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Strahuvannya - Osadets SS

Розділ 10. Health insurance

10.1. Obovyazyvoy medicine insurance

In the systems of public health, the social status of the citizens is important to the person who is unable to stay in a safe place, he must be able to maintain his health, so that he can be medically assisted.

Світовий досвід показує, що прямки вирішення цієї вопросым муть бути різні. Загалом вони відрізняються структуратурою джерел фінансування інрони здоровія й orgізацією наданя медичних послуг.

Fіnnsuvannya zharoni zdorovya mozhe budi budennym, sotsіalnim i privatnim.

The budgetary system for the health of nairaznіshe bula is represented in the republics, which were before the CDSR. The social system is typical for the territory of Zahidnii Є Europe, and privately private - for the United States.

For the budget system, the financial support for health insurance, insurances abnormally, is not important. Budgetary system fіnansuvannya peredachaє vіkoristanna koshtіv podatkovich nadohodzhen up to the budget, ale tse ti ne sbryaє stabіlnostі fіnansovogo zabezpechennya zhabroni zdorov'ya.

Social system of funding for health is grounded in tsilovyh vnedskah pіdpriemstv, pravcіvnikіv, on sovereign subsidies. Prichomu vneski pidpriemtziv є perevazhayuchim dzherel nadohodzhen. Nezvazhayuchi for those who are interested in the payment of earnings, income, vinyatki, yakі hundredsuyutsya pensioneriv, osib in the low rivnem income.

For sotsialnoї sistemi it is characteristic співіснування державних systems to protect health and private systems.

In the marginal regions, the pittance for the spivnisnuvannya base of the state and private systems is virishuyetsya in a rarity. Napriklad, Nimecchyni pobobachena mozhnivіst vyhodu pevnoї kategorії naselenna іz sistemnoi sistemi ta її fate in private insurance for the control of the state for yoga yakisty. In France, the system of power is not reserved for the overhaul of the varosty, the spontaneity of the brotherhood of the fate of private insurances. In the Great Britain the order is the same, but the entire population is insured by the state, in the vipadkas, if the system is not dominated by the hulk, by the method of the service, take care of the fate of the private insured.

In the United States, the financial support for health is based on Mayge wikly on the basis of payment, for example, in the populated part of the population, you can get to the bottom of the balance (pensions, bidnyaks, loans), to service the state programs "Mediker" and "Medikade."

Organizatsiya zharoni zdorov'ya, yaka zabezpechuyet the right skin gromadyanina on otderzhannya medichnoe dopomogi, mozhe bouti zabezpechena sistemoy insurance medical. For the sake of insurance medicine, the supply of guarantee and accessibility of medical services for the wide vestiges of the population, zaduchchenya dodatkovyh resources in the sphere of health.

Insurance medicine is fostered by the science of dosleness, the preparation of medical personnel, vitrathy for the development of the material and technical basis of likkuvalnyh mortgage, the provision of medical assistance to the population.

Insurance medicine is based on singing principles, so there are many ways to name the economy that is economical and socialistic in the middle and poorly protected outposts of the population, the guarantee of the rights of the skin grenadier to a medical emergency, the obesity of extracurricular immigrants, and juridical osibs.

Vazhlivim Element of the systems of insurance medicine - medical insurance . Medicaid insurance in the forefront of insurance for vipadok vtrati zdorovya z be-cause. Воно забезпечує більшу доступність, якісність і пвноту schodo задоволення різноманітних consumer needs in the median services, є efektivnimym pobіvnyano z stavnim fіnnsuvannіm sistemi zharoni zdorov'ya.

Medicines are insured against misuse, compensated for the viturate of the Gromadians, yakis are reinforced by medically assisted, and such are the least of the vitriments that are spun on the health pidrim.

Соціальна та економічна ефективність of medical insurance to be laid in order, naskilki gliboko і vsebіchno пророблено конітцію розвитку страхової медицини в країні.

The subject of medical insurance is the life and health of the Gromadyans. The meta yogo is spent in a safe haven in a safe place for the insurance vipadku mozzolisti mediocre support for rakhunok accumulation of koshtiv and finance of professional encroachments.

Medicaid insurance can be carried out in obovvyazykovy and goodwill forms. Vibiar forms of medical insurance in the skin of the territory to be found in specific economical and cultural-historical minds, in particular for demographic and socio-cultural manifestations, for rivalry of those factors, for characterizing the zagalny camp of health and the ridge of medical services.

The principle of obovzjakovogo medichnogo strahuvannya dіє, napriklad at Frantsії, Kanadі, Nіmecchini, Niederlandy.

In Ізраїлі і Швейцарії переважає добвільне страхування здоров'я, а обов'язкове існує лише що осіб have enlightened professions.

