Social Insurance

Social Insurance. Contents: Social insurance in tsarist Russia . .

204 Social insurance in tsarist Russia. The first laws concerning the provision for mine and factory workers were issued in 1861 for the Urals. The purpose of the associations specified in them was 'care for workers in case of illness, old age, and domestic accidents, and the maintenance of widows and orphans of workers'. Factory associations were organized after the model of so-called fraternal funds, existing in Germany and Austria. Similar associations also existed in Poland. In addition, there were savings-assistance and pension funds for railway workers. Minimal benefits were provided under the 1901 law 'on benefits for ill and injured workers from penalty funds'. In 1903, a law on employer responsibility for accidents was introduced, under which factory owners were obliged to treat the injured person and pay him monetary benefits during treatment and a pension in case of disability. The growing organization of the proletariat and the intensification of the revolutionary movement in tsarist Russia after 1905 forced the government to concede to the workers' demands in the field of social insurance. As a result of the work of several government commissions during 1905-12, on June 23, 1912, the Third Duma approved laws on provision for workers in case of illness, and on insurance of workers against accidents. Under the 1912 laws, insurance covered only one-sixth of the proletariat. Insured workers contributed to social insurance from their earnings from 2 to 3%. Employer contributions amounted to only two-thirds of the workers' contributions. Sickness benefits could not exceed two-thirds of the workers' earnings for 26 weeks (without interruption) and 41 days of illness. The duration of benefits in case of childbirth was 2 weeks before childbirth and 4 weeks after. Under the 1912 law, sick funds were organized (see). The tsarist insurance laws had a clearly reactionary character. Lenin defined these laws as 'a law conceived for the purpose of new enslavement and oppression of the proletariat' (Lenin, Collected Works, Vol. XV, 3rd ed., p. 387). The resolution of the Prague conference of Bolsheviks, adopted regarding the Duma insurance bill, proposed to transform these oppressive tsarist laws into an instrument for developing the class consciousness of the proletariat, 'strengthening its organization, intensifying its struggle for full political freedom, for socialism' (Lenin, Collected Works, Vol. XV, 3rd ed., p. 385). In opposition to the tsarist law, the Bolsheviks at the conference, following the report of Comrade Semashko (then pseudonym-Aleksandrov), put forward the following workers' insurance program, drawn up under the leadership of V. I. Lenin: 'The best form of insurance for workers is state insurance, built on the following principles: A. It should provide for workers in all cases of loss of capacity to work (injury, illness, old age, disability; for women workers, in addition, pregnancy and childbirth; compensation for widows and orphans after the death of the breadwinner) or in case of loss of earnings due to unemployment. B. Insurance should cover all persons hired labor and their families. C. All insured should be compensated on the principle of full wage replacement, and all insurance expenses should fall on entrepreneurs and the state. D. All types of insurance should be administered by unified insurance organizations, built on a territorial basis and on the principles of full self-government of the insured' (Lenin, Vol. XV, 3rd ed.). The Krakow meeting of the CC RCP(b) in 1912 adopted a special resolution on the insurance campaign, which unfolded under the leadership of the Bolsheviks, who used the workers' struggle for social insurance 'in close connection with explaining the entire situation in tsarist Russia, clarifying our socialist principles and revolutionary demands' (Lenin, Collected Works, Vol. XVI, Pt. 1, pp. 231-232). The Bolsheviks pursued this tactic within the sick funds themselves. The Mensheviks opposed their thoroughly opportunistic tactic of betraying the interests of workers and betraying the revolutionary workers' movement in the insurance campaign. The Mensheviks accepted the tsarist law as an end in itself—as a means actually capable of providing for workers—and put forward a program demanding only partial improvement of the law. In the insurance campaign, workers fought for the uncut Bolshevik program, for the overthrow of autocracy, the bourgeoisie, for revolution. The insurance laws of the Provisional Government differed little from the tsarist laws. On July 23, 1917, the Provisional Government published 'new laws on social insurance', which contained nothing new. Only minor amendments were made to the 1912 insurance laws. Contributions from employers were equalized with contributions from workers. In addition to what was mentioned, the Mensheviks abolished representation of enterprise owners in the boards of sick funds, but instead introduced a representative of capitalists into the audit commissions of sick funds. Social insurance in the USSR. Social insurance in the USSR is one of the means of strengthening the dictatorship of the proletariat. The main task of social insurance is to increase labor productivity for the construction of socialism by improving the material, domestic, and cultural position of workers. In the USSR, social insurance is one of the measures of the party and government aimed at raising the standard of living of the working people. Soviet social insurance is built on the principles of the workers' insurance program developed by the Bolsheviks under the leadership of V. I. Lenin and adopted at the Prague conference of Bolsheviks in 1912. The declaration of the Soviet government on the introduction of social insurance was published on November 31, 1917. The first laws on social insurance on the transfer of medical institutions to sick funds were published on November 16, 1917, the regulation on insurance in case of unemployment—December 11, 1917, in case of illness—February 22, 1917. During the period of war communism, the system of social insurance was replaced by the system of social provision (decree of November 31, 1918). With the introduction of the New Economic Policy, social insurance was restored by a decree of the Sovnarkom of November 15, 1921. The law on social insurance was included in the code of labor laws of the RSFSR (articles 175-192). Social insurance in the USSR, unlike in capitalist countries, extends to all workers and employees. Funds for social insurance consist exclusively of contributions from employers. Workers and employees are exempt from any contributions to social insurance. The amounts of insurance contributions are established by special tariffs, normal and preferential. Under preferential tariffs, contributions are paid by institutions on the state and local budget, transport, heavy industry, as well as a number of other organizations. Social insurance legislation provides workers and employees with benefits for the following types: 1) for temporary disability due to illness, injury, care for the sick, and for quarantine, 2) for pregnancy and childbirth, 3) additional types, 4) pensions for disability, 5) old age, 6) in case of death of the breadwinner, for length of service and personal pensions. Until the end of 1930, social insurance provided for unemployment. This function of social insurance ceased at the end of 1930 due to the complete elimination of unemployment in the USSR. Legislation on social insurance is subordinated to the tasks of socialist construction. The law on provision for the insured in case of temporary disability is directed toward the preferential provision of the main proletarian cadres, the introduction of socialist forms of labor, reduction of morbidity, and the fight against worker turnover. Benefits for temporary disability are paid in case of illness, regardless of the cause of the illness, from the first day of disability until its recovery or until the sick person is transferred to disability. The amount of benefit for temporary disability is based on the principle of full wage replacement depending on social position and length of service. Under the law of June 23, 1932, the amount of benefits was differentiated. Higher amounts of benefits (full wage) are established for shock workers and workers and employees who have worked at one enterprise for 2 years and have a total work experience of at least 3 years. In addition to benefits for illness, social insurance provides insured women with benefits for pregnancy and childbirth by replacing their earnings during a leave of 56 days before childbirth and 56 days after for women workers engaged in physical labor, and for women employees—42 days before and 42 after. Benefits are also provided in case of quarantine and in case of caring for a sick family member. Benefits for temporary disability are paid exclusively from social insurance funds on special disability certificates, so-called sick certificates, issued by treating physicians serving in health care institutions. Benefits for additional types of provision are given for the purchase of items for care for newborns—in monetary form or in the form of a natural ration, for feeding the child and for burial in case of death of the insured or a member of his family.

