Distinguished Exellencies, delegates, ladies and gentlemen,

It is an honor and pleasure to greet this World Assembly which is a significant contribution to the efforts of the International Community for the improvement of the status of the elderly people.

I would also like to express my deep gratitude to the Government and people of Spain for hosting this important event and especially for the warm hospitality extended to all of us.

The changes that occurred in the general population structure of the Republic of Macedonia as a result of the processes of industrialization, urbanization, migration and economic transition, as well as the changes in the code of conduct and values, have led to an in-depth transformation of the overall social and family climate. All this has negatively affected a number of groups of people, and particularly the elderly who have found it hard and painful to come in terms with these changes.

In other words, in the period from 1948-1994 in the Republic of Macedonia the process of demographic transition was carried out at notably fast rate. In the very beginning of this cycle, the growth of the population in Macedonia resulted in the recognition of the young population as a visible feature of the population age split. However, the development of the process of transition led to an increase of the presentation of the elderly in the total population, and since 1994 Macedonia has embarked on a process of population demographic split. This can be confirmed by drawing lines of comparison between the three indicators and their respective competencies for evaluation of the population aging process. Namely, 13.03% of the total population is presented by the people aged 60 more than 60; then 8.5% of the total population is presented by people aged 65 more than 65; and finally by the means of the index indicating the population aging, and the rate of which is 0.39, which is very close to the limit rate of 0.40 when the population embarks on the process of aging. At present, Macedonia is only one step away from the last stage- a country with very old population.

Even at the daylight of the 21st century, the accelerated process of aging is expected to continue, and this, on the other hand, will cause grave problems to the fixture demographic, economic, social and technological development. The process of aging in Macedonia has been more intensively covering the female part of the population as well as the rural or so to say the agricultural population. Another feature to underline is the existence of significant regional and ethnical differences present in the process of aging.

• The economic status and the living standard of the elderly in Macedonia has been seriously threatened.

The existence of more than 92% of elderly has been directly related to pensions as forms of secure and permanent source of income. A specific number of elderly has provided for their living by the means of social cash benefit and other forms of social welfare services. A small number of old people are able to improve their living by receiving other types of income (ownership and ownership rights).

The pension system in the Republic of Macedonia has been regulated with the Pension and Disability Insurance Law, and it comprises three kinds of pension: age pension, disability pension, and family pension. The amount of the pension itself is dependent on the pension basis and the years of service.

Categories entitled to old pension are males aged up till 64 and females aged up till 62 with a minimum 15 years of service. Farmers are entitled to pension under the same conditions as all other workers paying the pension insurance. After the death of a pension insurance beneficiary, his or her spouse, parent or child can inherit the family pension on the grounds of a specifically regulated procedure.

The pension system in Macedonia has established a form of the so called minimum pension, and it is determined on the basis of the length of pension service of the beneficiary, and is a percentage of the average wage in Macedonia, This pension provides the minimum standards for living.

In order to overcome the weaknesses of the pension system in Macedonia, there was initiated a process ofthe system restructuring. The new pension system is expected to ensure secure pension allowances for its beneficiaries, and it will exert a positive influence onto the overall economical development of the country. The reforms in the pension system underscore an establishment of a new structure comprised of three components, and they are as follows:

1) A compulsory pension insurance grounded on an age related solidarity; 
2) A compulsory capital financial pension insurance; and 
3) A voluntary capital financial pension insurance.

The multi-leveled pension system has a notable advantage over the current financial pension system, which, due to the age related solidarity, did not incite people to start saving a penny for old days; then, it is resistant to the demographic influences and provides long-term financial and social support for the elderly.

• In Macedonia, the health care for elderly has been regulated with the Health Care Law and the Health Insurance Law and is executed within the frames of the health care for the total population at all levels: primary, secondary; and tertiary.

The health care facilities are not equally developed in all municipalities and regions. Health insurance is compulsory, and for certain types of and rights to health care a voluntary insurance has been introduced.

The system of compulsory health insurance covers almost all categories of elderly. For citizens older than 65 and not having health insurance funds have been provided by the national budget through the system of social welfare.

In compliance with the health care reformed system, the health facilities in the sphere of primary health in the year 2000 were provided without the cash participation on behalf of the beneficiaries, and the people older than 65 with a very small amount of cash participate in the provision ofthe secondary and tertiary health services. Right to health care also implies provision of medicaments broken down on the list of medicaments developed by the Ministry of Health as well as enjoyment of benefits in the sense of obtaining orthopedic and other supporting tools. The people older than 65 participate in cash to the provision of their health services less than the rest of the citizens. In regard to the disabled elderly, the state has approved a specific Health Care Program in compliance to which certain interventions and some brands of medicaments are provided free of charge.

Bearing in mind the fact that the main form of treatment for elderly should be the home health care, efforts have been made to form mobile services well equipped with human and technical resources. Also, it is necessary to organize special training programs in the areas of gerontology and geriatrics as branches deserving a highlighted attention.

• The social welfare has been regulated in compliance with the Social Welfare Law and its target groups are the old and the financially insecure people.

The social welfare provides several forms of care and protection: non-institutional and institutional care, as well as realization of rights to social cash allowances and social allowances in kind.

The institutional welfare is implemented within four homes for elderly, which are owned by the state and in which the services provided are a full leg behind the contemporary gerontology findings and best practices in the developed countries. These services cannot ensure overall territorial coverage.

Recently, there has been noticed the emergence of private homes for elderly, which are run on profit basis and in which the service price is too high and unaffordable for most of the elderly.

In Macedonia, there are about 30 homes independently providing accommodation to pensioners, and they differ from the homes for elderly. They all function on revenue-generation basis and due, to the lack of financial means, are left to their own.

The Family Law is a legal act foreseeing the opportunity for the children to look after their parents in case the latter are not able to provide for themselves.

Although the Social Welfare Law provides legal opportunities for the development of noninstitutional forms of protection for elderly, such as day centers, services delivered in the homes of recipients etc., this kind of protection in regard to provision of home services is at its very nascent phase. The pending reforms in the social welfare are directed towards the decentralization and privatization of the current provision of services, as well towards provision of support to the development of private initiative with gradual involvement of NGOs and volunteers. In that respect, the social care for elderly has been consuming several types of volunteer and humanitarian working, and that is: Third Ear University, Red Cross of the Republic of Macedonia Department for Senior Citizens, Union of Pensioners etc.
 

Thank you for your attention