Inshorar kiwon lafiya - menene wannan? Health Insurance Asusun

Arziki na ingancin harkokin kiwon lafiya shi ne muhimmin da kuma ɓangare daga cikin tsarin na zamantakewa kariya al'ummominsu. Duk inda da jama'a, abin da yake a halin da ake ciki kudi, ya iya samun mai kyau kula da lafiya, a kan abin da ya faru na unpredictable halin da ake ciki.

A ci gaba da kiwon lafiya inshora masana'antu

A inshora kasuwa ne wani ɓangare daga cikin tsarin tattalin arziki, da kuma ci gaban kasuwar dangantakar bukatar a siffar da m inshora kasuwar a yarda da kasa da kasa da bukatun da kuma matsayin. Social kariya na 'yan kasa ba zai iya zama m ko zabe, don haka ta dindindin arziki na bukatar hukuma don gudanar da dukkan bangarorinsa.

Da son rai da lafiya inshora ne ba togiya. Saboda a yau kowane dan kasa ne kawai hanyar da za a samu wani isasshen matakin na da isassun magunguna. A ci gaba da kiwon lafiya inshora masana'antu a yanzu rike da baya a yawan dalilai, wanda su ne manyan raguwa a harkokin kiwon lafiya, samar da kudi, m abu tushe, rashin magunguna, alƙaluma da ci gaban Manuniya na kasar da kuma matakin 'yan kasa' cutar da kuma da yawa wasu. Yau, akwai kullum mai yawa saba wa juna da kuma matsaloli a yankin na kiwon lafiya inshora, wanda ya bukatar kara nazari.

hamzari inshora

A matakin na taimakon kudi kiwon lafiya a Rasha ne ba quite isa, da ke shafar rayuwar jama'a da kuma ingancin magani. Low albashi na likitoci da kuma shelar da kundin tsarin lamunin free taimako a bangaren lafiya, shi ne abin takaici ba karfafa su samar da ake bukata da ayyuka kiwon lafiya. Saboda haka, a cikin kiwon lafiya masana'antu a yau da yake a kan kai isar, wanda aka bayyana a cikin mãsu yin sadaka gudunmawar da unforeseen doka m. Saboda haka, rabo na da gwamnati ke kashewa a total kashe kudi a kan magani a Rasha ne kawai game da 56%, alhãli kuwa a kasashen - EU mambobin - game da 76%. Da yawa daga cikin kudade wajibi ne ga tsabar kudi kudi na yawan jama'ar, yayin da sauran (game da 4%) a Rasha (a kusa da 40%) - a cikin son rai da inshorar kiwon lafiya da kuma yin sadaka taimako.

Inshorar kiwon lafiya - ne sirri inshora masana'antu. Yana yana da za'ayi a 2 babban siffofin: son rai da wajibi. Bisa ga dokoki, da son rai da inshora na wadannan iri: likita inshora ( kiwon lafiya ta ci gaba), inshora na likita halin kaka da kuma kiwon lafiya inshora. da kiwon lafiya inshora dokar ne tsananin kayyade.

Ganin cewa karuwa a jama'a kudade na kiwon lafiya masana'antu ne matsala saboda da wuya tattalin arziki halin da ake ciki a kasar, kana bukatar ka sami wasu hanyoyi da kawo kudi a cikin masana'antu. A babu wani m nau'i na son rai kiwon lafiya inshora iya warware wani babba yawan matsaloli.

Analysis na inshora kasuwar

Health inshora - wannan zamantakewa Trend, don haka da bukatar irin wannan inshora da aka girma a tsakanin yawan jama'a a kowace shekara. A matakin na biya LCA kwangila, daya daga wanda factor ne shekara-shekara karuwa a yawan zaunar da inshora siffantawa.

Analysis na inshora kasuwar bada Yunƙurin ga shawara game da asarar LCA ga masu rinjaye na inshora shugabannin. Bayani dalla-dalla na inshora a matsayin irin kasuwanci aiki saboda gaskiyar cewa mafi kudaden shiga ga wani takamaiman irin inshora ne wani kamfanin inshora, da girma da yiwuwar m inshora premiums karuwa a matsayin kudaden shiga girma a rabo tare da inshora wajibai.

Yana rubuta wani karuwa a 2013 net inshora biya domin ci gaba da kiwon lafiya inshora da 34.2% idan aka kwatanta da shekara ta 2011. Net inshora premiums ga kiwon lafiya inshora a hali na rashin lafiya kuma ayan kara - da kusan rabi. Amma a general akwai haddi inshora premiums kan biya, wanda shi ne mai kyau ma'ana a cikin ayyukan kamfanonin inshora.

