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MPs propose empowering Kazakhstan citizens to manage a portion of their own social security contributions

Kazakh Parliament's Mazhilis deputies approved modifications to health insurance in a first reading on April 30, suggesting reforms. Deputies Aidos Sarym and Murat Abenov expressed their disapproval of the existing system during an interview with our reporter.

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Parliament deputies in Kazakhstan approved amendments to the mandatory social medical insurance...
Parliament deputies in Kazakhstan approved amendments to the mandatory social medical insurance (OSMS) in a first reading on April 30th. They proposed reforms to the system along with the approval. Deputies Aidos Sarym and Murat Abenov shared their perspectives on the current system, expressing criticism, in an interview with our correspondent.

MPs propose empowering Kazakhstan citizens to manage a portion of their own social security contributions

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On April 30, parliament members in Kazakhstan took a big step toward revamping their Compulsory Social Health Insurance (CSHI) system by approving amendments in the first reading. However, these changes aren't just tweaks; they're sweeping reforms targeting the system's core, especially giving citizens and employers a more active role.

Aidos Sarym and Murat Abenov, two vocal deputies, shared their thoughts about the current CSHI system in an interview with our reporter. Both agreed that power should shift from the government to the citizens and employers, transforming them from passive contributors to active participants in medical insurance.

Aidos Sarym, one of the main critics, highlighted the issue of the state's dominance in controlling and managing CSHI funds, resulting in subpar medical services and poor financial oversight. He believes that a versatile approach should be adopted, allowing part of the insurance premiums to be managed by insurance companies at the discretion of citizens.

"I suggested, for instance, that 1% of the funds paid by the employer or the employee be directed to a private fund or structure of their choice," Sarym explained. "We have a restrictive system in place, where only state clinics and limited private clinics are available. In rural areas, there's no choice at all, only state facilities. But why shouldn't I have a choice?"

Sarym pointed out a common challenge faced by Kazakhstanis: the need for medical care while traveling for work, where state clinics may not offer free care. A flexible choice system, Sarym underlined, would foster patients' self-care and decision-making about spending their insurance funds wisely.

The ideal system, according to Sarym, should be universal and personalized, centered around a single number that allows users to track their healthcare records, manage their insurance effectively, and access services across the country.

Sarym also warned about fraud, such as fabricated medical services shown on an app for billing purposes in other regions. However, he believes a competitive environment would make such instances rare, driving up service quality and growth in the medical insurance and savings market.

Deputy Murat Abenov, meanwhile, blamed the initial CSHI model for excluding citizens from the decision-making process, as their money forms the basis of the system. Abenov urged for accountability, even to the point of criminal charges, for violations by clinics, with fines serving as a deterrent.

"In some cases, the fine is lower than the violation itself," Abenov mentioned. "For severe violations, such as lacking a license, poor equipment, or insufficient expertise, the organization should not only return the funds but face criminal charges, accounts freezes, restrictions, and additional financial penalties."

Abenov advocated for greater transparency, giving patients access to information about how their funds are used for treatment. This would empower Kazakhs to demand quality medical services, make informed decisions, influence clinic choices, and actively participate in their medical insurance management.

While these proposed reforms aim to improve healthcare access, particularly by including the unemployed and vulnerable populations, they lack concrete details for the flexible choice system or greater citizen and employer involvement beyond insurance contributions. The focus primarily lies on expanding coverage and financial support for underserved groups rather than offering diverse medical options directly.

Key Insights:

  • Revised Contribution System: Some proposals suggest cancelling the VAT on healthcare goods and services tied to the compulsory health insurance system and free medical care.
  • Inclusive Approach: The new reforms aim to extend coverage to more than one million unemployed and vulnerable citizens from 2026 onwards, with local and regional budgets responsible for their insurance contributions.
  • Legislative Changes: Draft legislation is currently under review, allowing local governments to fund insurance contributions for eligible groups and expand insurance coverage beyond income and employment status.
  • Beyond Reforms: Kazakhstan's ongoing economic reforms focus on modernizing and fairer funding mechanisms through the implementation of a new Tax Code, indirectly supporting the healthcare sector.

Even though the proposed amendments prioritize inclusivity and financial support, further measures must be implemented to empower citizens and employers with concrete options, strengthen their role in managing the CSHI system, and provide a flexible choice system for medical services.

  1. The revised contribution system in Kazakhstan's Compulsory Social Health Insurance (CSHI) could involve cancelling the VAT on healthcare goods and services tied to the system, potentially leading to free medical care.
  2. The new reforms aim to extend CSHI coverage to more than one million unemployed and vulnerable citizens from 2026 onwards, with local and regional budgets responsible for their insurance contributions.
  3. Draft legislation is currently under review in Kazakhstan, allowing local governments to fund insurance contributions for eligible groups and expand insurance coverage beyond income and employment status.
  4. Kazakhstan's ongoing economic reforms focus on modernizing and fairer funding mechanisms through the implementation of a new Tax Code, indirectly supporting the healthcare sector.
  5. While the proposed amendments prioritize inclusivity and financial support, further measures are necessary to empower citizens and employers with concrete options, strengthen their role in managing the CSHI system, and provide a flexible choice system for medical services, fostering a more active participation in health and wellness, insurance, finance, business, and science sectors.

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