Volume, types, conditions
The current Program of State Guarantees for Providing Medical and Health Care to Citizens guarantees the volumes, types of medical services in Kyrgyzstan, the conditions for their provision by health care organizations, regardless of the form of ownership.
Simply put, we are talking about free or preferential medical care, which, as established by the SGBP, can be received by various categories of citizens. These are, for example, minor children, participants and invalids of the Great Patriotic War, pensioners and others.
The areas of medical care provided by the program include types of support such as emergency, hospitalization, dental, consultation, palliative, specialized oncology and psychiatry.
The condition for the provision of free and preferential medical care under the State Guarantee Program is the availability of a document proving the right to benefits (passports, birth certificates for children under 16 years of age, birth certificates for a child before receiving a birth certificate , pension certificate, compulsory medical insurance policy), as well as referrals for laboratory diagnostic tests, hospitalization in a hospital, which are prescribed by specialists.
Reach vulnerable populations
In the fall of 2022, Klara Oskombayeva, First Deputy Chairman of the Compulsory Health Insurance Fund (MHIF) of the Kyrgyz Republic, briefed journalists on the government’s instructions to reorient the current SGBP to cover vulnerable segments of the population with services doctors.
– We anticipate reviewing and establishing various packages of basic services, taking into account the categories of the population -for pregnant women, children, socially vulnerable groups- that will be guaranteed by the State and provided free of charge. It is also planned to review the medical care provided at the outpatient and hospital level to citizens of EAEU member states, citizens of other states, he explained in an interview with a local news agency.
According to the head of the department for the implementation of health insurance programs of the MHIF, Zhipara Azizbekova, another reason for the need for a new program was the entry into force of the law on compulsory health insurance in the Kyrgyz Republic. “Now citizens of Kyrgyzstan and foreigners living in the country must purchase a compulsory health insurance policy,” recalled Zhipara Azizbekova in an interview with an RG correspondent.
The draft of the new program of state guarantees to provide health care to citizens, according to her, is a joint work of various government agencies. The document was agreed with the medical community and the non-governmental sector of Kyrgyzstan. It is now in the public comment stage.
Public hospitals only
As Zhipara Azizbekova explained, in order to receive medical services under the new SGBP, three conditions must be met. “You need a compulsory health insurance policy, a registration with the family doctors and a reference that they give you. If, for example, you come for a diagnostic laboratory test, then it will not be done for free without a reference. The own patient will.” not decide what kind of analysis the family doctor needs,” said Zhipara Azizbekova.
As for the socially vulnerable segments of the population, all medical services at all levels will be free for them. “The new SGBP differs from the current one in a large number of sections, which describe in detail the types, volumes and conditions for the provision of free and preferential medical care. In addition, we pay special attention to foreigners and citizens of the EAEU members living in the republic In particular, family members of a citizen of a state that is a member of the Eurasian Economic Union have the right to annually purchase an insurance policy compulsory medical not for 16,391 soms, the cost for foreigners, but for 1,722 soms, as the Kyrgyz do. But there is one condition: in this family, someone must officially work and pay taxes on the territory of the republic,” Zhipara Azizbekova explained.
– An important point: when we talk about the provision of free or preferential medical care within the framework of the SGBP, we are talking about those who work in the Single Payer System. At the moment, these are state health agencies that have signed agreements with the territorial directorates of the MHIF. Private traders unfortunately do not agree to our conditions, he added.
According to Zhipara Azizbekova, today most people complain that they have to buy the medicines they need when they seek medical services at state hospitals. “There are a lot of complaints about this. Not so long ago, the government created the state-owned company Kyrgyzpharmacy, which will deal directly with manufacturers of medicines and supply them to the republic. Together with the new SGBP and the law on compulsory health insurance, this will help to find solutions to many problems so that people in Kyrgyzstan are insured and receive all the medical services they need”, summed up the head of the Compulsory Medical Insurance Fund department.
According to the new SGBP, citizens of the Eurasian Economic Union states (Russia, Kazakhstan, Armenia, Belarus) working in the republic are insured if they pay contributions for them in accordance with the legislation of the Kyrgyz Republic. “Members of families of workers permanently residing with a citizen of the EAEU state working in the Kyrgyz Republic have the right to purchase compulsory health insurance policies on equal terms with citizens of Kyrgyzstan…Citizens of the EAEU state and members of their families who are insured under compulsory health insurance receive medical services in the same volumes and under the same conditions as insured citizens of the Kyrgyz Republic, with the exception of: hemodialysis services (provided with the payment of full cost); specialized oncological services care (services are provided in the chemotherapy department with payment of full cost); specialized care in cardiac surgery; medical care, which is provided to patients with tuberculosis, ”says the draft of the document.
By the way
One of the innovations offered by the SGBP in regards to primary health care is the division of medical services into two packages: basic and additional. The first is provided free of charge to insured citizens affiliated with Family Medicine and General Medical Practice Centers.
The second depends on the diagnostic laboratory tests that must be carried out at the address. For example, ultrasound and X-rays are provided to certain categories of citizens (for example, workers for whom compulsory health insurance contributions are received) at a 50% discount on the cost of medical services indicated in the price list.
Additional laboratory and diagnostic studies for uninsured citizens are carried out on a paid basis.