Dominican Republic and Haiti: Country Studies

Dominican Republic: The Society and Its Environment
Social Security
The Dominican Social Security Institute (IDSS) , an autonomous
organization, is responsible for social security coverage,
which includes old-age pensions, disability pensions, survivors'
and maternity benefits, and compensation for work injuries.
General tax revenues supplement employer and employee contributions.
Wage earners, government employees (under special
provisions) , and domestic and agricultural workers are
eligible, although the benefits that most domestic and farm
workers receive are quite limited. Permanent workers whose
salaries exceed 122 Dominican Republic pesos (RD$—for
value of the peso, see Glossary) per week and the self-employed
are excluded. No unemployment benefits are provided. In
1994, 6.5 percent of the general population and 15.4 percent
of the economically active population, or approximately 22
percent of wage earners, were enrolled. Most of those enrolled
were in manufacturing, commerce, and construction. The
social welfare of workers in the hotel and restaurant sector is
provided by the Hotel Social Fund, a nonprofit public organization.
Pensions and social services, including medical care,
are covered by funds contributed by the government, employers,
and workers. The Aid and Housing Institute also provides
social services such as housing construction, medical care, and
pensions to civil servants and military personnel below a certain
salary level. Affiliation is compulsory for these two groups.
Although the level of government services exceeds that of
the republic's impoverished neighbor, Haiti, limited resources,
inefficiency, and a lagging economy until the late 1990s, have
limited the overall impact of these programs. In 1985, 8.8 percent
of the national budget supported health services, and an
additional 6.9 percent funded social security and welfare programs.
As a proportion of overall spending, the percentage
rose to 9.5 in 1990, but declined to 7.8 percent for 1991-92 and
remained at that level through 1995. More specifically, total
spending by SESPAS declined as follows: from 86 percent to 65
percent between the periods 1979-82 to 1987-90, and to 55.5
percent in 1991. However, the Office of the President, in order
partly to compensate for the decline, increased its share in
health spending from 1.8 percent to 18 percent and then to
38.4 percent, respectively, during the same years. In 1991 total
direct spending per doctor visit, bed, and hospital discharge
was 60 to 70 percent lower than in 1980. In 1995 the combined
national and local governments' public health expenditure was
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