Obovjazykov form of medical insurance to be vikorostovuyutsya, yak rule, in quiet areas, de perevazhne znachennya mese sospilna zhonrona zdorov'ya, and okolovilna - there, widened private insurance programs.

Medicaid insurance, yak to get through in obovyazykovy form, nabuvaє rice social insurance, okkilki order yogo vypolnya viznachaetsya soviet legislation. Obovyazykov form of insurance co-ordinated by the sovereign structures. Insurance payments, rallyed by those who are juridical persons, flaunting the form of the payment. Obov'yukove medicine strakhuvannya perebuvayot pid zhorstkim control of the state і characterize bezpributkosti. The form of the organization of the insurance fund allows you to plan your health care to the extent that it is necessary for the insurance fund to characterize the stability.

Obovyazykov medicine insurance based on such principles: zagalnostі, derzhavnosti, nekomertsіnosti (Insurance from A to Z), edited by LI Korchevskaya, KE Turbina .- Moscow: INFRA, 1996. - P. 540- 541). Principle zagalnosti poleah in that, vsol gromadyane nezalezhno vіd stati, vіku, zdoru zdor'ya, mіtscya zhizovannya, rivnya osobistogo income mait the right to the sustained medical attendants. The principle of sovereignty is meant, but the cost of obovzyazkovogo medical insurance - tse vlastnavna vlasnist. The power of care is the system of obovzyazkovogo medical insurance, and an insect-free insurer for the part of the population that is not part of the population (for example, pensioners). The undisclosed nature of obovyazovychnoy medical insurance is based on the fact that yo yogo zdіysnennya i pributok - tse nesimіsnі rechі. Pributok vіd spent obovjazyakovogo medical insurance є джерелом поповнення фінансових резерів системи так страхування і не може бути засобом збагачення.

For obovjazykovogo medical insurance is typical for those who pay insurance payments to residents during the renovation of the premises and at the insurrections for an hour, and a bank guarantee insurance for all insurances.

Behind the symptoms of obovyazkovogo medichnoy strakhovannya robotodevtsi majut vidrahovuvati vіd svoyїh protyvіv fears vneski. Tsі koshi formyut insurance fund, yakim kerує power. Part of the fund can be stolovoyvatis і for rahunok vneskiv, yakі udimuyutsya iz zabrobitnoi plati pratsyuuchih. Part of the skinhead is stored in specific economical minds spent on such insurance and medical care. Із коштів стреного страхового фонду відбувається відшкодування необхідного мінімального рівня vitrat on лікування застрахованх працівників у разі їхньої непрацздатності через втрату здоров'я.

In the basis of spent obovyazykovogo medical insurance covered by the programs obovjazykovogo medical obesgovovuvannya. Cі progry vyznachayut otsyagy i umovi nadannya medichnoy tіlіkuvalnії допомоги population. The program hunted me minimally unnecessary change of the medical services, guaranteed to the skin-hogger, how much they have the right to crooked.

Subjects of obovzjazkovogo medical insurance - insurers, insurers, insured, medical establishments.

Insurants - the goal of independent insurance of the organization, the status of a legal entity and the license of the state for the right to health insurance. Insurance of medical organizations for the razoon of molding insurance funds to pay for medical assistance to the insured, and so that the health services of the Gromadians are protected. Medicina insurance is the basis of special insurance, it is important to take care of other types of insurance, zvazhayuchi yogo specifichnist. When the health insurance is conducted, the insurance policy is mandatory for the mother in the right place with bugs, klієntami, yakі insurance, podsyakdenno virishuvati for them food for the drive nastannya insurance vipadkіv i vyplati znachnyh behind the insurance sum ins.

Страхові медичні оргаізації to bear відповіdність for neobyruvtovanu vіdmovu укласти договір обов'язкового medical insurance, невоєакчасне пътенняня paymentів зі прати medicochnoї establishments, vіikonannya minds to the contract of medical insurance. Yaksho insurance medical organization does not meet the requirements of the insured person, but the right to distribute it in accordance with the insurance policy of the yoga practitioner is covered by the insurance medical organization.

The main attribute of insurance medical organizations in the system of obovzyazkovogo medical insurance policy is that in case of payment for health care facilities, the control of health care providers should not be compromised by medico-economic standards.

Pід якістю медичної допомоги слід розуміти виконання by the medical personnel of professional functions, ефективне використання ресурсів, stepін ризику for the insured (небезпека травми або захворювання внаслідок медичного втручання), задоволеність пацієнта медичним обслуговуванням. To control the care of medical attendants in insurance medical organizations, as a rule, stvoemyayutsya spetsialnie ekspertny komіsії, yakі majut perevirjati in medical establishments the correctness of the established diagnosis, likuvannya tochno. If, as a result of the revision, you can see that you are in the middle of a medical establishment, then you can not put up a pesky sanitation. Moreover, the insurance of a medical organization can be determined by a medical practitioner, in order to be insured by insurance. Otzhe, fears of medical organization, zahischayut rights and intrepidi gromadyan with their medically supported care in programs of obovzyazkovogo medical insurance.