Daga cikin dalilan da asarar tattalin arziki da ake kira girma a cikin yawan abokin ciniki buƙatun ga likita taimakon saboda tabarbarewar ingancin kiwon lafiya, tsufa, yawan, m abokan ciniki, imperfections underwriting ayyuka, da yin amfani da tattalin arziki m tariffs, matalauta kungiyar na aiki domin shiri na asarar da, m abokin ciniki-fuskantarwa na jama'a likita da prophylactic cibiyoyin, inflated kudin da yin kasuwanci, incl .. hukumar kudade na inshora shamaki - sayarwa sabis don LCA.

da son rai inshora

Yau kafa wani tabbataccen tsarin a cikin filin na son rai kiwon lafiya inshora a Rasha. A tsarin da kasuwannin gida LCA hada da jihar gawarwakin dubawa na inshora ayyukan, masu zaman kansu inshora da ƙungiyoyi, kamfanonin inshora, inshora dillalai, likitanci, sabis Taimakon da kuma masu amfani da.

Yi la'akari da matsayin da sakamakon bincike, gagarumin 'yan adawa ga ci gaban da son rai kiwon lafiya inshora ne rashin haraji da taimako, saboda kamfanin, wasu daga wanda dole ka biya 41% na inshora biya, biya su bayan haraji daga net riba. Wannan halin da ake ciki da aka alaka da babu haraji amfanin, muhimmanci slows saukar da aiwatar detenizatsii na kiwon lafiya da sabis.

Lokacin da assigning da halin kaka na son rai kiwon lafiya inshora don Gudanarwa da sama ta halin kaka, dual-amfani, halin kaka hade da arziki na sabis, kazalika bayan da mazauna daga cikin matsalolin hade tare da tabbatar da dalilin da lamba adadin irin wannan halin kaka don haraji rahoto lokaci, za a iya kara ingancin kiwon lafiya da sabis, wanda zai ba mai kyau da tura detenizatsii a fagen kiwon lafiya da karuwar kudaden shiga ga na gida da kuma jihar kasafin kudi.

Inshora a matsayin wani kashi na zaman jama'a kariya na 'yan ƙasa

A yi na kiwon lafiya inshora take kaiwa zuwa ƙarshe cewa batutuwa ba tattalin arziki ihisani: for insurers - inganta harkokin kiwon lafiya. ga likita ma'aikata - don samar da ake bukata da ayyuka kiwon lafiya. Saboda haka ya zama dole su yi amfani da inji na ruri daga cikin batutuwa da gabatarwar da kiwon lafiya inshora shirin. Yana zai karfafa insurers don inganta da kuma ƙara da ingancin halaye na su kiwon lafiya, hana ta tabarbarewar, ba su halicci zama dole hadarin zuwa ga jiki yanayin.

Inshorar kiwon lafiya - shi ne wani kashi daga wani tsarin na zamantakewa kariya na 'yan kasa, wanda ya samar da diyya ga marasa lafiya likita halin kaka. Bi da bi, da son rai kiwon lafiya inshora ne a Bugu da kari ga m tabbacin da kuma biyan bashin da ayyuka kiwon lafiya. Tattaunawa tambaya dangantaka da matsaloli na kara load a kan la'ada asusu, iko inshorar kiwon lafiya, da inshora na kwafi da kuma sauran ayyuka.

Inshora a CIS

Matsaloli na kiwon lafiya inshora a matsayin zamantakewa kariya kashi da aka tsunduma a wani m kewayon biyu waje da kuma Rasha masana kimiyya - tattalin arziki da kuma likitoci. Muhimmanci nasarori a wannan yanki sun gudummawar da ci gaban da msar tambayar tushe na zamantakewa kariya na 'yan kasa, musamman da ci gaban da na ra'ayi na'ura da kuma gabatarwar m matakan.

Duk da haka, da tambaya ya zauna da arziki na likita taimako ga 'yan ƙasa na jihar, wanda ya tafi zuwa ga CIS kasashe, da kuma a kasa da wani daga cikin CIS kasashe, ya isa a Rasha domin wani lokaci. Wuya tattalin arziki yanayi da suke da halayyar Inganta tattalin arziki, karfafa da jama'a quite sau da yawa tafiya kasashen waje, musamman ma a cikin kasashen CIS. Kusa da tattalin arziki, abota da kuma iyali dangantaka ne ma wani factor for tafiya.