Pensions under Social Insurance are issued to workers and employees in case of permanent disability, established in special medical-labor expert commissions as a result of injury or occupational disease, regardless of the length of service (seniority), and in case of disability caused by a general disease, provided the insured has work experience and is classified as one of the three disability groups (see). The size of the disability pension is determined depending on the length of service, the industry in which the worker was employed before retiring, and the disability group—depending on the degree of disability loss. The highest pension amounts are established for workers employed in leading industries. In accordance with the length of service, supplements to the basic pension amount are established, progressively increasing. For disabled persons due to injury and occupational disease, higher pension amounts are established than for disabled persons due to general diseases. Disability due to occupational disease is provided for in the same amounts as disability due to injury. A special list of occupational diseases has been established that entitle to special provision, which contains 23 diseases. The right to old-age pensions is available for industrial workers working in all sectors of the national economy upon reaching 60 years for men and 55 years for women, with 25 years of industrial service for men and 20 years for women. For underground workers and for workers engaged in hazardous work, 20 years of service and 50 years of age are required. Old-age pensions are paid regardless of the degree of ability to work. Social Insurance also pays pensions to families of deceased insured persons, pensions for length of service, and personal pensions. The Social Insurance budget grows in accordance with the growth of the USSR's national economy. This growth is determined by two factors: the growth of wages and the growth in the number of workers and employees. Table 1. Growth in the number of insured persons (in millions). Years Number insured 1922 1923 1924 1925 1826 1927 1928 4.0 5.3 6.0 7.0 8.4 9.0 9.6 Years Number insured 1929 .... 1930 .... 1931 .... 1932 .... 1933 .... 19"4 (plan) 10.9 13.6 17.6 22.6 22.1 23.5 Table 2. Dynamics of the social insurance budget growth. Years Mln. rub. Years Mln. rub. 1924-25 . . . 1925-26 . . . 1926-27 . . . 400.0 670.0 900.0 1258.0 1327.0 1932 ..... 1934 (plan) . 1808.0 2 849.0 4 400.0 4 799.8 5 157.2 Correspondingly, contributions under Social Insurance in rubles per insured person are growing: in 1929 - 121.4, in 1934 - 219.3. The growth in the number of insured persons and the growth in wages mainly determine the growth of Social Insurance expenditures for monetary forms of provision. Table 3. Dynamics of Social Insurance expenditures for benefits and pensions (in million rubles). Types of benefits Benefits for temporary disability . . For pensioning ..... Benefits for additional types ..... Benefits for unemployment . . . . 311.0 392.1 567.9 780.0 815.5 809.8 271.8 317.6 378.4 482.7 632.2 704.9 64.6 54.8 62.6 85.3 91.5 89.6 132.3 49.3 - - Despite the fact that the absolute amount of expenditures for paying benefits for temporary disability, additional types, and for paying pensions increases in 1933 by almost 2.5 times compared to 1928, the share of Social Insurance expenditures for benefits and pensions decreases from 60.7% in 1928-29 to 32.4% in 1933. Table 4. Growth of Social Insurance expenditures on collective forms of service. Items of expenditure Medical assistance and new construction of medical institutions .... Rest homes, sanatoriums and resorts (maintenance and capital investments) . - Therapeutic nutrition Children's institutions (nurseries, kindergartens, children's homes, schoolchildren's nutrition) ..... Housing construction .... Training of personnel ........ 264.4! 359.1 1932 | 1933 502.4] 817.1 41.6 118.4 56.8 0.5 190.7 59.4 114.5 8.3 45.1 334.2 140.0 229.7 31.6 245.4 48.2 140.9' 193.0 710.0 91.8 600.0 593.5 1 198.6 234.3 63.3 255.7 672.0 705.0 Significant shifts in the Social Insurance budget occurred during the reconstruction period in favor of collective forms and methods of service for insured persons in accordance with the tasks of socialist construction and fulfillment of the five-year plan for the national economy. The direction of work towards expanding medical assistance, prevention (worker rest, sanatorium-resort assistance, diet therapy), children's institutions (nurseries, kindergartens, schoolchildren's nutrition), worker housing construction, etc., towards collective forms of cultural and socio-domestic service was determined by the resolution of the CC VKP(b) of 28/IX 1929, the decisions of the XVI Congress of VKP(b) (1930), the V Plenum of VTsSPS (January 1931), and the IX Congress of Trade Unions (April 1932). Expenditures on collective forms of provision under social insurance (as a percentage of the total) were: in 1927/28 - 38.1, 1928/29 - 35.2, 1929/30 - 48.7, 1931 - 54.0, 1932 - 60.0 and in 1933 - 67.6%. One of the main expenditures of social insurance were appropriations for medical assistance to insured persons in the form of a subsidy to funds allocated for healthcare from state and local budgets. Table 5. Growth of appropriations in the Social Insurance budget for medical assistance. Years Mln. rub. ; Years Mln. rub. 859.1 1933-24 . . . 100.0 1924-25 . . . 125.0 502.4 1925-26 . . . 175.0 847.1 1926-27 . . . 245-, O 945.5 1927-28 . . . 