Umshuwalense wezokwelapha eRussia kanye nezici zayo. Ukuthuthukiswa komshuwalense wezokwelapha eRussia

Umshuwalense wezokwelapha uwuhlobo lokuvikelwa kwabantu, okuhlanganisa ukuqinisekisa ukuthi ukukhokhelwa kosizo lwadokotela kusetshenziswa imali eqoqiwe. Iqinisekisa isakhamuzi ukuhlinzekwa kwenani elithile lezinsizakalo mahhala uma kwenzeka izinkinga zempilo. Okulandelayo, ake sikhulume ngalokho umshuwalense wezokwelapha oseRussia. Sizolinga ukucabangela izici zalo ngemininingwane eminingi ngangokunokwenzeka.

Imiqondo

Umshuwalense wezokwelapha okugunyaziwe (OMS) uqaliswa ngokuhambisana nohlelo lukahulumeni. Kuyinto yonke indawo izakhamizi zezwe. Umshuwalense wezokwelapha ozikhethela eRussia ukuvumela ukuthi uthole izinsiza ezengeziwe ezinganikezwa i-MHI. Lokhu kungaba inombolo ethile yokuvakashela ochwepheshe, ukwelapha iziguli, njll Ngokuhlanganyela ohlelweni lokuzithandela, umuntu ngokuzikhethela ukhetha izinhlobo nezinhlelo zezinsizakalo, izikhungo lapho efuna ukukhonzwa khona. Ekuphetheni kwesivumelwano, ikhasimende likhokha umnikelo, okuvumela ukuthi athole isevisi isikhathi esithile ngaphansi kohlelo olukhethiwe ngaphandle kokukhokha okungeziwe. Ake sibheke amanye amagama.

Umshwalense ngumuntu okhokhela iminikelo. Kungaba umuntu noma inhlangano.

Umshwalense uyinkampani esemthethweni enikezela umshuwalense wezokwelapha.

Izikhungo zokwelashwa kanye ne-prophylactic (izakhiwo zezempilo) yizikhungo ezihlinzeka ngezinsiza eziningi zokwelapha kubantu abanezifo ezihlukahlukene. Lokhu kufaka phakathi: izikhungo zokwelashwa, iziguli, izifo zengqondo, izinzwa, izifo zezokwelapha, izibhedlela zokubeletha nezindawo zokuvuselela.

Inqubomgomo idokhumenti eqinisekisa ukuhlanganyela komuntu ohlelweni.

Inhlangano yezokwelapha yomshuwalense (SMO) yinhlangano esemthethweni enezindleko ezigunyaziwe, ezisebenza kuphela ngomshwalense wezokwelapha ozizithandela noma oziphoqelekile. Lo msebenzi wenziwa ngezindlela ezimbili:

• Ukuqoqwa kwemali yokunikeza usizo kubantu;
• Ukuhlolwa emva kokuthola izinsizakalo.

Ukuthuthukiswa komshuwalense wezokwelapha eRussia

Isiteji sokuqala (1861-1903)

Isenzo samukelwa esethula izisekelo ze-CHI eRussia. Emabhizinisini aseHulumeni, kwakunezinhlaka zokubambisana namahhovisi ezinkokhelo ezisizayo, okwathi izinzuzo zesikhashana zokukhubazeka zanikezwa amalungu enkampanini, futhi idiphozi zamukelwa. Ngo-1866, izitshalo zaziphethe izibhedlela ezinezinombolo ezithile zemibhede. Ngokuvamile, abasebenzi abasebenza kwezokwelapha abazange bathande.

Isigaba sesi-2 (1903-1912)

Umshuwalense wezokwelapha eRussia wasinda esiteji sokuqala esibucayi ngo-1903, lapho umthetho udluliselwa, ngokusho ukuthi umqashi wayenecala lokulimala okubangelwa impilo yabasebenzi uma kwenzeka izingozi.

Isigaba 3 (Juni 1912 - July 1917)

Ngomnyaka we-1912, uMthetho woMshuwalense Wezokwelapha Okuphoqelekile wamukelwa uma kwenzeka izingozi nokugula. Engxenyeni yeRussian Federation kwakukhona izinkampani zomshuwalense wezempilo. Abasebenzi ngezindleko zamabhizinisi basizwa ezindaweni ezine: ukwelashwa kokuqala, ukwelashwa kanye nokwelashwa esibhedlela, obstetric.