The insurance medical organization may be regulated in the form of an organi- zation and legal form. One form of the forms is an ac- tionary form. Aktsionernaya form of the organization of the insurer allows the concentration of self-knowledge in the financial resources and security of the control over the disinfection of insurance organizations and medical establishments. Vodnochas, in Zahidnyi Єvropi sama, the accredited form of the secession of the insurance medical organizations was manifested in the unpopular, the accusations of the hour of the day in the sphere of health protection are important for the sake of pribudki. At Nimecchin, the Navpaks, the shape of the siidae, is the sign of the world. With the rule of law, Nimecchini zobov'azuє fears of medical organisatsiyi znachnu part pributku pass on the corridor klієntіv.

Страхові медичні оргаізації здійснють свою діяльність на основі договоів about співробітництвово із медичними установами.

In the system of obovzyazkovogo medical insurance, the insured can choose buti and the fund for obovyazkovogo medical insurance, yakis are self-esteem, non-financial, financial and credit establishments for the realizing the state of health in the medical insurance horizon. Takі fondi stvoiliuyutsya na sovervnomu i teritorіalnomu rivni.

Insurers in the system of obovyazovogo medical insurance for the population of the population - robotodevtsi (pidpriemstva, set, organisatsiya, seliansky (farmerski) gosdarstva; individuals who work on the estate, work without disability, individuals, borrow money, without privacy, gromadyani, yakі mait privatnu practice The order of the order, the hulks, the whicures of the vicarious people in the special government; for the non-populated popula- tion (children, school students, students, students, pensioners, unemployed, unemployed, registered in the established order) - the organ of state administration, the vikonavchogo authorities, and the administrations.

Insured - th Gromadyans, on the corridor of some way to settle the insurance.

Medical establishments of sub-ect obovyazkovogo meditschnoy insurance shall be one of them, establish a license for the right to provide medical assistance and services with programs of obovyazkovogo medical insurance (litkalno-profilakticnnyi set, science and dosage institute, enoshi seti, scho nadayut Різні visible medically). Ліцензія - це це державний дозвіл медичній установі на здійснення her пвних видів діяльності і іsg after programs of obovzyazkovogo medical insurance. Ліцензію повина мати be-яка медична установа незалежно від форми власності. In addition, you can pass the accreditation for adherence to the establishment of professional standards.

Medically, establish your disability on the contract with the medical insurance organizations, such as mediation of medical establishments, give the insured contingent medical assistance to the pivotal oath, that anchor in specific lines (in the interventions of obovzyazovy medical insurances). At the agreement, a voucher of lykuvalno-dinogostichnogo dopomogi і normativi vidstokduvannya vitrate. For nadannya medichnyh the medical service provider set the charge.

Medichna establishes the responsibility for the admission to the medical assistance to the insured, the lack of medical services for the vigilance and the contract for the insurance of the medical organisa- tion.

Розрахунки з медичними установов здійснються by insurance organizations for the fact that I will be put on the health insurance for a doctor or assistant. Tse zabezpechuet control over the medical care and assistance to those vicarities, and can create the economic incentives for the full service of the insured for the health of the medical pawns.

The system of obovzyazkovogo medichnoy zakobovnya zobov'azuyet insurance companies to arrange for the insured insurers who are insured for the right to receive medical services, the transfer and the ossyg of some to be installed by programs of obovyazkovogo medical insurance, in medical settings, including up to systems of obovzyazkovogo medichny Insurance. When the contract is concluded, the insured person is seen as an insured and insurance dogovir, and to the insured person - an insurance policy, a kind of contractual force. Do contractual obovyazkovogo medical insurance is vysnachaetsya, scho insurance organisatsiya take on zobov'jannya pay for medical and other services, which will be given to the insured person with the program of obovzyazkovogo medical insurance. At his chergo, an insurance lawyer zobovyazyevatsya rallying out insurance insurance body. At the agreement, the rozmіr, the lines і order of the insured insurances, the lines of the agreement, the contingency of the stay at the time of the invisibility of the minds of the contract, and the order of the visa disputes. Insurance polis obovjazkovogo medichnogo strukhuvannya pidtverdzhuyu right gromadyanina on otderzhannya medichnoї doppomogi pro programu obovjazykovogo medichnoy strakhovannya.

Obovjazykov medicine strakhuvannya hoplyuet practically all the population і zadovolnyaє stіnovnі першочергові consumer, але воно can not hunt the whole otsyag rizikіv. To this unpleasantness of insurance interests is realizing the organisation of a good medical insurance.