SAĞLIK SİGORTASI SİSTEMİNE DEVLET MÜDAHALESİNİN SEVİYESİNİN ÖLÇÜMÜ: ÜLKELER ARASI KARŞILAŞTIRMALI ANALİZ

Ekonomik kalkınmanın önemli amacı, günümüzde sosyal güvenceyi sağlamaktır. Sosyal güvencenin ana bileşenlerinden biri, nüfusun sağlık durumunun iyileştirilmesidir. Dünya deneyimi, sağlık sigortasının (özellikle zorunlu) nüfusun sağlık durumunun iyileştirilmesinde önemli bir rolünün olduğunu göstermektedir. Böylece, yüksek oranda sağlık sigortasına sahip ülkelerde, nüfusun sağlığı daha güvenilir bir şekilde korunur, tedavi ve önleme kapsamını genişletme fırsatı oluşur. Sağlık sigortası da dahil olmak üzere sağlık sisteminin gelişimi, devletin bu alana müdahale oranına bağlıdır. Araştırmalar, hükümetin sağlık sistemine ne kadar çok müdahale ederse, nüfusun sağlık durumunun o kadar iyi olduğunu gösteriyor. Ekonomik kalkınmanın önemli hedefi, modern zamanlarda sosyal korumayı güçlendirmektir. Sosyal korumanın ana bileşenlerinden biri, nüfusun sağlık hizmetlerinin sağlanmasıdır. Dünya deneyimi, sağlık sigortasının (özellikle zorunlu) nüfusun sağlık hizmetlerinin korunmasında önemli bir rol oynadığını göstermektedir. Böylece, yüksek düzeyde sağlık sigortasına sahip ülkelerde, nüfusun sağlığı daha güvenilir bir şekilde korunur ve tedavi ve önleme kapsamını genişletme fırsatı doğar. Sağlık sigortası da dahil olmak üzere sağlık sisteminin gelişimi, bu alandaki devlet müdahalesinin düzeyine bağlıdır. Araştırmalar gösteriyor ki, hükümet sağlık sistemine ne kadar çok müdahale ederse, halk için o kadar iyi sağlık hizmeti veriliyor. Şimdiye kadar sağlık sigortası sistemine devlet müdahalesinin gerekliliği çeşitli bilim adamlarının araştırma konusu olmuş ancak müdahalenin düzeyini ölçmek için herhangi bir araştırma yapılmamıştır. Sağlık sigortası sistemine devlet müdahalesinin düzeyini ölçmek mümkün müdür? Yazarlar, sağlık sigortası sistemindeki devlet müdahalesinin düzeyini ölçmeye izin veren bir metodoloji oluşturmaya çalıştılar. Bu metodolojiye Sağlık Sigortası Sistemine Müdahale Endeksi (IIHIS) denir. Yazarlar, IIHIS'i hesaplayarak, Sağlık Sigortası Sistemindeki devlet müdahale düzeyini belirlemektedir. Sağlık Sigortası Sistemine devlet müdahalesinin seviyesinin ölçülmesi, uygulanan reformların sosyal sonuçlarının değerlendirilmesine olanak tanır. İİHİS, zorunlu sağlık sigortası kapsamı, özel sağlık sigortası kapsamı, sağlık sigortası tarifeleri ve ilaçlarda Katma Değer Vergisi (KDV) olmak üzere 4 gösterge üzerinden hesaplanmıştır. İlk aşamada 31 ülke için IIHIS hesaplanmıştır. 31 ülke arasında gelişmiş, gelişmekte olan ve sosyalizm sonrası ülkeler var. IIHIS'e göre en dirigist (solcu) ülkeler Slovenya ve İsrail. İHİS'e göre en liberal (haklı) ülkeler Azerbaycan, ABD. Yazarlar, sağlık sigortası sistemine devlet müdahalesinin seviyesini ölçmek ve Azerbaycan'ın sağlık sigortası sisteminin konumunu belirlemek istiyor. Yazarlar korelasyon, analitik-istatistiksel ve ülkeler arası analizler gerçekleştirdiler. Sağlık sigortası sistemine devlet müdahalesinin düzeyi 31 ülkede ölçülmüştür.

MEASUREMENT OF THE LEVEL OF GOVERNMENT INTERVENTION IN THE HEALTH INSURANCE SYSTEM: CROSS-COUNTRY COMPARATIVE ANALYSIS

The important goal of economic development is to strengthen social protection in modern times. One of the main components of social protection is the provision of health care of the population. World experience shows that health insurance (especially compulsory) plays an important role in the protection of the health care of the population. Thus, in countries with a high level of health insurance, the health of the population is more reliably protected, and there is an opportunity to expand the scope of treatment and prevention. The development of the health system, including health insurance, depends on the level of government intervention in this field. The research shows that the more government interferes in the health system, the better health care for the population. So far, the need for government intervention in the health insurance system has been the subject of research by various scientists, but no research has been conducted to measure the level of intervention. Is it possible to measure the level of government intervention in the health insurance system? The authors have tried to create a methodology that allows for measuring the level of government intervention in the health insurance system. This methodology is called the Index of Intervention of Health Insurance System (IIHIS). By calculating IIHIS, the authors determine the government intervention level in Health Insurance System. Measurement of the level of government intervention in the Health Insurance System allows for evaluating the social consequences of the implemented reforms. IIHIS has been calculated on the basis of 4 indicators – Coverage of compulsory health insurance, Coverage of private health insurance, Health insurance tariffs, and Value-Added Tax (VAT) on medications. At the initial stage, IIHIS has been calculated for 31 countries. Among 31 countries, there are developed, emerging, and post-socialist countries. According to IIHIS, the most dirigist (leftness) countries are Slovenia, and Israel. According to the IIHIS, the most liberal (rightness) countries are Azerbaijan, USA. The authors want to measure the level of government intervention in the health insurance system and to determine the position of Azerbaijan health insurance system. The authors have performed correlation, analytical-statistical, and cross-country analyses. The level of government intervention in the health insurance system has been measured in 31 countries.

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