"Atameken" proposes to extend the period of preparation for the introduction of compulsory social health insurance until 2019

The main proposals of the business community on the effective introduction of the system of compulsory social health insurance were discussed at the site of the National Chamber of Entrepreneurs of RK "Atameken" with the participation of Health and Social Development Deputy Minister Elzhan Birtanov and other representatives of the Ministry of Health, industry associations, employers and business communities.

In June of this year at the site of "Atameken" has already been discussed a draft concept on amendments to the law "On compulsory social health insurance". As it was noted by the Deputy Chairman of NCE RK Yuliya Yakupbaeva the issue of introduction of CSHI is a "sensitive" topic for the professional community and employers. "The load on the business must be sufficiently justified by the benefits that people and businesses will receive from the new system. That is why we focus on the quality of services that the client will receive as a result of introduced innovations", - she said.

According to her, if now questions of administration will not be regulated carefully, as well as issues of financing of medical institutions, the participation of private institutions in the system of voluntary medical insurance and the participation of others, it is necessary to think of postponement of the introduction of CSHI until 2019.

As it was noted by Yuliya Yakupbaeva, the draft concept reflects a proposal of NCE to exclude the extension of the period for payment of contributions for medical aid within the system of CSHI from 12months to 11. The concept also includes some new elements, as an adjustment of sums of contributions paid for the year and the obligation to pay contributions by enterprises which are in liquidation or bankruptcy.

NCE also raised the issue that in the case of non-payment of charges and fees, the client will be able to get help with the system compulsory social health insurance for a maximum of 3 months from the date of the termination payment.

The representative of the Association “Kazenergy” Dastan Tulenov focused on the formation of the Fund's reserve for contingencies and proposed to develop a clear list of such costs, and to develop a procedure for allocation of funds from the Fund for this purpose and to ensure control over the expenditure of funds. He also proposed to make all payments – both from employers and the state at one time from January 1, 2019. "Why does the employer must pay contributions for six months, and the employee during this time will not even receive medical care within CSHI?” - Dastan Tulenov put a reasonable question.

The representative of KMG "KazMunaiGas" Bakyt Imangaliev drew attention to another problem. Family members of oil workers often use medical services paid under the voluntary health insurance of the employer. In this regard, he proposed to exclude housewives from the labor force, which is obliged to make contributions to the system of mandatory social health insurance, as well as to consider the possibility of combining the financing of CSHI and VHI (voluntary health insurance) packages at the level of outpatient care and hospital care. This will allow the population with a higher level of return to receive superior service, a reception at a certain doctor. According to the representative of KMG, it is also to include a mechanism for co-pay of the patient to CSHI Fund.

According to the representative of Kazakhstani Association of Insurers Marina Shipovalova, the draft concept does not take into account the following fact: "Why it does not consider that the person, the recipient of services may have several sources of income? He may have several jobs, one-basic, the other – part time, he can as well be an individual entrepreneur, since it is not prohibited by the law. He can also receive income from other sources under civil law. How will be the limit administered - income from of all places or from one place? Does he have to pay it "from each income source? She asked.

Shipovalova also noted that the draft law on the concept of CSMI does not include VHI, about which she has repeatedly spoke. "We do not need to regulate, but to stimulate!" - she said.

The representative of the Association of mining and metallurgical enterprises drew attention to the proposal on inclusion in the list of health care provided in the framework of CSHI, the periodic and shift health inspections and examinations of workers engaged in heavy work or working in harmful (particularly harmful) and (or) dangerous working conditions. He also asked to include in the Labor Code the norm, according to which for the conclusion of an employment contract on work in harmful and (or) hazardous working conditions, the applicant should submit an extract from the medical records of outpatient, inpatient care, in order to avoid risks, associated with hazardous conditions and the development of a vocational disease.

Elzhan Birtanov spoke on all proposals of entrepreneurs. He said that the Ministry of Health supported the exclusion of the need to adjust the amount of contributions with the need to pay additional amounts for the year, and the participation of medical assistance companies as health care providers. Regarding the possibility of co-pay of patients to the Fund of CSHI, the Vice-Minister of Health pointed out that at this stage, the issue of co-payment is considered in the field of some drugs.

At the end of the meeting Chairman of the Committee of pharmaceutical, medical industry and medical services NCE RK Dzhambulat Sarsenov noted that you can’t rush with the adoption of the Law on compulsory social health insurance, since this question has many different nuances that you need to work out before the adoption of the document. In his opinion, it is necessary to discuss the draft law in single-industry towns and industrial cities where there are companies that have the medical units, and they should know what they will receive as a result of CSHI.

The Head of the Committee of NCE also supported the proposal to establish a road map for the introduction of CSHI. "If we want to get high-quality legislation that will be a credit to us all, developers and executors, we must now actively take up the creation of the Road Map, to distribute among participants the areas of responsibility", - concluded Dzhambulat Sarsenov.