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Medical insurance: obligatory, but not so fast

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Mazhilis deputy Vladislav Kosarev offers to postpone the introduction of mandatory social health insurance until 2019

The proposal was made at a meeting of the working group of the Mazhilis, where with the participation of NCE "Atameken" were discussed legislative amendments to compulsory social health insurance. Vladislav Kosarev said that we can’t rush this issue. It is necessary to prepare thoroughly for the introduction and it must be done slowly.

"I wish that the preparatory process was more soft and perfect. If we implement quickly, we can make mistakes, and if we postpone for one year, then we can thoroughly prepare", - said the MP during the discussion.

NCE RK "Atameken" supports the position of the deputy Vladislav Kosarev.

Speaking at a meeting of the working group of the Majilis, Deputy Chairman of NCE RK "Atameken" Yuliya Yakupbaeva voiced the stance of employers on the issue of implementation of compulsory social health insurance. "Why big employers are concerned? Because, in fact, for them it is a fairly large financial burden. We estimate that, if the deduction will be 2% of the fund, they will gradually increase from the payroll up to 5%, then we will pay as citizens, plus there are additional financial burdens on the employer, the load on the payroll for 2018 will reach 40%. That's a lot", - said Yuliya Yakupbaeva.

According to her, the National Chamber of Entrepreneurs have repeatedly held public hearings on the subject with participation of the Ministry of Health, MPs, employers, listening to the points of view of each party. Understanding the importance of the issue and, in general, by supporting the introduction of CSHI in Kazakhstan, as the new system will improve the efficiency, availability and quality of care, NCE still believes that you can’t hurry with the introduction of compulsory health insurance system. It will take a certain time. In addition, there are many nuances, without settlement of which the innovations can’t be introduced.

"The model of CSHI does not disclose what benefits can citizens receive, what additional forms of assistance will be offered to the public for additional charges, and how it will improve the quality of services", - expressed her opinion the vice-chair of the Board of NCE Yuliya Yakupbaeva.

According to her, the existing information system in the health sector does not meet all the requirements for the implementation of CSHI (the need to make allowance payments and contributions on the basis of personal identification number, the ability of medical organizations in the on-line to see all the necessary operational information, the rapid exchange of information between participants of CSHI, monitoring of CSHI system as a whole, etc.) Moreover, it takes time to introduce an electronic passport of a patient.

"Without the establishment and effective functioning of information systems, the quality of services within CSHI will come to a new level and, therefore, possibly the emergence of discontent and misunderstanding of the new system on the part of citizens and employers (which pay the extra money if the quality and quantity of services remains as before?)", - commented Yuliya Yakupbaeva.

She also stressed that the question of the administration of companies is not resolved completely, which are in the process of rehabilitation / bankruptcy, according to them the arrears of wages of employees are more than 950 million tenge.

Executive Director of the Association “KAZENERGY” Togzhan Kozhalieva also agrees with the opinion of V. Kosarev that the law needs to be improved. At the same time, she stressed that the issue of development of voluntary health insurance remains open. "We are for the introduction of CSHI, but we want to save jobs at the expense of our profitability, so we can pay salary", - she said. According to her, today all the 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 single-industry towns of Zhanaozen, Zhezkazgan, etc.), because of the insufficient quality and availability of medical services provided by public hospitals, offer packages of VMI to its employees and their families. Togzhan Kozhalieva believes that "the introduction of a new system of CSHI, which establishes the employer's obligation to make monthly mandatory contributions, significantly complicates the purchase of services on voluntary medical insurance due to double costs of health insurance services".

Bibigul Malgazhdarova, deputy executive director of the Association of Mining and Metallurgical Enterprises, also supports the proposal of the deputy to delay the introduction of CSHI from 1st of January 2019.

According to her, the enterprises of mining and metallurgical complex are also concerned about how the system of CSHI will work. As stated by the representative of AGMP, preliminary discussions, public hearings of the draft law with representatives of the Ministry of Health and Social Development of the Republic of Kazakhstan at the site of NCE before its submission to the Mazhilis of Kazakhstan did not give a clear understanding of the mechanism of the proposed system. "These meetings have not convinced us that within CSHI quality of services will be at a new level. Why employers should pay extra money, if the quality and quantity of services remain the same? Successful implementation of the mechanism of CSHI requires perfection: for collecting, recording cash receipts and expenditure, and information system and others. The President instructed to listen to the way society relates to innovations in medicine, to develop a road map of action on the implementation of CSHI. The  roadmap is required to ensure transparency of the implementation mechanisms, to improve the quality of medical services within the framework of the proposed legislation",- said Bibigul Malgazhdarova, adding that for the successful implementation of CSHI system, additional preparatory period is required.


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