244.6 1 134.0 261.4 Appropriations for medical assistance are transferred, according to the resolution of the SNK USSR of 13/V 1934, to healthcare authorities. Trade unions participate in planning the healthcare budget and monitor the fulfillment of the plan and the quality of medical service for insured persons. In order to eliminate equalization in medical service and to ensure differentiated service and provide qualified medical assistance to workers in leading sectors of the national economy (coal, metallurgy, railway and water transport, basic chemistry, machine building, ore, oil), higher norms of appropriations for medical assistance were established for them from 1932, which in 1932 averaged 65 rubles per worker in coal, metallurgical, basic chemical industries, 60 rubles in oil, 58 rubles in machine building, 52 rubles in railway transport, 62 rubles in water transport, 60 rubles in mining, instead of contributions of 30 rubles 46 kopecks in 1932 on average per insured person per year. Higher appropriations for medical assistance are established for national republics (per 1 insured person in 1933): 72 rubles in Tadzhik SSR, 61 rubles - Turkmen SSR, 50.75 - Uzbek SSR; 42.0 - ZSFSR, 36.5 - BSSR, 29.5 - Ukrainian SSR and 28.5 - RSFSR. The distribution of appropriations in the social insurance budget for medical assistance by republics in absolute figures and as a percentage of 1933 (without capital investments) (in million rubles): Table 6. Republics RSFSR . Ukrainian SSR . BSSR . ZSFSR . Uzbek SSR . Turkmen SSR Tadzhik SSR 1933 1934 In % to 1933 460.0 557.8 21.1 144.1 173.6 20.4 15.6 17.5 12.2 30.9 36.4 18.8 14.4 17.0 18.0 3.7 4.3 16.3 3.4 4.0 20.6 To ensure better differentiated medical-sanitary service for workers in leading industries, social insurance authorities, in addition to increasing appropriations for medical assistance in these industries, set the task for healthcare authorities to allocate the best medical and medical-prophylactic institutions for exclusive or preferential service of workers in leading industries and transport (closed network) and to establish for them higher norms and better quality indicators in these institutions. To ensure these requirements and the most effective use of funds allocated under the Social Insurance budget, Social Insurance authorities transferred funds for medical assistance, in accordance with the resolution of the SNK USSR of 3/III 1932, to healthcare authorities by contract. Contracts for the closed network serving workers in leading industries were concluded with healthcare authorities by the corresponding Social Insurance funds of these industries; for the general, open network—by territorial Social Insurance funds, and after the merger of social insurance with trade unions, contracts with healthcare authorities for this network were concluded by trade union councils, through which the financing of this network was carried out. By the resolution of the SNK USSR of 13/V 1934, this procedure for transferring social insurance funds was changed. According to this resolution, all funds for medical assistance, as determined by the social insurance budget of trade unions approved by the SNK USSR, are then transferred to the People's Commissariats of Health of the union republics. The latter, with the participation of VTsSPS and the CC of trade unions, draw up plans and control figures for healthcare with differentiated service norms for workers and employees in basic industries, and upon approval of these plans and control figures by the SNK of union republics, they finance their subordinate healthcare authorities and medical-sanitary networks.

In addition to financing medical care from the social insurance budget and participating in healthcare planning, trade unions were also tasked with controlling the work of health authorities in providing medical-sanitary assistance to workers and employees, with monitoring the implementation of approved healthcare plans and control figures differentiated for workers in leading industries, and with controlling the proper use by health authorities of the social insurance funds, state and local budgets allocated to them. The share of social insurance funds in the total healthcare budget was: in 1928/29 - 42.1%; in 1929/30 - 39.8%; in 1931 - 45.5%; and in 1933 - 48.1%. Allocations from social insurance for the maintenance and construction of children's institutions amounted to 2.8 million rubles in 1929 and 327.0 million in 1934 (including benefits for newborns). These funds are transferred to health authorities (for nurseries, milk kitchens) and education authorities (for kindergartens, children's homes) according to differentiated norms: for nurseries per 1 woman worker employed in heavy industry, on average 24.4 rubles, transport and communications - 21.7, light and food industry - 22.3, agriculture and forestry - 12.0, culture and service - 4.1; for kindergartens in heavy industry - 15.4, transport and communications - 13.4 rubles, light and food industry - 11.8, agriculture and forestry - 5.6, culture and service - 1.9. Table 7. Growth of allocations from the social insurance budget for children's services (in million rub.). Items of expenditure 1933 1934 in 1931 % to | 1933 Maternity allowance ...... Milk kitchens..... Nurseries (maintenance) .... For additional nutrition for schoolchildren and students in FZU.... Pioneer camps and children's 68.0 4.5 85.5 51.9 17.8 29.2 6.9 71.3 5.0 120.0 20^0 37.6 9.7 104.8 111.1 143.7 121.1 112.3 128.7 140.5 Total . . . £63,8 327.0 124.9 Since 1931, social insurance has allocated special funds for nutrition and material assistance to schoolchildren: 5.7 million rubles in 1931, 15.3 in 1932, 29.2 in 1933, and 37.6 million rubles in 1934. Great development has been achieved in the activities of social insurance in the organization of preventive care for workers and employees - worker rest, sanatorium-resort care. Social insurance has at its disposal a powerful network of resorts, sanatoriums, and rest homes organized according to a decree signed by V. I. Lenin in 1921. Currently (in 1934) the following network of preventive institutions is under the jurisdiction of social insurance: resort sanatoriums - 5,615 beds, local sanatoriums - 14,310 beds, rest homes (stationary) - 73,842 beds, weekend rest homes - 3,700 beds, worker youth colonies - 1,156 beds. The total number of beds in all preventive institutions of social insurance was 44,547 in 1927, 74,400 in 1932, and about 100,000 in 1933. By therapeutic types, the resort sanatoriums of social insurance are distributed as follows: sanatoriums - 28, beds in them - 5,615, including cardiac - 1,750, nervous - 260, stomach - 1,355, tuberculosis - 1,045, and mud therapy - 1,205. At the expense of social insurance funds, the number of people treated in sanatoriums and resorts was: 80,703 in 1929, 86,705 in 1930, 101,384 in 1931, 171,181 in 1932, and 213,500 in 1933. Through rest homes: 466,835 in 1929, 519,949 in 1930, 808,428 in 1931, 944,940 in 1932, and 973,892 in 1933. By social composition, workers treated in sanatoriums and resorts accounted for: 77.5% in 1929, 80.4% in 1929/30, 87.4% in 1931, 88.1% in 1932, and 91.2% in 1933; in rest homes - 72% in 1928/29 and 89.6% in 1933. For worker rest and sanatorium-resort care, social insurance spent 972.4 million rubles during the period 1929-1933 (inclusive). Standards for sending insured persons