The introduction of mandatory health insurance requires thoroughness

Compulsory health insurance (CHI) is the most significant indicator of the quality of life in modern society, because according to the statement of the Parliamentary Committee of socio-economic policy Hadi Racabli, the country's readiness for the introduction of the service from the beginning of 2015 is the socio-economic issue number one from the beginning of the year.

With the introduction of CHI the insurance market will grow at times, and access to free and quality health care eventually receive all (almost all) people of Azerbaijan. In addition, the financial flow still adjusted by the Ministry of Health will be distributed directly by policyholders between medical institutions that will create the conditions for real competition - both private and public institutions will fight for good doctors and advanced technologies, and existing institutions will formally disappear.

The law "On Medical Insurance" (http://medportal.az/ru/zakon-o-medicinskom-strahovanii) adopted in 1999 is based on the experience of Russia, Norway, Germany and Holland. In addition, according to Finance Minister Samir Sharifov annually laid are means of financing the implementation of CHI. "When a special agency under the Cabinet of Ministers responsible for administration services , to do the work , we will provide the funds for them to use," - he said traditionally at each annual budget debate .

"Voluntary health insurance can not be replaced on the scale , focus and effectiveness of social CHI, which is an integral part of the state social insurance, providing the population receiving medical and medicinal aid in full," the head of the Center for Economic and Social Development of Azerbaijan Vugar Bayramov told Turan. According to him, the government is not ready for direct regulation of horizontal relations of citizens with treatment because the time span of the full implementation of CHI stretches over several years. The root cause is that, despite the existence of a legal framework, there is a need to bring it in line with social realities.

Thus, the decision of the Ministry of Health on February 1, 2008 declared all services in public health facilities (they are the majority in the country) free. Then the purpose of compulsory health insurance gets lost. The law "On Medical Insurance" is also no mechanism for the successful application of the CHI. There is a need for specifying functions of the Agency under the Cabinet of Ministers responsible for this type of insurance. And yet, legislation should define public payers of insurance premiums on behalf of the poor.

In addition, although mandatory interest payments between the employee and the employer are defined under the Social Security, there is no clarity in the allocation of compensation between these subjects of law. This will cause that the employer, carrying a large financial burden even without that, will not be interested in a full-length allocation to social health insurance.

The quality of service in most public hospitals and clinics does not meet the requirements for participants in CHI. They have no skills to provide a reliable service with obligations to customers - in Azerbaijan there is still no precedent of exemplary punishment of doctors for criminal acts during the performance of their official duties , the expert believes .

Finally, there is a need to revise the structure of incomes of the population, as average payroll taxes across the country are small. Approximately 70 % of expenditure is on food, 10% - on taxes and duties and the rest is for current expenses, medicine, education, etc. No funds remain for insurance. By the end of 2013 the insurance market amounted to almost 405 million manats (AZN 3.56 per person per month, or 0.8% of the average wage). For comparison, it is 11% in Europe and 8% in the United States.

According to experts, one of the main arguments that inhibit the introduction of CHI in the near future is the old methodology of health - for every thousand citizens accounts for 7.6 hospital beds, which is 2 times higher than in Germany and 3.5 times more than in Turkey. At the same workload of hospital beds (26.1%) is much lower than the average in Europe - the EU - 76.9 %, Turkey - 61.9%, in Russia - 86 %, etc.

In the market of compulsory health insurance there are 3 "players", the legal relationship between which have not yet formed - citizens, hospitals and insurance companies. In addition, the population is weakly aware of the essence of the innovation. Because, according to Bayramov, if the government wants civilized introduction of CHI, they should spend hard work in these areas, rather than rush to reports and promises. - 17D-