the referral bodies. Then, we in the government will take a position on this and return with how we have landed.
Isabell Mixter (V)
Mr. Speaker! Sweden is unique in the Nordic countries in having a quarantine deduction or a quarantine day. From my perspective, it is negative. But one can have different opinions about us being very unique in this.
In the working group's review, it has been mentioned that there are differences between the Nordic countries. But they have not analyzed what that actually means in terms of sick leave. Is it the case that "Monday sickness" only occurs in Sweden, or does "Monday sickness" exist in the other Nordic countries? It would have been an interesting question to get an answer to. But they have simply not given an answer to that.
Women are on sick leave to a higher degree than men. More people in the public sector also need to be on sick leave from time to time because they simply have a higher risk of being affected by illness. I became very curious as to why the Minister of Justice thinks it is specifically women who should pay the price for the period of absence before sick pay begins. The applause for the healthcare staff that everyone gave during the pandemic seems to have been forgotten for a long time.
Anna Tenje was also pointing out that Vänsterpartiet does not think controls are needed. It is part of a contract when one is employed that one has someone as a supervisor. One has, for example, a manager who checks how one is doing. If one is repeatedly absent, it is usually followed up with conversations with the manager and the like. I do not understand why the person who works and pays into the insurance should repeatedly have to lose large sums of money just because they happen to catch a cold.
Anna Tenje argues that the big problem is those who have many sick days. But the single mother who is now pinching every penny cannot afford to be sick. Why does Anna Tenje think she should be forced to go to work with a fever and risk infecting others? I wonder.
Statsrådet Anna Tenje (M)
Mr. Speaker! I would like to begin by thanking Member Mixter for a good debate on this important issue. It has been recurring, so obviously there is a great interest in discussing just that issue. When we have looked at what the referral bodies say and landed on the question, we will certainly have every reason to return to the chamber to discuss any proposals.
There are nuances, and sometimes slightly larger nuances between certain parties than between others. It is important to state that we can still land on the fact that it is important to both protect and care for our employees. It is a matter of ensuring that they are doing well and that one reduces sick leave.
At the same time, it is necessary to ensure that we have a control function so that there is no over-exploitation of our common welfare systems, given that it is there that the entire legitimacy of our welfare lies.
The working group proposes generous proposals. At the same time, it notes that the care deduction has been good and has served us well. It is good that it exists to reduce over-utilization.
We have every reason to return here to debate and discuss these issues. But until then, I would like to thank you for the debate.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.