Government considers country's readiness for implementation of compulsory social health insurance

At the Government conference call chaired by Prime Minister Askar Mamin, the results of the pilot project on the implementation of compulsory social health insurance in the Karaganda region were reviewed.

Minister of Healthcare Yelzhan Birtanov, Akim of the Karaganda region Zhenis Kassymbek, Chairman of the NJSC Fund for Social Health Insurance Aibatyr Zhumagulov presented their reports.

Since Sep. 1, 2019, the pilot project for testing the social insurance system and preparing for its full-scale implementation in Kazakhstan has been implemented in the Karaganda region. Over two months, the coverage of the region’s population with rehabilitation assistance increased (by 42.2%), more people started taking expensive tests (CT and MRI) with medical insurance (by 192%).

A new model of the guaranteed volume of free medical care and the social insurance package provide for the introduction of a three-level medical care system from Jan. 1, 2020.

The first level – the new model of the guaranteed volume of medical care defines clear boundaries of state obligations and implements the universally recognized international standard for universal coverage of basic health services.

The second level is the compulsory social health insurance package for the insured population, which ensures the availability of medical care beyond the guaranteed volume of medical care.

The third level is medical services that are not included in the guaranteed volume and insurance packages. They are provided for a fee or through voluntary health insurance.

The state continues to provide the population with the necessary package of basic medical services at the level of primary health care (preventive vaccinations and medical examinations, patronage, pregnancy management, etc.) and access to emergency and emergency care.

Taking into account the introduction of the insurance, in aggregate, the health budget in 2020 for the country will be about 1.5 trillion tenge, including more than 500 billion tenge due to the insurance. Financing of priority types of medical care based on the needs of the population, including medical rehabilitation, will increase significantly, which will increase by seven times next year and up to 11 times by 2025. The salary of health workers next year will be increased by 30% among doctors and by 20% among nurses, and by 2025 it will increase by two times compared with the current salary.

“Elbasy Nursultan Nazarbayev set the task to ensure complete readiness for the introduction of the insurance. The Head of State Kassym-Jomart Tokayev in his Address to the People noted that it is necessary to approach the issue of implementing social health insurance with utmost responsibility. It should cover all Kazakhstanis. For this, medical organizations of all levels must be connected to the necessary information systems. The data on each citizen should be updated,” Mamin said.

The prime minister praised the results of the pilot project for the implementation of OSMS, indicating the need for the regions to take into account the experience of the Karaganda region.

The head of government instructed until the end of this year, to ensure the full readiness of medical organizations to start working under the insurance system, to complete the updating of population data and to ensure the accuracy of information in information systems for children, students and unemployed persons raising children under three years of age.

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