Health inishuwarenzi: mamiriro, chinangwa uye mhando inishuwarenzi utano muna Russian Federation

Wevanotungamirira ezvinhu, kuchinja hurumende kuiswa pokutanga mumunda bhajeti havashandisi mari kwakaita kuti nokuwedzera basa private zvoutano mari zvinyorwa. Munyika dzose apo kukurumidza kutanga inishuwarenzi utano, pane customized zvigadzirwa kuchengetedza upenyu uye utano vatengi. Russia hakusi kurwadziwa. Funga Mhando mikuru utano inishuwarenzi muna Russian Federation.

mwoyo

Zvakakodzera kusiyanisa okuti "mushonga inishuwarenzi" uye "utano inishuwarenzi". Muchiitiko chokutanga tiri kutaura pamusoro dzoutano mari nzira, uye wechipiri - pamusoro basa. We funga zvakadzama mamiriro uye mhando inishuwarenzi yeutano.

Iri izwi rinoreva rudzi munzanga nedziviriro hutano vemo. chinangwa chacho - iri zvinoitirwawo chiitiko insured kupa vagari pamwe mukana wokugamuchira mishonga nokuda kuunganidza mari uye mari chokudzivirira dzokuvhiya. Mhando inishuwarenzi noutano kwairayirwa uye nokuzvidira kuchengetedzwa.

Musimboti izvi iri ngozi yedzimudzangara chokuita noutano hwakanaka (pfupi kana yechigarire) uye mari chokuita kwayo kupora. The kubata insurer yakabudisa kondirakiti. The chinhu ndiko pangozi kuwana mari chakakonzerwa namaneja panyaya pakurapa insured munhu kuti vezvokurapa nzvimbo rubatsiro pakurapwa. Kukosha mupiro rinowanikwa kwakavakirwa ndingangokuvara panowanikwa insured chiitiko, mamiriro hutano nemhosva, hwake zera uye zvimwewo. The Vanotongwa ndiwo: vagari, ari insured, zvokurapa sangano.

Zviga kushanda utano inishuwarenzi ndivo yakatarwa panguva zvemitemo chechetere:

• Russian mubasa zvirongwa rokubva utano inishuwarenzi (Chi) ;
• mari uye mamiriro ezvinhu kuti kupa rubatsiro kune vanhu vari gadziriro OMC;
• uwandu vakasununguka mabasa;
• PB mugari kutsigira yokuzvidira inishuwarenzi (LCA), iro rinotaura mabasa pamusoro MLA purogiramu;
• wemishonga în format DMS uye OMS.

The epamutemo divi nyaya

Rights mumunda utano vomuUmambo enshrined Art. 41 wokuRussia reMitemo uye mutemo "On inishuwarenzi vezvokurapa vari Russian Federation". In mirau iyi rinotaura kuti vanhu vose vane kodzero zvoutano. Panguva mamiriro matunhu neminisiparati masangano zviri pachena, kureva kuti, tichiregeredza yacho bhajeti, kubhadhara inishuwarenzi nezvimwe zveminda. Residents uye vasiri vagari pamusoro munharaunda Russian Federation, pasi MLA. Kuti, utano kunofanira zvidikanwi vanhu Pakuchengeta woutano zvisinei zvavo marii.

Health inishuwarenzi: mifananidzo, misiyano

On mundima Russian inogona akapa mutemo utano inishuwarenzi rokumanikidzirwa, yokuzvidira uye dzakawanda. Miti All vatatu vakasiyana cost, nouwandu mabasa inopiwa. MHI chezvawanyora fanira vanhu vose vaigara munharaunda yacho Russian Federation. Pasina izvozvo, mahara chete zvashata kurapwa. Kana insurer achida kugamuchira zvakawanda mabasa vari kuwedzera kana nani quality, zvinova VHI. Vashanyi vanoshanyira kunze mundima Russian Federation anofanira vanosungirwa kuti ape inishuwarenzi dzakawanda pacharo.

Chi

urema nengozi zvinoreva ngozi, panowanikwa asingasvavi kuvimba munhu, asi kunoita kuti zvinokosha mari. Havana chokuita kwete chete vanhu asiwo nzanga yose zvayo. It anofarira tiine utano ose nhengo.

inishuwarenzi rokumanikidzirwa utano kunotoreva evanhu inishuwarenzi. It kunovimbisa kudzivirira kana urwere zvose vanhu zvakaenzana. Rokumanikidzirwa utano inishuwarenzi - rudzi pfuma dziviriro, izvo zvinoita kuti vanhu vose, zvisinei kuti bonde, zera uye munzanga, anekodzero yekuwana mishonga. Zvinonzi chinozoiswa kuburikidza kwegadziriro mari (yeUnited uye miganhu) nemasangano kushandiswa. Wokupedzisira muviri OMS kushanda musi dzokutengesa hwaro. Insurers vari vanozoshanda pakati mari nemasangano kupa rubatsiro kune vagari. Sangano uye kudzora nyika yose iri kuitwa kuburikidza nheyo - asiri purofiti masangano, izvo anoshanda maererano mutemo Russian.

