Criticism of Kazakhstan’s Health Insurance System Reaches Parliament

Members of Kazakhstan's Mazhilis (lower house of parliament) have voiced strong criticism of the country’s healthcare system, particularly the Social Health Insurance Fund, which they argue has lost public trust. Many citizens reportedly view the quality of medical services as unsatisfactory. Kazakhstan operates a system of compulsory social medical insurance, wherein doctors' services are funded through a combination of contributions from working citizens, their employers, and the state budget. These financial contributions are collected by the Social Health Insurance Fund, which then allocates the funds to medical institutions based on the volume of services provided to the population. Speaking in Parliament, Health Minister Akmaral Alnazarova defended the system, claiming that it has led to improvements in key health and demographic indicators since its introduction. “Today, 83% of Kazakhstanis are connected to the compulsory social health insurance system, 72% of whom are from vulnerable segments of the population. This demonstrates the availability of medical care in the country,” Alnazarova stated. However, Mazhilis Deputy Chairman Dania Yespayeva pointed out that despite increasing healthcare budgets, public satisfaction with medical services continues to decline. According to surveys, up to 47% of Kazakhstanis consider the quality of domestic healthcare to be poor. Deputy Askhat Aimagambetov echoed these concerns, accusing medical institutions of manipulating service statistics to secure additional funding from the Social Health Insurance Fund. He cited a case where a five-month-old child, who had not yet developed teeth, was recorded as having received dental services. Aimagambetov also claimed that hospitals sometimes charge the insurance fund for dozens of services provided to the same patient in a single day - an impossibility. “The financing system encourages such behavior because payments are based on the quantity of services rendered, not on the effectiveness of treatment. As a result, the [Social Health Insurance Fund] has become a de facto bank for the Ministry of Health. Citizens and doctors alike have become hostages of inconsistent and poorly planned reforms, while the availability and quality of care have deteriorated. The system remains underfunded, and the resources it does have are spent inefficiently,” Aimagambetov stated. He emphasized the need for stricter oversight of the reports submitted by medical institutions to the insurance fund for reimbursement. Currently, inspections cover only about 1% of these reports, a figure Aimagambetov described as insufficient. Public dissatisfaction with health care is also reflected in broader trends. As previously reported by The Times of Central Asia, approximately 5% of Kazakhstanis considering emigration cite access to better medical services abroad as a primary reason.

New Labor Code Comes Into Force in Kyrgyzstan

A new Labor Code has been implemented in Kyrgyzstan, introducing significant changes to labor relations in the country. The updated code includes provisions for remote work, digital labor records, and streamlined labor contracts. Additionally, relations between employees and employers will now be regulated by a separate law, “On Social Partnership.” President Sadyr Japarov signed the new Labor Code into law following its approval by Kyrgyzstan’s parliament. The reforms aim to modernize the nation’s labor practices by accelerating the digitalization of processes. Under the new code, paper labor contracts are no longer mandatory. Instead, electronic contracts will suffice for official use and inspection purposes. One of the notable provisions in the code allows for remote and hybrid work arrangements. “The labor contract, by agreement of the parties, may establish both remote work and combined remote work,” states the law, marking a shift toward more flexible employment practices. The reforms also address labor books, which traditionally served as a lifelong record of an individual’s work history. Citizens now have the option to use digital labor books, though paper versions remain valid. However, the exact platform or system for storing the digital data has yet to be determined. Another change eliminates the longstanding practice of shifting days off to accommodate public holidays. Previously, the Ministry of Labor, Social Security, and Migration could declare surrounding weekdays as non-working days. Under the new code, this practice has been discontinued, reducing the total number of non-working holidays. The Labor Code introduces several worker protections. Employers are now required to provide lump-sum benefits in the event of labor-related injuries or the death of an employee. A single penalty rate of 0.25% has been established for late payments of wages, vacation pay, severance pay, and other compensation. Employees will also have a three-year limitation period to file wage-related disputes. Additionally, the code prohibits the employment of pregnant women and nursing mothers in hazardous or physically demanding jobs, further strengthening workplace protections for vulnerable groups. These reforms are expected to streamline labor relations, improve worker protections, and align Kyrgyzstan’s labor policies with modern international standards.