Presentation
The prospects of development of health insurance in Kazakhstan
Saule Jundubayeva, Chairman of the Board of Directors of Interteach Kazakh Health Care and Medical Insurance Corporation JSC, DBA (Kazakhstan, Russia, Switzerland)
The introduction of the social health insurance from July 1, 2017 in Kazakhstan will establish health care financing principle at the expense of the Government, employer, citizen and other sources, and provide for joint and several liability of participants of the system in preservation of health. At the moment, a massive public awareness campaign to introduce the CSHI continues, public and private clinics have been active in preparatory work regarding technical equipment, the introduction of computer technologies and equipment, renewal and training of stuff.
Principles of organization of health insurance are classified, according to the nature of the assistance provided, as compulsory and voluntary insurance.
One of the principles of the CSHI system implementation is liability and universal coverage. Compulsory health insurance is an integral part of the Government social insurance and provides all citizens with an equal opportunity in obtaining medical assistance provided at the expense of the CHI to the extent and under the conditions complying with the programs of the compulsory health insurance.
As a result of innovations it is expected to improve the quality of services provided. The clinics, both private and public, will compete for the patient. In pursuing these aims they will seek to provide better services and of a higher quality so that the patient chooses them.
For the successful introduction of the CSHI, the Government must attract private medical business. Only the creation of healthy competition between the private and public institutions in the health sector can raise medical industry to a whole new level.
In order to attract existing private companies to provide services of compulsory social health insurance, and to expand the presence of the private sector in health care, several mechanisms were developed.First of all, it is the removal of all kinds of administrative barriers, simplification and improvement of the procedures for reviewing projects under public-private partnerships and other mechanisms to ensure that the private sector is involved in trustworthy management of the public clinics and more active provision of the CSHI services. A road map for the development of the PPP in the health care system over the next 4 years is created, also the rules for selection and contracting of suppliers of medical services in the health insurance system is under preparation. Further development of the PPP will implement and develop the capacity of private investors, attract the funds of the institutional investors and keep the Government's functions in socially significant sectors of the economy.
The main advantages in favor of the PPP model is attracting private businesses with more efficient managing system and optimized costs.Also the private sector brings innovation into the field of health care.The PPP reduces fiscal deficit, speeding up the emergence of new health care facilities with modern equipment, while under the constant Government supervision.
The implementation of the strategy in achieving financial security of the Government guarantees is expected.
The strategy stipulates growth of public financing of health care in conjunction with the restructuring of the health care system and its efficiency improvement. This strategy focuses on the development of the VHI while maintaining unchanged the Government guarantees of health care to the population.
In many developed countries, where the the CSHI system was successfully introduced, voluntary health insurance plays a very important role. The voluntary health insurance (VHI) is a voluntary will expressions of an employer, citizens of the Republic of Kazakhstan and foreign nationals. These are all the services that client wishes to acquire, whether he is a citizen of the Republic of Kazakhstan or a foreigner.
At the conclusion of the contract of medical insurance the client’s wish is his right and it may include a variety of components and other features, to be agreed upon between the two parties. The VHI and CSHI are two different categories of insurance. It is legally incorrect to raise and discuss the question of the delimitation of the VHI services from the CSHI services for the benefit of workers, since they are two absolutely different products that have essential differences such as:
- the right on the form of payment (voluntary and compulsory);
- the right to receive medical care (the depth of the provision of services, the quality of examination and treatment, volume, service).
The voluntary medical insurance allows the insured to receive timely, high quality medical services in private clinics and medical centers.
Purchasing the VHI policy, a citizen can use the following advantages of their choice:
- Independent choice of the insurance company
- Independently specify the insurance program
- Protection against financial losses and minimizing financial risks upon the occurrence of a disease
- No queues
- The use of more costly medicines or modern methods of instrumental examinations
- Comfortable treatment setting
- High level of service
At the same time VHI plays an important role in the development of overall health system, since it brings in additional funding into the system. The VHI is also a major channel of reducing the level of hidden economy in medicine.
In Kazakhstan the volume of health care financing by the VHI system is less than 2% of the total volume, but the popularity of this product is growing annualy. Introduction of the CSHI will give impetus to the development and introduction of the new VHI products, service improvement, development of competition, improvement of the quality and efficiency of the services rendered in that sector.
Today the Government is pursuing a policy of active changes in the organization and financing of health care, increasing the effectiveness of the use of the joint resource potential of the health care system, development of new forms of participation of the population in paying for medical care, in this scenario the private sector turns out to be a tool for modernization and seamless part to the emerging integrated and effective health care system.
An essential tool in improvement of the health care system effectiveness and competition in the provision of health care became the introduction of the compulsory social health insurance starting from July 1, 2017.
The world experience shows that investment in the health of the nation creates not just economic, but also social benefits - responsible attitude of a citizen towards himself, his family and the Government, social cohesion. Investing in strengthening of the well-being of the nation includes a large range of possible directions, one of which is the transformation of a subsystem of social economy, affecting health care, as an element of the system of recovery and reproduction of human capital.
It is through the system of compulsory social health insurance, in which citizens themselves are jointly and severally responsible for their own health, along with the Government and employers, it is possible o change the mentality of the society and improve the efficiency of the health care system. And companies with significant investments in infrastructure, will have a competitive advantage over the other and will have more opportunities in the first years to conquer this market.And we are also one of the companies that strategically considering this direction.