MHI ari inotsigirwa inishuwarenzi premiums (mipiro chete mutero yevanhu 3,6%), mari kubva bhajeti. Munyika ino, insurers ndiwo vashandirwi, izvo zvinofanira kupinda zvibvumirano tsitsi vashandi, Entrepreneurs uye voruzhinji yaitonga hurumende zvese.

MHI urongwa

Gwaro iri certifies kodzero mugari yokugamuchira vakasununguka dzokurapa inopiwa kuumbwa purogiramu. Rine mashoko pamusoro muridzi mutemo, kondirakiti nhamba pamwe kambani yacho inishuwarenzi, chiratidzo kutyira imwe kiriniki.

Mukati inishuwarenzi Gwaro pa kambani inishuwarenzi upi pakati avo vaisanganisira vari Chi remazita. Urikushanda yose ndima Russian Federation. Kana kushandura Full zita, nzvimbo dzokugara, gwaro Data kana kuziva chero kusabvumirana, mutemo zvakakodzera kuzodzosera kunyoresa mukati mwedzi. About nokurasikirwa mugwaro inofanira kuziviswa kunyorwa rweinishuwarenzi, uye ipapo mberi kusvika yokutsiva zvichiitwa.

Services chirongwa

Mari uye zvinhu kuti kuwana nebumbiro iri gwaro rinokosha zvakabatanidzwa. The chikuru Chirongwa kunokudziridzwa neShumiro Health uye aifarirwa Hurumende. On hwaro ichi dzakabudirira emunharaunda zvirongwa. Ivo kutaridzwa mhando mikuru utano inishuwarenzi, nhamba uye unhu mabasa, mutero mamiriro, nzira mubhadharo rubatsiro. Kodzero insured vanhu kuna MLA yakatekeshera munyika Russian Federation.

Sezvo chikamu chikuru chirongwa kunopa chikuru utano, chokudzivirira, kushandiswa kurapwa vanhu nezvirwere zvakadai:

• Zvirwere, parasitic (kunze venereal zvirwere, tiibhii uye AIDS);
• kenza, ganda, zvirwere kwemakemikari anobudiswa hurongwa;
• vachidya zvinetso, asi huta, Urinary hurongwa;
• zvirwere kweropa hurongwa;
• ziso, nzeve uye zvirwere zvokufema;
• kunotevera;
• zvirwere zvetsandanyama nemapfupa hurongwa;
• vachiberekwa anomalies nedzevakuru;
• zvirwere zviri zvirwere;
• chromosomal abnormalities;
• pamuviri, mwana uye pamuviri.

Miganhu chirongwa zvinosanganisira:

• pamazita zvirwere uye mhando rubatsiro inopiwa kune vagari tichiregeredza budgetary appropriations uye achishandisa miganhu pavane Chi;
• nzira kuti urongwa okurapwa dzimwe Mapato vokuparidzira;
• ndandanda mishonga zvinokosha uye mishonga, izvo zvinokosha urongwa okurapwa;
• pamazita mishonga kuti vari mushonga pachena kana 50% dhisikaundi;
• Nyora masangano kuti ndiitewo chirongwa.

Medorganizatsii pokuita Chirongwa remunharaunda, rinogona akabhadhara mabasa:

1. kunze kweaya akapa mupurogiramu, kusanganisira pasi chikumbiro mamiriro:

• pokugadzwa munhu romukova mednablyudeniya panguva muchipatara;
• kushandisa zvinodhaka kuti murege chokuita zvinokosha.

2. Kwaakaita mabasa anonymously.

3. Non-vagari, ndeyedu vanhu vasina MHI itsika.

4. With nokuzvidzora pakurapa insured munhu asi nyaya yokukurumidzira, unyanzvi, kutarisirwa.

Paid mabasa inopiwa pamusoro uye pamusoro inosimbiswa zvemaBhaibheri Chi. The Chibvumirano anoperetera kunze mhando uye vhoriyamu okurapwa, izvo anopiwa mahara. Kuramba kusaina chibvumirano haana kuva chikonzero kuderedza uwandu kana chatingatevedzera mabasa anogoverwa pasi chirongwa hurumende.

inishuwarenzi Kwokuzvidira zvokurapa

Kuti tiwane nokurapwa zvinopfuura shoma zvakafanira kuti ape mitemo LCA. Pakati nemhosva uye boka racho inishuwarenzi akaurayiwa chibvumirano pasi iyo, mukutsinhana shoma vaibhadhara insurer inozviita mari mari kurapa chirwere kana yaizoitika makuvaro.

Zvichienderana chimiro vachibhadhara kuti govera mhando izvi yokuzvidira utano inishuwarenzi: zvepuraimari uye yokuwedzera. Muchiitiko chokutanga tiri kutaura pamusoro kubhadhara kunorapwa mari (kureva. E. The insurer anogamuchira pasina mari muruoko). Mukuwedzera, inishuwarenzi anopa kubhadharwa nzira, izvo haana kuiswawo pakati OMC (experimental kurapwa, mazino uye mabasa prosthetics, Mabatirwo kenza uye zvichingodaro. D.), Uye zvisina kunanga mari (kurasikirwa zvakaoma nokuda kuremara, maternity kutarisirwa, uye zvichingodaro. D.) .

