The financial mechanism in the healthcare system of the republic of Kazakhstan

Abstract

The article examines the current financial mechanism of the healthcare system of the Republic of Kazakhstan, focusing on its structure, sources of revenue, and schemes for the redistribution of financial flows. International experience emphasizes the need for a balanced approach to the formation of a financial mechanism for healthcare, which involves a combination of state, insurance and private sources with a priority on protecting households from excessive financial costs. Key financing actors have been identified: government bodies, the Social Health Insurance Fund, the population, and the private sector. Special attention is given to the role of the state as a coordinator and regulator of the system, as well as to the SHIF as the operator of public procurement within the framework of the Mandatory Social Health Insurance (MSHI) and the Guaranteed Volume of Free Medical Care (GVFMC).
A comparative analysis with international practices (OECD countries) is conducted, and the efficiency of the current financing model is assessed. The analysis proposes an original scheme of interactions between the financial mechanism's stakeholders and a classification of expenditure categories based on funding sources. It is established that the persistently high share of out-of-pocket expenditures by the population exceeds the WHO’s recommended thresholds, indicating the need for systemic changes. Reform directions are substantiated: diversification of funding sources, strengthening the role of MSHI, and enhancing transparency in the use of funds.