Kazakhstan’s compulsory medical insurance program, which will come into effect January 1, 2020, will provide everyone with sufficient medical care, said Tatyana Tsechoyeva, the Central Railway Hospital deputy director for medical and preventive work.
“Today, unfortunately, patients are increasingly faced with the need to pay for medical services and, by the way, it should be noted that prices in private clinics are sky-high,” she said, as reported by elorda.info.
“Therefore, today there is a need to develop two packages of medical services – a package of guaranteed volume of free medical care (GOBMP) and a package of compulsory social health insurance (OSMS).
“The population will be able to receive services not included in the guaranteed volume of health insurance within the framework of the OSMS by becoming a member of the Social Health Insurance Fund (FSMS).”
Talks about compulsory health cover about the OSMS system began in 2017, although its introduction was postponed from January 2018 to January 1, 2020. Many did not buy the idea.
Tsechoyeva said many citizens hold the popular opinion that it is unfair to pay a monthly fee if one rarely visits a hospital.
Yet four out of every five causes of death in the country are chronic diseases, which could have been prevented or controlled with early treatment. Insurance might motivate people to have regular check-ups and, therefore, improve the stats.
“You will probably agree with me that prevention is much cheaper than treating advanced diseases and that only 15 percent of your health depends on medicine. The rest is the lifestyle of citizens,” she added.
GOBMP will allow all everyone, including oralpersons (repatriates), stateless individuals and foreigners permanently residing in Kazakhstan to receive medical care.
This compulsory insurance will provide assistance in emergency situations and control diseases and illnesses that are significant for the whole society.
“There are a number of services in the GOBMP package like fluorography, blood analysis, cardiography and examination by the therapist,” said Tsechoyeva.
“A healthy person must undergo these simple procedures to understand what is happening with his/her body. This is the very necessary minimum. If there are any deviations, then the guaranteed volume of free medical care allows the state to receive services free of charge.”
Another benefit of state-sponsored versus private medical insurance is that it allows people to receive treatments even if the cost is more than their accumulated personal account.
“The public system is equally reliable and beneficial for all citizens, regardless of the size of their contributions and income. First, when choosing this model, payers in the health insurance fund are all parties – and the employer, the citizen himself and to a greater extent the state, all of them are jointly responsible for a person’s health,” she added.
Introducing insurance medicine will largely boost the competitive environment in the medical services sector.
“During the current procurement of medical services, it turned out that 45 percent of the entire list of potential providers of FSMS are private medical organizations,” said Tsechoyeva.
“These are the private clinics where many of our patients prefer to go to find more qualified specialists, lack of queues and high-quality service. Over time, the competition will select the best providers of medical services who can provide the population with high-quality and affordable medical services.”
To ensure a smooth change to the OSMS system, the state will issue minimum social guarantees or limited GOBMP to the uninsured population from the government budget for 2020-2022. FSMS will fund the insured citizens to receive an expanded package of medical services.