to sanatoriums, resorts, and rest homes are established by the All-Central Council of Trade Unions for 100 insured persons differentiated for each union. The maximum number of referrals falls on workers in leading industries. Priority is given to shock workers, trade union members. Special allocations are made from the social insurance budget for organizing therapeutic nutrition: 8.3 million rubles in 1931, 31.6 million rubles in 1932, 48.2 million rubles in 1933, and 63.3 million rubles in 1934; 62.8% of all allocations for dietetic nutrition are issued for workers in leading sectors of the national economy, who constitute about 30% of the total number of insured persons. In addition to the above mentioned, huge sums are allocated from the social insurance budget since 1930 for training personnel for industry: 59.4 million rubles - in 1930, 140.0 - in 1931, 600.0 million rubles, including scholarships for students, in 1933; for developing worker housing construction: in 1929 - 118.4 million rubles, in 1930 - 190.6 million rubles, in 1931 - 334.2 million rubles, in 1932 - 710.0 million rubles, in 1933 - 600.0 million rubles, and in 1934 - 672.5 million rubles. By spending huge funds from its budget to raise the cultural-domestic and material level of the working class, to carry out broad health measures, social insurance has become one of the most important factors in improving working and living conditions and raising the material and cultural-domestic level of workers, thereby contributing to the increase in labor productivity in the interests of socialist construction. - The activities of Soviet social insurance, combined with the general growth of the material and cultural level of workers, the 7-hour working day, the socialist reconstruction of industry, and the organization of social insurance, medical and worker control and the fight against illness, has led to a sharp reduction in morbidity and injuries. The number of paid days for temporary disability was 875 per 100 insured in 1929, 833 in 1930, 840 in 1931, 752 in 1932, and 715 days in 1933. A sharp reduction in morbidity has been achieved in leading sectors of the national economy (Table 8). The number of accidents has also sharply decreased. In 1932, the number of accidents as a percentage compared to 1928 was T a Я л. 8. Industries Years Number of cases per 100 insured 1932 In % To 1928 Number of days in temp. dis. per 100 workers 1934 in % To 1928 Coal mining .... Ore mining .... Machine building .... Textile industry .... Basic chemistry .... /1928 \ 1932 /1928 1 1932 j 1928 \ 1932 1 1928 \ 1932 / 1928 \ 1932 /1928 /1932 156.5 95.4 144.6 100.5 128.3 95.0 103.4 121.3 122.1 166.1 148.5 89.9 61.0 69.5 74.1 79.1 86.9 60.5 1 370 1064 1 056 940 1 113 972 1 273 1065 990 885 1329 77.7 89.0 81.5 82.9 89.4 66.2 by industry per 1,000 fully insured: in coal mining ...]

74.5 The growth in the material and cultural level of workers, the widespread development of preventive care, and the improvement of medical services for workers have reduced the increase in disabled workers. Table 9. Number of social insurance pensioners. Years Average annual number (in thousands) Number of pensioners per 1,000 insured Total number of pensioners Insured 1928 890.4 1883.6 90.8 1929 1,049.8 9,865.4 96.0 1930 1,171.1 10,932.2 85.9 1931 1,234.4 13,658.8 69.9 1932 1,765.8 17,658.4 61.2 As a result of the successes of socialist construction, the overall mortality rate among the insured has sharply decreased. Organizational structure of S. s. Soviet S. s. since 1922 was in the system of NKT. In the NKT of Labor of the USSR there was a special Central Administration of Social Insurance (TSUSSTRAKH). The network of S. s. bodies was built until the decision of the V plenum of the VTSPS (January 1931) on a territorial basis: district, city, regional and republican social insurance funds. After the resolution of the V plenum of the VTSPS and the resolution of the CIK and SNK of the USSR of June 23, 1932, the servicing of workers in leading industries was transferred to a special industry system. Industry funds were organized in coal, metallurgical, ore, basic chemical, oil industries, railway, water transport, and funds for general machine building, transport, agricultural and aviation-automotive tractor machine building. The remaining insured were served by the territorial system. By the resolution of the CIK, SNK of the USSR and VTSPS of June 23, 1933 on the merger of NKT of Labor with VTSPS, all affairs of S. s. were transferred to the trade unions and restructured exclusively on an industry, production basis. From the IV quarter of 1933, 47 central industry funds of S. s. of the central committees of trade unions were organized, 1,222 regional, territorial and republican industry funds, 18,269 district, city and mine industry funds and 186,200 payment points at all factory committees at enterprises, in state farms, MTS and in institutions. In connection with the reduction in the size of trade unions, according to the decision of the IV plenum of the VTSPS on September 5, 1934, 154 trade unions were created and in them 154 insurance central funds of the union committees. Workers are involved in the work of servicing workers in the field of S. s. in the form of insurance delegates, the number of which reaches several hundred thousand. The insurance active in enterprises and institutions carries out extensive work to assist payment points and health authorities in improving the quality of medical services, combating illness and injuries, improving household assistance, monitoring long-term and frequently ill persons, in combating absenteeism, etc. The general leadership of S. s. in the USSR is carried out directly by the VTSPS. The scientific study of the problems of the history, theory and practice of S. s. in the USSR and in capitalist countries is concentrated in a special research institute of the labor movement of the VTSPS, organized on the basis of the S. s. institute created in 1933. With the transfer of S. s. to the VTSPS, all work in servicing workers in the field of social insurance became the most important organic part of the entire work of the trade unions. Social insurance in capitalist countries. The emergence and development of S. s. in capitalist countries is a result of class struggle. The struggle of the proletariat for S. s. is part of the general struggle against capitalism. The bourgeoisie, as the organizational level