Duk da haka, da kasada ga lafiyar dan adam, akwai ko da yaushe, ko da kuwa ko da suka kasance a kan yawon shakatawa tafiya tikitin (a lokacin da inshora ake bukata), ko da kansa. Da bukatar magani daga likita na 'yan ƙasa waɗanda basu da irin wannan daftarin aiki, a matsayin kiwon lafiya inshora siyasa, da shawara zalla kudi matsala. Wannan shi ne yadda da magani daga kasashen za a biya? A Rasha, misali, akwai wani wajibi kiwon lafiya inshora, bisa ga abin da magani daga likita kawai zuwa Rasha jama'a da aka bayar kyauta. Irin wannan halin da ake ciki ta wanzu a Belarus. Saboda haka, akwai wani matsala musamman da kariya daga Rasha 'yan ƙasa a cikin CIS kasashe, wanda ya ba tukuna aka warware ba a msar tambayar matsayi, ko a yi.

Inshora barin a kusa da kasashen waje

Da son rai da lafiya inshora a Rasha Federation ci gaba da girma, nuna da wayar da kan jama'a na 'yan ƙasa na da bukatar a kare lafiya. A kowace shekara wani gagarumin yawan mutane zuwa daidai lokacin da kasashen waje. Yawan masu yawon shakatawa tafiya kasashen waje na karuwa ne a kowace shekara.

A lokacin tafiye-tafiye akwai yiwuwar cewa Rasha jama'a, na iya samun kansu a cikin wani mawuyacin hali (rashin lafiya, raunin da ya faru, da sauransu. D.). Don magance wannan al'amarin na bukatar wasu ilimi, kamar inda ya samu wani kiwon lafiya inshora siyasa, wanda zai a lokaci guda abu halin kaka. Duk da haka, kamar yadda mai mulkin, waɗanda suka je kasashen waje don zumunta ko abokai, ba su dogara ne a kan gaskiyar cewa su da lafiya, da kuma suka za a kasaftawa zama dole kudi domin magani (akwai wani inertia na tunani, a lokacin da magani daga likita a cikin Tarayyar Soviet ya free).

Wani lokaci, likita taimako na iya zama gaggawa (a lokacin da kaska cizo, kwayar cututtuka, raunin da ya faru da kuma kama. D.). Analysis na halin da ake ciki ba filaye don tabbatar da cewa arziki da kiwon lafiya taimako ga 'yan ƙasa na Rasha ne da za'ayi a kudin a wasu jihohin. Bi da bi, da baƙin da a kan ƙasa na Rasha samu damar sami magani daga likita kyauta. Domin tabbatar da zaman kariya na 'yan kasa a cikin hali na rashin lafiya a kasashen waje ana kiran aiwatar da wani matukin jirgi aikin (tare da m haƙƙin na dokokin ƙa'idar arziki) da gabatarwar a kan wani kwantiragi akai na wajibi kiwon lafiya inshora ta cikin Health Insurance ofishin tsakanin CIS kasashe da kuma Rasha.

Katin tafiya kasashen waje

Idan ka haye kan iyaka a kan nasu abin hawa, Kwastam iya duba lafiyar ka inshora siyasa. Idan kana tafiya da jirgin sama, jirgin kasa ko bas, tikitin farashin kamata hada da inshora biyan bashin. Samarwa m kiwon lafiya katin tafiya kasashen waje zai taimaka wa rufe duk da halin kaka na magani (inpatient, outpatient), sayan kayayyakin, samun kula da lafiya,, sufuri, kai motar asibiti, da kuma a yanayin saukan mutuwa - yi da mayar da jikin marigayin zuwa gida kasar.

Wajibi likita katin for kasashen waje tafiya zai zama m ga kowane ɗan takara kasar na aikin. Wannan kiwon lafiya inshora manufofin za a iya bayar na tsawon kwanaki 90. Katin tafiya kasashen waje ya kamata a yi bayãni da wannan tsari, wanda za a amince a kan ta duk aikin mahalarta. Health inshora ba zai iya zama daya da ɗari bisa dari tabbacin cover magani halin kaka na tafiya kasashen waje. Domin inshora da'awar ba sun hada da:

• lura da shafi tunanin mutum da cututtuka.
• magani na cututtuka, raunin da ya faru sakamakon hananne ayyuka.
• raunin ci a Jihar barasa ko kwayoyi.
• roba tiyata, fãce idan suka bukatar saboda rauni.
• hakori kula, fãce idan mutum yana mai tsanani ciwon hakori.
• magani na cututtuka hade tare da AIDS da kuma venereal cututtuka.
• lura da zumunta, kuma kusa abokai na da inshora, a cikin abin da ya ke zama.
• raunin ci a wani harin yunkurin.
• aiwatar da zubar da ciki, sai dai a lokuta inda shi ya razana mace ta rayuwa;
• gudanar da bincikowa ga insurer ta request.
• magani a spas da kuma more.