Isigaba 4 (July 1917 - Okthoba 1917)

Umshuwalense wezokwelapha okugunyaziwe eRussia wawuguqulwa kakhulu nguHulumeni oPhezulu:

• Kwakukhona izidingo ezikhungweni zemali yokugula;
• Umbuthano we-insured uye wanda;
• Izimali zokugula zajoyina ngaphandle kwemvume yabomabhizinisi.

Isigaba 5 (Okthoba 1917 - November 1921)

Lesi simemezelo sasihlanganisa umshuwalense wezempilo osemphakathini eRussia, owatholwa kubo bonke abasebenzi basezimpesheni, kungakhathaliseki ukuthi yiziphi izizathu zokukhubazeka. Kwakukhona ukuhlanganiswa kwe-People's Commissar kwezeMpilo no-Umshwalense. Icala lezokwelapha ladluliselwa ku-People's Commissariat of Health. Imithi yemali yasuswa.

Isigaba 6 (November 1921 - 1929)

Umgomo omusha wezomnotho uphinde wavuselela umshuwalense womphakathi uma kwenzeka ukukhubazeka. Amanani wemali abalwa ngenani labasebenzi abaqashiwe ebhizinisini. Izimali ezimbili zahlelwa lezi zimali. Enye yayisetshenziselwa iziphathimandla zomshuwalense womphakathi, owesibili - wezempilo yomphakathi.

Isiteji sesi-7 (1929 - okwamanje)

Eminyakeni engu-60 eyalandela, izimiso zokuxhasa imali zakhiwe. Nakhu ukuthuthukiswa komshuwalense wezempilo eRussia.

Uhlelo lwanamuhla

Umshuwalense wezokwelapha eRussia okwamanje ukhona ngezinhlobo ezintathu. Umbuso uxhaswe ngemali ngokugcwele kwisabelomali. Umshuwalense ukhiwa ngokuqoqwa kwemali yamabhizinisi azo zonke izinhlobo zobunikazi kanye neminikelo ye-IP. Inani lemali eliya emzimbeni wangasese libalwe yisiguli ngokwakhe.

Uhlelo lukahulumeni aluhlinzeki ngokunakekelwa kwezokwelapha okusezingeni eliphezulu ngenxa yokuntuleka kwezimali. Imithi yangasese iyiphilisi ebiza kakhulu. Ngakho-ke, umshuwalense wezokwelapha ubhekwa njengendlela engcono yokuthola ukunakekelwa. Okufanelekile, bonke abantu kufanele bathole izinsizakalo zekhwalithi. Phela, ukuphindwa kwenkokhelo akuhambisani nezikhalo eziphathimandla zezempilo. Lena isimiso sokuqoqa. Futhi njengoba izinga lokuncishiswa kwiSikhwama Somshuwalense Wezokwelapha waseRussia kuzo zonke izigaba zezakhamuzi libekwe elifanayo, khona-ke inani lemali yokukhokha kufanele lilingane.

I-OMS

Umshuwalense wezokwelapha okuphoqelekile eRussia uyingxenye yenqubo yomphakathi yomphakathi. Ngaphakathi kohlaka lwaso, zonke izakhamuzi zinikezwa amathuba afanayo ukuthola usizo lwezokwelapha kanye nokwelashwa ngokwezinga elivunyelwe ngaphambili.

Izinhlelo eziyisisekelo nezindawo zisebenza eRussia. Bakhetha ukuthi yiluphi uhlobo losizo futhi yiziphi izikhungo ezinikezwa izakhamizi ezihlala kule ndawo noma leyo ngxenye yesifunda. Eyokuqala yenziwa nguNgqongqoshe wezeMpilo, okwesibili kuvunywe ukuphathwa kukahulumeni.

Uhlelo lomsebenzi

Uhlu lwamabhizinisi wenyanga uhlu lwama-3.6% we-FOP ku-CHI. Kulezi zinsuku, ama-3.4% akhokhwa endaweni kanye no-0.2% ku-MHIF yase-federal. Umbuso ukhokhela abantu abangasebenzi. Zombili izimali zikhungo ezizimele eziqongelela izimali, ukuqinisekisa ukuzinza kwesistimu nokulinganisa izinsiza zezimali. Imali eqoqiwe iya ukukhokha inani lezinsiza zezokwelapha.