of the proletariat grows and the revolutionary movement intensifies, is forced to make concessions to the demands of workers by carrying out various reforms, one of which is S. s. The first laws on S. s. were introduced in Germany in the early 1860s and concerned the insurance of miners. Subsequently, as a result of a significant intensification of class struggle, in Germany in 1883 a law was enacted on compulsory insurance in case of illness and accidents, in 1884 - on disability insurance and in 1889 - on old-age insurance. Following Germany, S. s. was introduced in other countries. The development of S. s. occurred by types: in case of illness, injury, disability, widowhood and orphanhood, old age and unemployment. S. s. received the greatest development in capitalist countries after the imperialist war. S. s. reached the greatest 'prosperity' in the pre-crisis period in Germany, Austria. As a result of the crisis and fascistization (Germany, Austria, Italy, Poland), the bourgeoisie's offensive on the living standard of the proletariat begins, and the gains of the proletariat in the field of 'social policy' are curtailed. The spread of social insurance and the most important dates of the adoption of insurance laws are given in table 10. In the following countries not listed in the table, S. s. does not exist: in Albania, Arabia, Afghanistan, Belgian Congo, Vienna - Table 10. Spread of social insurance and dates of most important laws. Countries Types of insurance maternity disability old age widowhood and orphanage accidents** occupational diseases*¹ unemployment Australia..... Austria...... England...... Argentina ...... South Africa . , Belgium ...... Bulgaria ..... Bolivia ..... Brazil .... Hungary ..... Germany ..... Holland. . . . , Greece ...... Denmark....... Spain ...... Italy ...... Canada..... China...... China (Soviet) Latvia..... Lithuania...... Luxembourg . .. . Norway .... Poland..... Portugal . . . Romania .... USA....... Uruguay ..... Finland ... France..... Czechoslovakia - Chile....... Switzerland . . . Sweden..... Estonia ..... Yugoslavia . . . Japan..... Voluntary Compulsory 1888 Compulsory 1911 Voluntary Voluntary 1894 Compulsory 1918 Compulsory 1891 Compulsory 1883 Compulsory 1922 Voluntary 1892 Voluntary 1908 Voluntary1886.Insurance against accidents 1927 Voluntary 1919 Compulsory Compulsory Compulsory Compulsory Compulsory Compulsory Compulsory 1930 1922 1925 1901 1909 1620 1919 1912 Voluntary 1897 Compulsory 1930 Compulsory 1924 Compulsory 1924 Compulsory 1914* Voluntary 1910 Compulsory 1920 Compulsory 1922 Compulsory 1922 State pensions 1912 Compulsory 1888 Compulsory 1911 Voluntary Compulsory 1918 Compulsory 1891 Compulsory 1883 Compulsory 1922 Voluntary 1915 State security 1923 Compulsory 1923 Compulsory 192W Compulsory 1922 Compulsory 1926 Compulsory 1901 Compulsory 19C9 Compulsory 1920 Compulsory 1919 Compulsory 1912 Voluntary Compulsory 1913 Compulsory Compulsory 1921 Compulsory 1914* Voluntary 1910 Compulsory Compulsory 1922 Compulsory 1922 State pensions 1908 Compulsory 1906 Compulsory 1911 Compulsory 1921 Compulsory for miners 1924 Compulsory 1924 Compulsory 1932 Compulsory 1928 Compulsory 1889 Compulsory 1913 Compulsory 1922 Compulsory for members of sick funds 1921 Compulsory 1921 Compulsory 1923 Compulsory 1930 Compulsory 1925 Compulsory 1881-1927 Compulsory 1912 State pensions 1919 Compulsory 1930 Compulsory 1924 Compulsory 1924 Compulsory** Compulsory 1913 Compulsory 1522 State pensions 1908 Compulsory 1906 State pensions 1908 Compulsory1925 State pensions Compulsory 1924 Compulsory 1924 Compulsory 1932 Compulsory 1938 Compulsory 1938 Compulsory 1913 Compulsory 1922 State pensions 1891 Compulsory 1919 Compulsory 1923 State pensions 1927 Compulsory 1930 Compulsory 1925 State pensions 1923 Compulsory 1884-1927 Compulsory 1919 Compulsory 1.912 State pensions in 8 states 1923 State pensions 1919 Compulsory 1930 Compulsory 1924 Compulsory 1924 Compulsory** Compulsory 1913 Compulsory 1922 Compulsory 1906 Compulsory 1925 Compulsory 1924 Compulsory Compulsory 1932 Compulsory 1928 Compulsory 1911 Compulsory 1913 State pensions 1891 State pensions Compulsory 1930 Compulsory 1925 Compulsory 1927 Compulsory 1919 Compulsory 1912 Compulsory 1930 Compulsory 1924 Compulsory 1924 Compulsory** Compulsory 1922 Employer liability in some states 1915 Compulsory 1888 Employer liability 1897 Employer liability 1915 Employer liability 1914 Employer liability 1903 Compulsory Employer liability Compulsory Compulsory Compulsory Compulsory Employer liability Employer liability Compulsory Employer liability Compulsory 1918 1924 1919 19C8 1884 1900 1914 1898 1916 1912 1905 Compulsory in 2 provinces Voluntary Compulsory 1930 Compulsory 1927 Employer liability 1903 Compulsory 1801 Compulsory 1911 Compulsory 191.9 Compulsory 1919 Compulsory 1912 Employer liability 1902 Employer liability 1920 Compulsory 1917 Employer liability 1898 Employer liability 1887 Compulsory 1924 Compulsory 1911 Compulsory 1916 Compulsory 1912 Compulsory 1922 Employer liability 1911 Employer liability 193) Compulsory 1928 Employer liability 1906 Employer liability 1915 Employer liability 1924 Compulsory 1927 Compulsory Employer liability Employer liability Compulsory Compulsory Compulsory Compulsory Compulsory 1924 1924 1919 1927 1925 1928 1932 1933 Compulsory 1929 Employer liability in some provinces since 1918 Compulsory 1930 Compulsory 1927 Compulsory 1928 Compulsory 1928 Compulsory 1919 Compulsory 1933 Employer liability in a number of states Compulsory 1925 Employer liability 1919 Employer liability 1932 Compulsory 1927 ! Compulsory 1911 / Compulsory 1929 Compulsory 1922 Compulsory in the state of Queensland Compulsory 1920 Compulsory 1911 Voluntary 1920 Compulsory 1925 Compulsory 1624 Voluntary 1916 Voluntary 1827 Voluntary 1919 Compulsory 1923 Compulsory 1930 Voluntary 1906 Compulsory 1924 Voluntary 1917 Voluntary 1925 Voluntary 1921 Voluntary (compulsory in 13 cantons) Voluntary In some can-tons. ** Only in the canton of Glarus. illnesses under the employer liability system. The marks 'employer liability' shown in this column indicate compensation for injuries and occupational dis- eases, India, Egypt, Colombia, Costa Rica, Mongolia, Persia, Africa, Siam, Turkey. In addition to the above, S. s. does not exist in English, Dutch, Spanish, Italian, Portuguese, North American, French and Japanese colonies. Out of a total of 77 countries, S. s. in one form or another exists in 37.