Medical Assurance ofishin

Health Insurance Ofishin (SMEs) - ne kawai ƙungiya daga inshora kungiyoyi a kasar. Wannan shiri zai kunshi wani yawan aboki da kuma cikakken members, wanda gudanar da inshorar kiwon lafiya ga tafiya kasashen waje. Wato, da membobinsu shi ne babban sharadin da yiwuwar dauke da fitar da irin wannan inshora. A mambobi na Ofishin kowa na da hakkin lissafa a kiwon lafiya inshora kiwon lafiya inshora premium asusun "wajabta likita katin tafiya kasashen waje." A Ofishin, bi da bi, za su samar da dace da ingantaccen shiri na inshora da'awar karkashin wadannan alkawurra. A kiwon lafiya inshora duk mambobi ne na SME za su iya yin biya a lokaci asusun haƙuri a bukatar magani a kasashen waje, samar da ayyuka kiwon lafiya, mayar da mutane zuwa gidajensu a taron na mutuwa. Medical Assurance Ofishin zai yi aiki a matsayin mai ba riba kungiyar.

Samarwa aikin "Wajibi likita rikodin na tafiya kasashen waje" samar da:

1) kafa National Health Insurance ofishin, to wanda aka hada da duk insurers dauke da fitar wajibi kiwon lafiya inshora na tafiya kasashen waje.

2) wajibi kiwon lafiya inshora na mutane tsallaka jihar iyakar nasu zuwa ziyarci CIS kasashe don wani lokaci (90 days).

3) da wanzuwar wani dace majalisu tsarin on Health Insurance, wanda shirya ayyuka na insurers a cikin wannan yanki.

Health inshora kudi na Rasha Federation

M Health Insurance Asusun an halitta su da kuɗaɗen da Rasha 'yan ƙasa da kudin kiwon lafiya. Wajibi inshorar kiwon lafiya - shi ne wani na game da rabo daga National Insurance.

The main manufofin da asusun:

• domin iko da m kwarara daga kudaden.
• biyan bashin da niyya shirye-shirye.

Income asusu ne da wadannan gudunmawar:

• kiwon lafiya inshora daga jihar kasafin kudin.
• gudunmawar da kamfanonin.
• yin amfani da wucin gadi free kudi na Asusun.

Babban ayyuka na Tarayya Asusun na chi hada da:

• kudi na magani.
• jari na kudi da albarkatun;
• a harkokin kiwon lafiya - aiwatar tarayya shirye-shirye.

Yankin tsarin na wajibi kiwon lafiya inshora samar kai tsaye kudade ga likita cibiyoyin. Inshora taimako kudi daidai da 3.6% dangane da avarage Hakkin. Inshora premiums a sallar wajibi kiwon lafiya inshora asusu dangantaka da kudin. Biya na likitanci, zamantakewa da kuma fensho kudi kira hadade zamantakewa haraji.

key dalilai

Daga cikin gabatar ba, yana yiwuwa a gano babban abubuwan da zai shafi kiwon lafiya inshora a cikin zamani da yanayi na aiki da inshora kasuwar:

• Tattalin arziki da rashin zaman lafiya a kasar, abin da ya sa mutane tafiyar da kudi kudi kawai don danda bukatu.
• Ajizai dokokin (misali, wannan da aka nuna a cikin rashi na haraji ihisani).
• Kara tallace-tallace girma da kuma darajar magunguna.
• Kara zamantakewa nauyin da inshora kasuwanci (karuwa a cikin rabo na kungiyar inshora na ma'aikata na VHI shirye-shirye da ta sa shi ba zai yiwu ba don kauce wa m diyya ga likita kudi).
• Mai monopolization na ayyuka kiwon lafiya kasuwar sa likita cibiyoyin ƙara da darajar da yawa na ayyuka bayar.
• Low inshora al'adun jama'a.

A takaice, zamu iya cewa da yiwuwa ga ci gaban da kiwon lafiya inshora, ciki har da son rai irin, da kwantar da hankali. A rabo daga LCA a cikin inshora kasuwa ne a kan Yunƙurin, insurers wanda samar da ayyuka ga LCA, suna samun mafi m, kara mutane ta sha'awa cikin irin wannan inshora da kuma kamar tunaninsa.