Presenting the second project “The New Model of Guaranteed Amount of Free Medical Care” Serik Tanirbergenov, managing director of Strategy and Methodology of the Social Health Insurance Fund, has mentioned the idea of the main priorities in healthcare development expressed by the Head of State in the missive to the people of Kazakhstan “New Opportunities for Development in the Context of the Fourth Industrial Revolution”.
“We should pass from ineffective and costly clinical examination to management of main chronic diseases using remote diagnostics and ambulatory treatment. It`s necessary to create a new model of Guaranteed Amount of Free Medical Care defining specific boundaries of state obligations. Services that are not guaranteed by the state obligations will be available to the population by becoming a participant of compulsory health insurance system or through voluntary health insurance or co-payments” – Nursultan Nazarbaev
Kazakhstan’s health system is influenced by a number of global trends as said managing director of Strategy and Methodology of the Social Health Insurance Fund. Population growth and the change in population composition by age and gender due to the increase in the number of elderly citizens and children, the most intensive consumers of medical services, is expected by 2025. The influence of chronic non-infectious diseases, which are the main causes of disability and mortality of the population remains high.
A high level of emergency hospitalization to hospitals (68% of 2.9 million cases in 2017) remains as a result of the low effectiveness of preventive measures, the influence of harmful factors, and the lack of skills for self-monitoring of chronic diseases. Overall, 46% of inpatient care consumers are economically inactive, including: children – 13%; disabled people – 5%; pensioners -15%, and others. He has added, that these categories of the population consume 47% of the inpatient care budget.
Given these trends three-level health care system is proposed, including Guaranteed Amount of Free Medical Care, Compulsory Health Insurance
and other sources of funding.
Within the framework of this system, the minimum social standard – Guaranteed Amount of Free Medical Care – will be directed to help with emergency and urgent conditions for EVERYONE and control over diseases important for the whole SOCIETY. These measures will ensure an equal access to all categories of citizens for primary health care, medical support in emergency situations requiring urgent medical intervention, diagnosis and treatment of socially significant diseases, major chronic non-communicable diseases, managed by primary health care, and infectious diseases that are dangerous to others.
The Compulsory Healthcare Insurance for insured citizens guarantees (in addition to Guaranteed Amount of Free Medical Care) the second package, which include medical assistance improving the quality of life of EVERYONE, and also the medical assistance providing a basis for health of the FUTURE GENERATION. It includes expensive laboratory and diagnostic services outpatient drug support for diseases not covered by Guaranteed Amount of Free Medical Care, wide access to hospital-replacement medical care, planned inpatient care restorative treatment and medical rehabilitation. The third package is other funding sources.
In conclusion of presentation Serik Tanirbergenov pointed that has defined precise limits of the state obligations, citizens, medical workers and medical organizations.