Unhealthy insurance

December 8th, 2011


6299   0

5 min

Ever since Mongolia had a transition to free-market economy, the government of Mongolia has been making amendments to the law on health insurances every four years and today’s government is rushing to make changes to this law as well. Even though the government says that a total of three law amendment projects are ready now, it is unclear if those projects reflect people’s voice or have fully covered their social life. The only clear thing is that government officials are afraid because, if a broad discussion on reality of today’s health insurance and its issues is carried out by people, the truth about the inefficiency of our incapable administrative system will be discovered. The basic reason why a new government makes changes to this law is that lasting principles and ideology on health insurance are still not set.    

Every amendment to this law is made by outcomes of political battles over authority because a large amount of public and private money is circulated almost with no control within the health insurance system that does not have a main goal or purpose. Therefore, there has not been made any significant changes except raising operating costs by increasing tax. That is why Mongolia was ranked 145th by public health protection system from 191 member countries of the World Health Organization (WHO). The health insurance system is not healthy itself. It should be in the center of the government attention because public health security is a basic part of social security.      
Public health service includes preventing people from getting sick and treating those who are already ill. Is it that hard to set who provides service, how it is financed and how it is controlled with world standards and implement them? It can be seen from experiences of countries with the best health protection that, in those countries, it is very clear who does what and the system is very transparent with faster transactions. In France, the country with the best health protection, there is a fund called “Social Security Fund”, which collects and manages the money deducted from people’s salary for social security such as health insurance and pension. This management is done by an administrative council that includes representatives from related state and local organizations, employers and employees and the fund’s operation is supervised by all of the ministries (Ministry of Finance, Ministry of Health …).

In Mongolia, General Office of Social Insurance belongs only to the government and, therefore, operation of this agency is not transparent and lacks adequate supervision. That is why the director of this organization is the only one who knows the exact estimation of this huge amount of public money and where it is located with what interests and the position of this fund’s director has become most attractive in politics. The government itself owes to the social security fund and it has started to pay it due to pressure from social society. Even though it is said that the fund’s money has been put in bank and profits been made, it is still unclear how the money was allocated to which banks. In highly-developed countries, most of the health insurance is constituted by the social security fund (78 percent in Finland) and payments from patients make up the rest (about 20 percent). However, a limit is set on every service such as medical examination and, if the limit is exceeded at the end of a year, the government pays the compensation.          
It has become so much easier to involve private hospitals in insurance because payments are made with a special card (KELA card in Finland). Therefore, costs associated with this card are shared by private hospitals as well. There is no private hospital in Finland and every hospital belongs to the locals or universities that prepare medical professionals and are financed by the state or local administration. Apart from the fund mentioned above, including other costs, Finland spends 7.5 percent of its GDP in health protection while France spends 11.2 percent. The time has come to change this government-centered health protection system into a people-centered one and think again if the money is spent wisely before raising income. Only when it is done, other goals that would increase the benefits of social insurance can be accomplished.

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