Kazakhstan reforms medical insurance but terms are not clear yet

/REUTERS, Astana, Murat Buldekbaev, Dec 25, 01/ - The government of Kazakhstan sequentially performing structural reformations in economy intends to reform medical insurance system moving to solidary-budget model of medical services payment, said the minister of health protection Zhaksylyk Doskaliev. "Budget model of financing due to lack of means does not allow adequately cover expenditures for medical aid payment. At the need of 72.9bn tenge, actual financing accounted for 41.0bn tenge, 39.6bn tenge is a deficit of financing", said the minister at the meting of the government on Tuesday. According to his words, in new scheme payment of each employee for medical insurance will account for 1.9 percent of monthly salary and employer, in his turn, will pay out 2.1 percent. Therefore, 4.0 percent of monthly salary will go to medical insurance. Under this approach the minister thinks, wealthy participants of medical insurance system will pay medical services of low-income citizens and pensioners. Minimal amount of services the medicine will offer for free at the expense of budget. Although, the government today in general approved the conception of transition to new system of financing of medical insurance, terms of reform performance have not been determined yet. It was assumed before to start reformation in 2003, however, making speech on Tuesday at the meeting the minister of state revenues Zeinulla Khakimzhanov said that medical insurance reform could not be started earlier of 2005. According to his words, people have not got accustomed to high enough Kazakhstan taxes. Kazakhstan has had already big scandal with the Fund of mandatory medical insurance (FMMI) when in 1996-1997 former head of non-existing nowadays FMMI Talapker Imanbaev stole and spent more than 900m tenge ($12m) and disappeared in USA. In 2001 the court of Kazakhstan sentenced him to 9 years of imprisonment in his absence. However, a confidence in the system had been broken and development of medical insurance in Kazakhstan dramatically slowed down. Kazakhstan has an experience of successful pension reform started in 1998. For thirty years Kazakhstan hopes to move from solidary to accumulating scheme of pension savings formation. Today in Kazakhstan paid medical services are offered for the amount of 3.1bn tenge but more non-taken into account payments go to pockets of medical staff for medicines etc. Parliament members said it on Tuesday considering the conception of medical insurance. It remains unclear when the reform of medical insurance will start. The head of the Ministry of health protection proposed to have an experiment in Karaganda oblast, however he received sharp enough answer from the prime minister. "It's enough to have experiments there", said Tokaev meaning unsuccessful experience of introduction in Karaganda oblast of payment for telephone services by the hour.