In November, the ruling coalition of GERB and United Patriots suddenly decided to abolish paying out the first day of an employee's sick leave, prompting a tidal wave of public resentment. Currently, the first three days of sick leave are paid out by the employer. The National Social Security Institute (NSSI) is covering the sick pay after the third day. The distribution of the burden between the employer and the state was introduced during the financial crisis on the condition that it would be temporary. Employers' organizations have been insisting for the past several years that the government should take back the part of the burden allocated to them since the economy is back on track.
Following a meeting between the coalition partners, representatives of the two parties said that the government will vote on a proposal to make the first day of sick leave unpaid. The idea was that this waiting period in which neither the employer nor the state will cover the sick pay would discourage people who fake their medical papers and would save the national budget 80 million levs from withholding a day of public sector employees' sick leave.
The public outcry was so big that it was only a matter of time before Prime Minister Boyko Borissov intervened personally to cancel the plan. And he did but the issue remains: sick days are increasing faster than the rise in the employment rate. The cost is rising for both the public and the private sector. Even though some of the sick leave claims are false, bigger factors are the inflexible labour market, insufficient social benefits and the unreformed healthcare system.
A sick day or a day off
In Bulgaria, getting a paper for sick leave from your general practitioner instead of taking a few days off is common and many people take advantage. NSSI data shows that close to 10,500 papers for sick leave were issued for workdays falling between two sets of holidays at the beginning of May. In comparison, the average daily number of sick leaves issued during that month was around 6,700. Moreover, in one of its latest quarterly reports, the NSSI says that the number of sick days for general illness paid out by the state has increased by 19% in the past five years to 2.9 million days. The increase is not proportionate to the rise in the number of people employed which is close to 7% during the same period.
According to the NSSI, the main reason for the increase is that the number of sick leaves with a longer duration - between 15 and 30 calendar days, is growing rapidly. The number of sick days paid out by employers has also risen in the last five years by close to 20% to 5.8 million days in 2018.
The root(s) of the problem
Part of the significant growth rate is due to a rise in the number of short-term sick leaves of up to 3 days. They are covered by the employer who pays out 70% of the employee's wage during that period. Even though people can ask for time off, their employer can refuse, which makes taking sick leave an easy alternative if a person is close to their doctor. Also, working mothers, for example, take a sick day when their children are ill or if the kindergarten suspects that they might be.
Others opt for sick leave in order to go to medical examinations. As part-time and other more flexible employment options are rare in Bulgaria, many people have to take a day off even if they only need an hour or two. The longer sick leave of over 15 days or more is a larger issue. These sick days are paid for by the State Social Insurance fund at 80% of the employee's wage. The money in the fund comes from monthly instalments of 3.5% of employees' wage. The fund was in deficit of about 160 million levs in 2018 but the money is basically the only income workers get while sick.
There are several malpractices here. For one, public sector employees tend to take long sick leaves when there are changes among the holders of political power or when the risk of redundancies arises. On the other hand, the private sector also has a contribution by making employees get sick leave during periods of economic contraction. That way, a company doesn't have to fire workers and they still get paid - by the NSSI.
Another factor for the significant growth of sick leaves is the unreformed healthcare system. According to Dr Nikolay Branzalov from the Bulgarian Medical Association, only 15% of all sick leaves come from general practitioners. Hospitals have an incentive to admit more patients so that they can get paid more by the state-run National Health Insurance Fund. Some complex medical examinations covered by the health fund like MRI scans require several days of hospitalization. The number of people hospitalized has risen by 70,000 per year in the past two years, while Bulgaria's population decreased by 50,000.
The drama with sick leaves is a recurring one. Two years ago, there was a suggestion to cut the amount employers pay for each of the first three days of absence due to illness to 50% of the daily wage of the employee. However, the idea was dismissed quickly after the prime minister promised to tighten control of fraudulent practices. Clearly, that promise was not followed through. Control can be tightened both through general practitioners and the NSSI with more advanced data processing and risk analysis of sectors and people. Currently, NSSI data doesn't differentiate between economic sectors or even between private and public sector sick leaves.
According to the institute, sick leaves are most often challenged when a discrepancy is found between the length of the leave and the diagnosis. NSSI challenges less than 1% of all issued sick leaves per year. Moreover, the procedure is lengthy and complicated.
Another option is for the government to set an example by monitoring more closely the frequency and length of sick days in the public sector. Such practices are implemented in large private companies by human resource departments by talking with employees' direct supervisors to establish if there are problems.
Also, a possible solution is to set limits on the number of paid sick days per year. Ex-Labor Minister Biser Petkov who resigned in November had said that not so long ago the sick leave paid by the employers could not exceed 15 days per year. According to Petkov, another option is to decrease the length of sick leave that can be issued by general practitioners to half of the 14 days currently permitted by law. Similar restrictions are in place in almost all EU member states. Bulgaria is one of the few countries with no limit on paid sick days per year issued to every employee.
According to a report requested by the European Commission, restrictive measures on sick leave are more easily implemented in times of economic crisis, because workers are fearful for their jobs and are more likely to accept such limitations.