By the beginning of 1934, accident insurance had been introduced in 43 countries (of which compulsory insurance in 25 countries, voluntary in 18), insurance in case of illness—in 39 countries (compulsory in 24, voluntary in 25). Maternity insurance—in 27 countries (compulsory in 24, voluntary in 3). Old-age insurance exists in 30 countries (compulsory in 25 and state pensions in 9). Disability insurance—in 22 countries, widowhood—in 13 countries and orphanage—in 16 countries, insurance for occupational diseases—in 17 countries. In capitalist countries, as a result of the world economic crisis and the colossal unemployment, the number of insured persons is constantly declining. In Germany, the number of insured (against illness) decreased from 22.4 million in 1929 to 18.7 million in 1932. The decrease in the number of insured is the result of various restrictions and deterioration of legislation regarding the circle of persons covered by the Social Insurance law. More precise data on the number of insured have been developed based on materials from 1929. Table 11. States On compulsory insurance, the number of insured in absolute figures (in millions of people) in % to the number of workers and students 2.3 19.0 90 100 33 46 80 66 65 Hungary ....... Germany ...... Czechoslovakia . . . 0.2 1.0 22.6 2.8 2.6 The total number of insured against illness in all capitalist countries in 1929 amounted to about 70 million people. ²/3 of this number falls on compulsory insurance and 1/3 on voluntary insurance. By the beginning of 1934 (according to calculations by B. G. Dansky), due to the world economic crisis, the number of insured decreased by at least 25%. The number of insured against unemployment in capitalist countries was about 35 million in 1929, and about 25 million by the beginning of 1934. The decrease in the number of insured against unemployment is the result of the deterioration of unemployment legislation and the mass removal of the unemployed in Germany, Austria, England, Poland, Italy and other capitalist countries from benefits (implementation of laws on 'means testing' in England and the fascist attempt to 'eliminate unemployment' in Germany, etc.).-Funds for Social Insurance in capitalist countries consist of contributions from the insured themselves, additional payments from employers and in some cases subsidies from the state. In capitalist countries, deductions by workers for Social Insurance are a tax on the meager, constantly decreasing wages of workers. The average amounts of contributions for Social Insurance vary for each type of insurance and were Table 12. Participation of the insured, employers and the state in various types of insurance (in %). Countries Insured Employers State

I. Insurance in case of illness Austria .... England .... Bulgaria .... Hungary .... Germany .... Poland .... Romania .... Czechoslovakia Japan .... 50.0 38.0 33.3 60.0 66.7 40.0 100.0 60.0 45.0 50.0 40.0 33.3 50.0 33.0 60.0 50.0 45.0 22 33.3 II. Insurance in case of unemployment Austria . England . Germany Italy . Poland . 36.0 34.0 50.0 60.0 11.7 36.0 38.0 50.0 60.0 50.0 28.0 28.0 III. Insurance of disability, old age, widowhood and orphanage Austria .... England .... Germany . . . Italy .... Czechoslovakia France .... 45.0 38.0 36.0 40.0 50.0 60.0 45.0 10.0 40.0 22.0 36.0 28.0 40.0 20.0 50.0 - 50.0 ' in 1931 g. by insurance in case of illness in percentages to wages: in Austria-7.0, England-2, Germany-3 - 7.5, Poland-7.5, Romania-2.77-3.66, Czechoslovakia-5.6, Yugoslavia-6, Japan-6.0 etc. By all types of insurance the amount of insurance contributions amounted to percentages to basic wages: in Austria-17, Germany-17, England-8, Czechoslovakia-13. Budgets of S. s. of capitalist countries as a result of crisis, growth of unemployment, decrease in number of insured and deterioration of insurance legislation fall. Budget by all types of S. s. in Germany in 1933 g. comparatively with pre-crisis period and with 1932 g. amounted (in million marks): Table 1. Types of insurance Insurance in case of illness: income ........... expense ... ....... Insurance against accidents: income ........... expense ........... Insurance in case of disability of workers: income.......... expense ..... ...... Insurance in case of disability of employees: income ........... expense ........... Insurance of miners and employees of mining industry: income ........... expense ........... All branches of social insurance except unemployment: income ........... expense .......... 1929 g. 2 322.4 2 219.3 429.9 410.7 1628.7 1 324.3 495.9 186.2 262.0 231.9 5 138.9 4 372.4 1932 g. 1 234.6 1217.8 330.7 333.0 1104.1 1 288.8 446.4 203.6 200.1 200.8 3 315.9 3 304.0 1 160.0 1 125.0 299.0 305.1 1 144.3 1 186.9 448.8 275 " 201.0 197.0 3 253.1 3 089.6 The total size of budget of insurance in case of illness in Germany decreased in 1932 g. comparatively with 1929 g. almost twice. Most strongly decreased the fund of benefits for temporary disability: in 1932 g. it amounted to only about one third of that sum which was before crisis in 1929 g. Expense on medical care decreased more than 2 times, expense on doctors decreased more than 7/3, expense on hospital treatment fell by 33%. Expenses on S. s. in Austria sharply decreased compared with 1933 g., namely 129 million shillings in 1932 g. and 86 million shillings in 1933 g. It is interesting to compare decrease of funds on S. s. with growth of military budget in the same Austria: 173 million shillings in 1932 g., 189 million shillings in 1933 g. S. s. in capitalist countries is subordinated to interests of bourgeoisie. Sizes of benefits and pensions constantly decrease. Benefits in case of illness in all capitalist countries are paid from 3-4th day of illness in amount not exceeding (optionally) 50-60%, provided that the insured has insurance period (i.e. payment in form of insurance contributions 40-46% of earnings). In England insurance period is established in 26 weeks. Size of benefit is differentiated-for men higher than for women. Single workers receive benefit for illness in smaller amount than family ones. In case of placement of sick insured in hospital the insured is so-called pocket money, and in some countries (England, Lithuania) payment of benefits stops altogether. Determination of size of benefits (except England, where fixed benefit is paid regardless of earnings) is made depending on that class of earnings, to which the insured is referred.