LCA anogona kushandisa oga kana kuti pamwe. Kusarudza wechipiri akakurumbira zvikuru munyika. Panyaya iyi, iyo insurer anoita sezvo kambani (mushandirwi) uye insured munhu - vashandi vake. Maererano chibvumirano, vagari vanogona kurapwa mune mamwe mamiriro ezvinhu. Mhando idzi noutano inishuwarenzi muna Russian Federation ushande chokuzvidira hwaro. Ndiko, mutemo iri yakatengwa nokuda nemhosva, pane madikanwa.

kubhadhara

Mutero rate nokuti LCA vari dzaona pachishandiswa mishonga uwandu, dzinokosha wevanotungamirira zviratidzo (upenyu anotarisirwa, mwero wokufa kwevanhu), hwevanhu vanorwara uye muchipatara. The mubhadharo pakuti nguva chesungano. Nokuti pagore mutemo kwakawedzera vari dzaona pahwaro chavanopinda of insured kune imwe zera boka. Kubhadhara dzinoitwa tichiregeredza ano mipiro. Tariffs, nokuti kwenguva refu zvibvumirano kufungawo kwete chete zera, asi wevanotungamirira zvinhu, hwevanhu vanorwara Nhamba panguva izwi chesungano. Inotsigirwa mipiro kuitika kubhadhara uye vakaumba reserves nokuda vachibhadhara ramangwana.

tariffs,

Medical inishuwarenzi, chinangwa, mhando izvo zvataurwa kare, zvainanga okudzivirira pfuma zvido vanhu vari chiitiko yokuremara. Asi LCA vanhu vane utano maitiro nomumwe akasiyana avhareji kuita uye mukana hosha iri yepamusoro.

Mutero rate pamusoro policies zvakadaro kusiyaniswa chaizvo. Vari kugadziridzwa kuti boka rakadaro, zvichienderana migumisiro ine kuongorora wezvokurapa:

• Group 1 - vanhu kushanda Vakagwinya vasina nhoroondo yemhuri. Kune vana, zvirwere zvokufema, appendicitis, heniya; tsika hapana chakaipa; kwete kushanda ngozi sika.
• Group 2 - vanhu vane mikana yakawanda chirwere, nhoroondo mhuri cheshuga, zvemwoyo, pochechnymi- uye gallstone, chirwere chepfungwa. A nhoroondo dzechimwe kukuvara pfungwa; Kune tsika dzakaipa; kushanda hunokuvadza ezvinhu okuwana.
• Group 3 - akagwinya vanhu vane chirwere nezvirwere; kudhakwa, mapiritsi; kutambura kubva neurosis, BP, ischemic mwoyo chirwere pasina angina.

Mutero rate vari kusiyaniswa pamusoro parameters izvi zvose, uye rinowanikwa yoga chimwe kutungamirirwa.

kutyora kodzero

Zvose mhando inishuwarenzi utano pasi chete mazano. Mune chiitiko chimwe chokwadi izvi kodzero vagari kugamuchira unhu dzokurapa vanoonekwa kutyorwa:

• zvisiri pamutemo muunganidzwa mari vanachiremba mudonzvo kuti vanobatsira uwandu zvaitaurwa papurogiramu mamiriro;
• zvisiri pamutemo muunganidzwa mari iri mari yokurapwa zvivako rubatsiro, zvokusumwa, tsamba yemishonga;
• kutenga mishonga uye zvigadzirwa mednaznacheniya kubva anotenderwa mazita zvirongwa tichiregeredza varwere;
• sokunonoka pakupa okurapwa;
• Kuramba kupa rubatsiro pasi MLA.

Kuti uwane mamwe mashoko pamusoro chii marudzi inishuwarenzi utano ushande imwe nharaunda anogona kuwanikwa kubva, kuti miganhu pavane Chi muna Health Committee.

International tsika

utano basa Kuwanikwa - musimboti nyaya chero nyika. Pokutanga zvokuzvivaraidza inishuwarenzi utano kunonyanya hunotsamira Nhoroondo tsika. Mune US, mhando dzose inishuwarenzi utano wakashanda nezvipo zvokuzvidira. Munyika dzakawanda, kwete purogiramu paruzhinji mari. Kwavari, LCA ndiko kudiwa kwokukurumidzira. Vanhu vakwegura uye murombo kuitawo zvirongwa mamiriro. Asi vose vakashandisa vanhu, vashandirwi kubhadhara VHI. UK mabasa National Health Service. VHI vari akaumba nenzira kuti vatengi anogona kubhadharira kuzvironga kuvhiya kurapwa kana Unganatsiridza nokurapwa. Mune dzimwe nyika mune pamusika dzisiri kukura mhando yezvokurapa inishuwarenzi vomuUmambo zvainanga mamwe kubhadhara dzisina kufukidzwa dzose nomutemo. MuEurope, pane hurumende rutsigiro zvirongwa. Asi chinonyanya kukosha tsime mari mitemo rweinishuwarenzi kwairayirwa.