NCE offers to postpone the introduction of CSMI to 2019
The key idea in health care reform – is to improve the quality of medical services
Currently, the Government of the Republic of Kazakhstan is developing a draft law on amendments to the Law of Kazakhstan "On compulsory social health insurance" regarding postponement of the functioning of the system of CSMI from 1st of July 2017 to 1st of January 2019 with the purpose of creation of the fund as a single strategic purchaser of health services, its affiliates, and consolidation of medical services at the national level.
At the same time, the National Chamber of Entrepreneurs of Kazakhstan "Atameken" has repeatedly held public hearings with the participation of large employers and the professional community to discuss health care reform. Business representatives expressed their concerns that the proposed model without addressing issues of improvement of the quality of care is reduced only to the introduction of an additional tax on employers (2-5%) and employees (1-2%).
In the course of these discussions, it was also noted that the information system in the health sector does not meet all the requirements for the implementation of CSMI. No on-line interaction between the participants in the health care system, the patient has not been introduced to the electronic passport, etc.
As a serious problem businessmen note unexamined issues of administration of contributions from self-employed individuals and contributions from companies that are in the process of rehabilitation / bankruptcy (the arrears of wages of employees of such companies is more than 950 million tenge), as well as access of this category to medical care in CSMI system.
The question of development of voluntary medical insurance (hereinafter - VMI) under CSMI is still open. Currently, all major employers whose employees are engaged in heavy work or work under harmful (particularly harmful) and (or) dangerous working conditions (in Mangistau, Atyrau, West Kazakhstan, Karaganda, East Kazakhstan, Aktobe, Kyzylorda regions, especially in mono towns Zhanaozen, Zhezkazgan, etc.,) offer packages of VMI to its employees and their families, leveling the insufficient quality and expanding the range of medical services, rendered by public hospitals.
Introduction of a new CSMI system that establishes the obligation of employers to make monthly mandatory contributions, significantly complicates purchase of services for employers due to double spending on insurance services.
The National Chamber of entrepreneurs within their expert opinion on the above mentioned draft Law proposes to postpone the introduction of CSMI to 1st of January 2019 and to provide additional training period for administration of cash receipts and expenditures, the efficient functioning of an information system that provides proper accounting of deductions and contributions, the program of electronic passports for patients, possible interactions CSMI and VMI, the mechanism of participation of private clinics and Assistance companies in CSMI.
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