哈萨克斯坦医疗保险制度改革问题研究

Research on Medical Insurance System Reform in Kazakhstan and its Problems

医疗保险制度改革是哈萨克斯坦医疗改革的重要组成部分。独立以后,在全民免费医疗无法维持的情况下,哈萨克斯坦政府先后实施了强制医疗保险制度和自愿医疗保险制度。然而,这两种医疗保险制度的运行效果远远没有达到政府和民众的预期。目前,哈萨克斯坦又出现了恢复强制医疗保险制度的倾向。纵观哈萨克斯坦医疗保险制度的发展过程,可以认为,这种改革缺乏持续性的政策和明确的目标。另外,如何妥善解决社会公平和效率之间的关系,以及转变民众的医疗卫生观念,是未来哈萨克斯坦医疗保险改革亟待解决的深层问题。

The reform of medical insurance system is an important part of medical reform in Kazakhstan. Given the deteriorating social and economic environment after its independence,Kazakhstan government was unable to maintain the Soviet-style system which offer free medical care to all citizens. Under this circumstance,the government carried out a compulsory medical insurance system ,and later replaced it by a voluntary one. However,the operating effects of both systems mentioned above didn’t reach the government and citizens’ expectation. Recently, there is a tendency emerging in Kazakhstan, which is to restore the compulsory medical insurance system. Viewing the reform process of medical insurance system in Kazakhstan, we can see that the reform lack consistent policies and definite goals. In addition,how could the government properly handle the relationship between social fairness and efficiency and how to update citizens’ conception of medical care are two underlying problems which urgently need to be solved in future reform process.