Izinkampani zomshuwalense ziphetha izivumelwano nezindawo zokunakekelwa kwezempilo ukuze zinikeze usizo kubanikazi bomgomo wezinqubomgomo ze-CHI, zivikele izithakazelo zabaxhasi, zilawule imigomo, imiqulu kanye nemfanelo yamasevisi anikeziwe. Abahlanganyeli ohlelweni bangaba izakhamizi zaseRussia nabangewona abahlali. Kodwa-ke, ngokuqondene nalokhu okulandelayo, uhlu lwezinsizakalo ezitholakalayo lukhawulelwe.

Uhlelo lwezwe lomshuwalense wezokwelapha oluphoqelekile

Le dokhumenti inquma inani lempilo yokwelashwa yamahhala enikezwe izakhamuzi. Ihlanganisa:

• Okuphuthumayo;
• Out-patient, out-isiguli;
• Ukunakekelwa kwabagulayo Izifo ezinzima nezifo ezikhungathekile, izifo, izifo zokukhulelwa, ukukhipha izisu; Ukwelashwa esibhedlela ukuze kwenziwe ukwelashwa.

Ukungafani:

• Ukwelashwa kwe-HIV, isifo sofuba nezinye izifo ezibalulekile zomphakathi;
• Usizo lokuqala;
• Imithi yokwakheka;
• Izinhlobo eziyindleko zokunakekela: kusuka ekuhlinzekeni kwenhliziyo evulekile kuya kumakhemikhali nokwelashwa okunzulu kwezinsana.

Amasevisi akhokhelwayo

Uhlelo lomshuwalense wezokwelapha eRussia lwakhiwe ngendlela yokuthi ngisho nasesimweni sohlelo lukahulumeni ngezinhlobo ezithile zezinsizakalo umuntu kuzodingeka akhokhe lapho. Lezi zinsizakalo zifaka:

• Ucwaningo luqaliswa izakhamizi.
• Imithi yokuxilonga engaziwa nokuvimbela.
• Izinqubo ezenziwa ekhaya.
• Imishanguzo yokuvimbela ngesicelo sezakhamizi.
• Ukwelashwa kweSanatorium.
• Izinkonzo ze-Cosmetology.
• Ama-dental prosthetics.
• Ukuqeqesha emakhono ohlengikazi.
• Izinsizakalo ezengeziwe.

Inqubomgomo ye-MHI

Le dokhumenti ingakhishwa yizo zonke izakhamizi zaseRussia, kuhlanganise nabangewona abahlali abahlala okwesikhashana ensimini yezwe. Igama le nqubomgomo lifana nesikhathi sokuhlala kuhulumeni. Izakhamuzi zaseRussia Federation zithola inqubomgomo kanye kuphela.

Idokhumenti kumele iphathwe ngumqashi noma i-SMO. Kulolu cala, umuntu onomshwalense unelungelo lokukhetha inkampani okufanele ihlinzekwe. Izakhamizi ezingasebenziyo zithola inqubomgomo ezitolo ezikhonza indawo yazo.

Hlela idatha

Izimpawu zomshuwalense wezempilo eRussia zithi emva kokushintsha indawo yokuhlala noma idatha yepasipoti, inqubomgomo endala kumele idluliselwe e-UK, futhi emva kokubhaliswa esifundeni esisha, kufanele itholakale. Uma ushintsha indawo yomsebenzi, idokhumenti kumele ibuyiselwe kumqashi. Usomabhizinisi ubophezelekile ukwazisa i-UK ngalezi zingakapheli izinsuku ezingu-10.

Uma kwenzeka ukulahlekelwa inqubomgomo kuyadingeka ukwazisa umshuwalense ngesikhathi esifushane kakhulu. Abasebenzi bekampani bazokhipha le mibhalo kusukela ku-MHI base bese baqala inqubo yokubhalisa inqubomgomo entsha. Ngesikhathi esifanayo, imali engu-0.1 MROT yokukhishwa kwefomu ikhokhiswa.

Umshuwalense wokuzithandela wezokwelapha eRussia (LCA)

Le sevisi ivumela izakhamizi ukuthi zithole amasevisi angeziwe ngaphezu kwe-CHI. Izihloko zohlelo zingaba:

• Abantu;
• Izinhlangano ezimele izithakazelo zezakhamizi, noma izikhungo zezokwelapha;
• Ibhizinisi.

