3 November, the Ministry of justice of Kazakhstan held a meeting of the Interdepartmental Commission for consideration which was submitted the draft Law "On amendments and additions to some legislative acts of the Republic of Kazakhstan on issues of health and socio-labor sphere".
Speaking at the meeting, Vice-Minister of health and social development of Kazakhstan, Elzhan Birtanov announced that the development of this bill due to the necessity of improvement and development of legislation of Kazakhstan in the socio-labor sphere and in the healthcare system, including the introduction of mandatory social health insurance (hereinafter OSMS), as well as to implement: the Protocol instructions of the President of June 14, 2016 on the need for analysis of the newly adopted laws in the social sphere for possible social risks, the State health development program "Densaulyk" for 2016 - 2019, 81 step of the Plan "100 steps".
The draft Law provides:
1. Expanding the list of persons for whom contributions to the Fund of mandatory social health insurance (hereinafter – the Fund) shall pay to the state:
- Persons caring for a disabled child under the age of 18 years;
- unemployed oralmans within 1 year;
- persons who completed their education in full-time education in the organizations of secondary, technical and vocational, post-secondary, higher education and postgraduate education within 6 months after completion of training;
- foreigners and persons without citizenship permanently residing in Kazakhstan, the number of categories for whom contributions shall pay to the state (12 socially vulnerable categories prescribed in the Law "On compulsory social health insurance").
2. Expansion of coverage for citizens of Kazakhstan of compulsory social health insurance.
In particular, the system OSMS will involve persons not in the labor force (the concept introduced by the Law of RK "On population employment"), with the exception of persons who receives contributions from the state and which are exempt from the payment of contributions in accordance with the Law "On compulsory social health insurance". To this category of persons includes, for example, Housewives, people engaged in the production for own consumption. They will be expected to make contributions to the Fund at the rate of 2% of the minimum wage from 1 January 2018, 3% from 1 January 2019 5% from 1 January 2020, 7% - from 1 January 2021.
The system OSMS are also encouraged to involve citizens working abroad, except those who left for permanent residence outside the Republic. They will be expected to contribute to the Fund based on income, but not less than the minimum wage established for the relevant financial year. The rates and terms of payment will be the same as proposed for persons not participating in the labor force.
In addition, the system OSMS will involve persons working in offices of international organizations in the Republic of Kazakhstan, diplomatic missions and consular institutions of foreign States, accredited in Kazakhstan. To acquire the right to receive medical care in the system OSMS, they will need to deduct contributions from income accrued by employers, except income which are not paid taxes and contributions, determined by the authorized body. Their rates and terms of payment of the same will be offered for persons not participating in the labor force.
3. It is proposed that the state transferred to the Fund for providing medical care to military personnel, law enforcement and special government agencies outside the military-medical organizations (research institutes, private and public institutions).
4. In order to ensure equal access to health services and outpatient drug provision, establishment of uniform tariffs for medical services for all regions, forming an integrated system of control over the efficient use of funds allocated for health care are encouraged to consolidate costs at the national level through increased expenditures of the Republican budget and the reduction (withdrawal) of the expenses of the regional budgets and budgets of Astana and Almaty in part of the guaranteed volume of free medical care (hereinafter - SBP).
This is because from 1 January 2018 is proposed to transfer fund functions to pay for all medical services under the SGBP.
5. Given that the OSMS except for the provision of medical services includes providing medications to inpatients and outpatients, the bill provides for the integration in the OSMS of the healthcare entities in the sphere of circulation of medicines and medical products. In connection with this proposed withdrawal from the Law of RK "On public procurement" procurement of pharmaceutical services under the SGBP and in OSMS, as well as procurement services for the storage, transportation, keeping and realization of drugs and medical products, and procedures for their procurement by the Government.
6. In order to improve corporate governance in health organizations proposes to expand the powers of the supervisory Board, to implement the collegial executive body (management board) and internal audit service.
7. Given that the draft Law "On amendments and additions to some legislative acts on issues of mandatory social health insurance" (is on consideration in the Parliament) provides for the transfer of medical care of pupils in secondary schools in the health care system, this bill provides for the amendment of some legislative acts aimed at further reforming of the school of medicine.
Innovations aimed at improving medical care in specialized, special educational institutions (for children with disabilities), the education organizations for orphan children and children left without parental care (legal representatives).
8. Improvement of provisions of the RK Code "On nation health and health system" to regulate relations in the sphere of international cooperation (strategic partnership of the health education and science with leading overseas medical educational organizations).
9. Amendments to the Law "On employment of population" regarding the vesting of employment centers authority for the development, approval and maintenance of good employment for the unemployed, as well as the issuance to such persons of certificates of registration as unemployed.
The bill will not lead to negative economic, social, and legal consequences.