-Sick funds have in their staff trusted physicians. As a result of crisis and desire of sick funds to decrease expenses on medical care and to conduct economy mode at expense of deterioration of service of workers in 1930 g. in insurance code of Germany was introduced new item (364 ab) on obligatory invitation by funds of trusted physicians for control over proper issuance by physicians of sick leave certificates. Trusted physician is consultant of fund on all medical questions. Main basis of his work is control over sick persons. With coming to power of Hitler was made "purge" of physicians of non-Aryan origin and "politically unreliable" elements. Trusted physicians are present in sick funds of Austria, Czechoslovakia, Poland etc. Number of paid days for temporary disability amounts on average per 1 insured in year in Germany-14.0 in 1929 g., 11.63 in 1930 g., 10.73 in 1931 g., 9.18 in 1932 g. Decrease of indicators of morbidity by number of cases and days of disability in years of crisis at colossal impoverishment of worker masses is explained by the following reasons: 1) sharp decrease of norms of benefits, conducted in a number of emergency decrees (Hindenburg-Brunnig-Papen), 2) selection of healthiest workers, remaining at work, and elimination of long-term sick and semi-invalids and 3) economic terror-fear of workers, remaining at work, to lose place because of frequent or long-term illness. Same phenomenon is observed in Austria. Per 1 insured worker in industry there fell days of disability: 16.2 in 1929 g., 14.1 in 1930 g. and 13.8 in 1931 g. Morbidity of insured women in capitalist countries is considerably higher than men. By number of days of illness older ages of insured give higher indicators; by number of cases of disability highest level is given by most productive age groups (20-35 years). Benefits in case of motherhood are united organizationally with insurance in case of illness; only in Spain, France and Italy there exists separate insurance of motherhood. Insurance of motherhood consists in issuance of benefits to insured women for pregnancy and childbirth (before and after childbirth) and issuance of lump-sum benefit for medical care or free provision of medical care, in issuance of benefit for acquisition of items for child care and in issuance of benefit for feeding. Main benefit for pregnancy and childbirth to insured women in most countries is issued in the same amount as benefit for illness. Terms of issuance of benefit in case of pregnancy and childbirth are established in Germany, Czechoslovakia and Bulgaria in 6 weeks before and 6 after childbirth, in Latvia, Hungary-4 and 8, in Norway-2 and 6, in Poland-2 and 4, Romania-2 and 6 etc. In England insurance of motherhood is limited by lump-sum benefit, provided presence of insurance period in 48 weeks. Benefit for feeding is provided in a number of countries, except England, Bulgaria, Hungary, Norway, Romania, Estonia and Japan. Size of benefit amounts to 50% of main benefit for pregnancy and childbirth. Duration of payment of benefits for feeding in most countries is established in 12 weeks. Insurance of disability, widowhood and orphanage in many countries is organizationally united. Sizes of pensions are extremely low. In Germany in 1932 g. sizes of pensions to disabled were decreased compared with 1931 g. by 23%. With coming of Hitler by new law of 7/XII 1933 g. size of pension sharply decreased again. Right to pension is conditioned by requirement of long insurance period; sizes of pension of disabled vary depending on class of wages. Pension consists of basic and supplements. In Germany pension is issued to insured provided condition of loss of working capacity not less than 67%. Pensions are issued for life or lump-sum in capitalized form. Size of pension is established depending on degree of loss of working capacity in percentages to earnings, which insured received before transition to disability. Size of pension in case of injury or professional injury amounts in percentages to wages: Austria-66.7, England-50-75, Germany-66.7, Poland-66.7. In a number of countries supplements for children, injured by injury, are provided. In case of death of insured benefits for funeral are issued in amount from 20- to 50-fold daily wages. Pensions for old age, as indicated above, are established in a number of countries. In Australia this type of insurance is conducted at expense of appropriations from state budget. Pensions are issued to men upon reaching 65 years, women-60 years, provided presence of disability. In Austria, in Sweden insurance contributions for insurance of old age are paid fully by insured. Insurance of old age is conducted in a number of countries on voluntary basis, in a number-on compulsory. For receipt of old age pension necessary is insurance period: in Austria-500 weeks, France-30 years, Italy-240 half-monthly contributions etc.-Calculation of pensions for old age is made: 1) in form of fixed rates regardless of size of earnings, 2) depending on previous earnings and 3) from amount of paid contributions. In a number of countries separate groups of workers have their own laws for provision of old people (Belgium-miners, Austria-forest workers etc.). In some countries exist parallel insurance and provision of old age. Table 14.

Reduction of the disability insurance budget in Germany during the crisis and Fascist period (in millions of marks). ] Types of benefits 1931 G. Pensions for disabled persons from general diseases........1 020,4 Pensions for long-term sick............j Pensions for old age . . . . ! Pensions for widows..... . Temporary pensions for long-term sick widows . . . Pensions for orphans.......! Treatment for long-term sick ............ 61,3 Maintenance of disabled homes...........