Umuntu angadala, azinzima (emkhakheni wamazinyo omzimba, ukuhlinzwa kweplastiki, i-ophthalmology, njll) amasevisi aphezulu, uthathe ukuhlolwa okwengeziwe, njll. Umshwalense wezokwelapha eRussia ulawulwa yisivumelwano ngaphansi kwalolu hlelo. Ngokwalo mbhalo, inkampani inesibopho sokukhokha izinsizakalo ezinikezwe izakhamizi ezifakwe ohlwini olufanele, ukukhipha isikhathi ngasinye isikhathi esithile inqubomgomo ngenhlelo yesevisi kanye nohlu lwezikhungo lapho kuzosiza khona.

Lesi sivumelwano sibuye sithi umuntu ophephile ubophezelekile ukuba akhokhe iminikelo esikhathini esithile, imigomo yedokhumenti, imigomo yokwedluliselwa kwayo, imithetho yokuthola isinxephezelo, kanye nokudluliselwa kwelungelo lediphozi ngemuva kokushona kwabase-insured.

Ngokusho kwedatha yakamuva, ngo-2015 62% wabaqashi baseRashiya abakhokhi izinsizakalo ze-VMI kubasebenzi babo. Iningi lezinkampani zenqabe ukuhlanganyela kulolu hlelo ngenxa yenkinga yezomnotho enzima. Izindleko zabaqashi abaphothula izinkontileka ngaphambi kuka 12/12/2014 izinyanga ezingu-12, zahlala zingashintshi. Kukhona izinkampani ezingu-14 kuphela ezingu-14 kuphela ezihlolwe. Kodwa kukhona okuhlukile. Aba-2% abaqashi abahlolisisiwe banciphise izindleko ze-VHI, ukuthuthukisa izinga lokusebenza. Amanyunithi aphethwe ukuphetha izinkontileka ezingaphezulu. Abanye osomabhizinisi banciphise inani lemali ngokususa amazinyo kusuka kumshuwalense. Enye i-5% yezinkampani ezibhekene nazo zahlolwa ukwanda kwamanani angu-5% ngenxa yokukhuphuka kwezindleko zezokwelapha.

Izinkinga zemshuwalense wezempilo eRussia

Kulesi sigaba sokuthuthukiswa, kunenkinga enjalo ekusebenzeni kwesistimu:

1. Ukunciphisa imali yesabelomali. I-tariff ekhona ye-3.6% ayihlinzeki ngokuhlinzekwa kokunakekelwa kwezokwelapha ngisho nakwazakhamizi zokusebenza. Abantu asebekhulile, abakhubazekile kanye nezingane badinga ukunakekelwa kwezokwelapha kakhulu. Ukukhishwa kwezakhamuzi ezingaqashiwe kudluliselwa kwisabelomali sesifundazwe. Ngenxa yalokho, kuncishiswa kwezimali, okuvela kuzo usizo lokuqala lokuqala oluthintekayo.
2. Ukuxhaswa kwemali yabantu abangasebenzi kungabizwa yi-anti-tuberculosis, izinsizakalo zengqondo nezengqondo. Kunengozi yangempela yegebe phakathi kokwelashwa nokuvimbela.
3. Ayikho imodeli yomshuwalense owodwa.
4. Ukungabi nolwazi olunokwethenjelwa ngemali engenayo nokusetshenziswa kwomshuwalense wezokwelapha eRussia.
5. Ubukhona bokukhokha emuva kokukhokha iminikelo.

Lapha izinkinga ezinzulu zomshuwalense wezokwelapha eRussia zikhona okwamanje.

Isiphetho

Enye yezinhlobo zokuvikelwa kwezenhlalakahle kubantu bezwe ngumshuwalense wezokwelapha. E-Russia, izici zalo zithi izinsizakalo zinikezwa ngezinkomba ezintathu. I-MHI ixhaswa yi-state, kodwa ngaphakathi kohlaka lolu hlelo, umuntu akawamukeli zonke izinhlobo zezinsizakalo. Imithi eyimfihlo ayitholakali kuwo wonke umuntu. Ngakho-ke, amaRussia anikezwa ukuba ahlinzekwe ngaphakathi kohlaka lwenqubo yomshuwalense wokuzithandela. Ngokukhokha imali eyengeziwe, umuntu angakhetha inkampani yomxhumanisi womshuwalense, umthamo wezinsizakalo, izinhlobo zakhe kanye nezikhungo, lapho azothola usizo lwezokwelapha.