1,8 Maintenance of orphanages ............. o,по Expansion of benefits and pensions . . ,.......... 2,6 0,8 16,B 182,9 0,6 117,5 г. a 4 4 5 6 1933 г. 3,6 10,5 130,4 0,4 48,2 34,1 1,1 0,09 0,7 Insurance against occupational diseases is conducted in a number of countries. In Belgium, the law provides only for compensation to victims of lead and mercury poisoning and of anthrax. The organization of this type of insurance is concentrated in the ministry of labor and industry. In Switzerland, occupational diseases are equated with injuries. The list of occupational diseases contains 80 substances, poisoning by which gives the right to compensation. In France (1921), the law applies only to lead and mercury poisoning. In England, occupational diseases are equated with injuries. The list of occupational diseases contains 11 names. In other capitalist countries, insurance against occupational diseases is very primitive.-Statistics of industrial traumatism among insured persons gives the following picture: in Germany per 1 000 insured persons employed in industry, 1920.-100,0; 1923.-82,0; 1927.-189,33; 1929.-188,58; in Austria: 1922.-100,0; 1925.-142,57; 1927.-L74,5; 1929.-212,41. The average duration of one accident is 22.5 days of disability. The rate of disability per 1 000 insured persons is: 14.4 in 1924, 16.0 in 1930, 15.3 in 1931, 12.7 in 1932, 12.0 in 1933. As a result of the impoverishment of the working masses and the displacement of elderly workers from production in Germany, there is a sharp increase in the number of disabled persons (per 1 000 insured): 67.4 in 1913; 80.3 in 1924; 101.9 in 1928; 114.8 in 1930; 129.5 in 1933 and 133.7 in 1934, or 13.4% of insured persons. The average duration of pension receipt in Germany (for the period 1930-32) is 8 years. The average age of onset of disability in Germany is 51.2 in 1927 and 51.8 in 1928. Medical care for insured persons. In most cases, mandatory social insurance provides for medical care for insured persons and the organization of its own medical care institution for this purpose. Insurance authorities are obliged to provide medical care to the insured and are responsible for its quality and scope. By legislative means or by means of contracts, the conditions under which doctors must serve insured persons are determined. In capitalist countries, the following systems of medical care exist: 1) unlimited free choice of doctors by insured persons, 2) limited choice, 3) district doctors to whom insured persons of their district can turn, and 4) doctors on the permanent staff of sick funds. In Germany and Austria, the free choice of doctors by insured persons among a certain number of doctors, established on the basis of the total number of insured persons and the specific characteristics of a given insurance authority, or limited choice among doctors who have contracts with the fund, is established. The practice of treating insured persons by district doctors or doctors on the staff of the fund is widespread. Insurance authorities at the place of doctors' association establish the fee schedule and pay the due amount directly to the doctor or pay the entire fee to the doctors' association, which then distributes it among its individual members based on the work done. The scope of medical care is established by the fund--it supervises the work of the doctor, it monitors the prescribed medicines. The doctor is obliged to inform the fund of all information about the disease of the insured person, he indicates the diagnosis on the sick leave slip--medical confidentiality is not observed with respect to the fund. Against this system, in recent years in some countries, a fierce struggle is being waged by professional medical organizations, they believe that social insurance authorities should not take upon themselves the responsibility for organizing medical care. The system proposed by doctors (called the subsequent compensation system) consists in that the insured person must himself take care of obtaining medical and pharmaceutical assistance; he can turn to any doctor having the right to medical practice without any restrictions and without any intervention of insurance authorities. Such a system of medical care exists in France--its results are expressed in the insured paying 30-40% of the cost of treatment, and in Norway since 1925, when the organization of medical care could not be established due to the impossibility of reaching an agreement with doctors, but in 1930 subsequent compensation was abolished there as clearly unsatisfactory. Along with the tendency to eliminate the organization of medical care by insurance authorities, another tendency is also emerging, aimed at replacing the medical care provided under social insurance with unified medical care for the entire population or at least for its poorest part (Poland). Expenses for payment of medical fees absorb large amounts of sick funds--about 40% of all expenses for medical care in Germany, about 23% in Austria, 40% in England, 10% in Poland, 47.3% in Norway. Outpatient treatment (with the exception of Poland and Latvia) is nowhere provided to insured persons. Inpatient treatment is provided in Germany, Poland, Austria and Latvia and other countries, partially in their own medical institutions or by renting beds. Sanatorium-resort care for worker-insured persons is provided to a small extent in Germany-0.5% of the total number of participants in sick funds, Austria-0.4%. Rest homes of sick funds exist in Poland, Latvia. The network of medical institutions of German sick funds before the crisis consisted of 108 institutions with 13,800 beds, including 58 institutions for the treatment of tuberculosis. In Germany, treatment of disabled persons was carried out. In England, expenses for medical care in 1931 amounted to about 10 million pounds sterling, of which 78% went to payment of doctors, 22% to supply of medicines. In Japan, the system of free choice of doctors operates. Medical care is provided in general outpatient clinics and medical institutions at the expense of insurance funds. In the years of crisis, expenses for treatment sharply decreased in a number of capitalist countries (Germany, Austria, etc.). Characteristic is the conduct of social insurance in the Soviet part of China, where the general law on social insurance was adopted by the All-China Congress of Soviets in 1930. The social insurance fund is formed from contributions of employers (10-15% of the total wage amount). Social insurance applies to all engaged in hired labor. Leadership of social insurance is carried out by revolutionary trade unions. Insurance in case of illness, accidents, occupational diseases, maternity, widowhood and orphanhood, disability and old age, unemployment, mandatory free medical care is established. Organizational forms of management of social insurance in capitalist countries are very diverse. The owners of insurance organizations are in fact the bourgeoisie and state officials. The organs of insurance in case of illness are 'sick funds', of accidents--'insurance societies', of unemployment--'unemployment funds', of disability--'pension funds', etc. Each type of insurance has its own budget and its own management, subordinate to the ministry of labor. The fragmentation of the network of social insurance organs in capitalist countries leads to high organizational expenses. In relation to the total amount of social insurance expenses, organizational expenses in Germany amount to 14-16%_; in England up to 17%. Optional participation of insured persons themselves in the activity and control over the work of insurance organizations in recent years in the period of fascistization has been completely eliminated. The struggle for social insurance is part of the general struggle of the working class against capitalism. In recent years, the struggle for social insurance has been steadily developing under the leadership of revolutionary trade unions and fraternal communist parties. An active insurance campaign is being conducted in various countries (Poland, France, Czechoslovakia, Austria, Italy) in elections to insurance bodies. Attempts to worsen laws cause decisive resistance from the proletariat. The struggle is also waged with social-fascists, who occupy the usual position of compromise with the bourgeoisie. The International Labor Office at the League of Nations repeatedly tried to raise various problems of social insurance, developed and adopted various conventions, which, despite their compromising character, were not adopted by bourgeois states. Social insurance meeting the interests of the proletariat is not possible under capitalism. The practice of social insurance throughout the world has shown that social insurance can be built in the interests of the proletariat only on the principles indicated by the Bolsheviks in their insurance program. And the implementation of these principles is possible only under the dictatorship of the proletariat.