KINH NGHIEM • THI/C TIEN Mf HOAN THIEN CHINH SACH AN SINH XA HOI DOI VOl NGIJCJI CAO TUOI Nl/OiC TA HIEN NAY Phan Ihu My* Tdm tdt: An sinh xd hdi (ASXH) ludn Id mot chu trUdng chinh sdch Idn cua Ddng vd N/id nUdc ta vi sUphdt trien ngUdi vd phdt triin kinh te - xd hoi ben vQng Trong nhiiu th&p kf qua, cung vdi sUphdt triin kinh te - xd hdi, Ddng vd Nhd nUdc ta da khdng ngiing hodn thien he thdng chinh sdch, phdp ludt veASXH, nhat Id he thdng chinh sdch bdo hie'm xd hdi (BHXH), bao hie'm y te(BHYT) cho ngUdi lao dong ngUdi nghi hiiu Tti khda: an sinh xd hoi; ngUdi cao tuSi Abstract: Social security is always a major policy of the Party and State for human development and sustainable socio-economic development Over the past decades, along with the socioeconomic development, the Party and State have continuously improved the legal system on sodai security, especially the social insurance policy, health insurance (health insurance) for employees, pensioners Keywords: social security; elderly Ngdy nhdn bdi: 13/10/2018 Ngdy sda bdi: 29/10/2018 Hiln nay, hi thong ehinh sach ASXH danh eho ngfldi eao tuoi (NCT) tai Viet Nam cd bdn bao dam cho NCT it nhat cd dflpc mflc tdi thieu vl thu nhap, ed cd hdi tilp can d mflc tdi thieu ve cac dich vu xa hdi cd ban, thiet ylu thdng qua vile nang eao nang Iflc tfl an sinh eua ngfldi dan va sfl trp giup cua nha nfldc Theo bao cdo cua Tdng cue Thdng kl, den nam 2017, ea nflde cd 10.259.200 NCT, chiem khoang 10,95% dan sd Nam 2016, tai bdi nghi Bd Lao dpng Thfldng binh vd Xa hdi to chflc Ngan hang The gidi (WB) da cdng bd bao cdo ve hiln tflpng gid hda dan sd khu vUc Ddng A - Thdi Binh Dfldng Theo dfl * ThS, Bdo hem xa hoi Vtet Nam 54 I Tap chi Khoa hpc N6i vu Ngdy duyet ddng: 15/11/201S dodn cua Liln Hpp qudc, sd Ifldng ngUdi Viet Nam trIn 60 tudi se d?it mflc 18 trilu ngiftf vao nam 2040, chilm tdi hdn 18% sd dan So Iflpng NCT tang cao tao dp Ifle cho nen kinh te - xa hpi M|c du ddi tflpng NCT la nhflng ngfldi cd kinh nghiem hdn ban nhflng dp tudi khdc, nhiln, lai ed sfle khoe kem Vi vay, nhflng chinh sdch danh eho NCT eang phai hoan thien dl giai quyet, dap flng nhu eau eua NCT, ddng thdi co nhiing phfldng an tan dung nhflng tflu ve chat xam cua NCT Khai quat thflc trang chinh sach ASXH ddi vdi NCT V X KINH NGHliM-THUC TliN I Thfle te hiln nay, viee thflc hien ehinh sdch dflpc tam quan trpng eua ehinh sach nin ASXH ddi vdi NCT d nfldc ta dang ed mdt sd da tham gia BHXH vdi hinh thfle tfl nguyen ban che, vfldng mac nhfl sau: Tuy nhien, mdt sd ngfldi lao ddng vd chu sfl - Quy dinh vl doi tfldng dung lao ddng van ehfla nhan thfle dung dan Theo quy dinh eua Ludt NCT nam 2009, dfldc chinh sach, edn nhilu doanh nghilp xay nhflng edng dan Viet Nam tfl du 60 tudi trd tinh trang trdn ddng, nd ddng BHXH ddn len thi dfldc coi la NCT Tuy nhien, dilu tdi viee giai quylt ehe dp hflu tri eho ngfldi lao cung dang gay sfl mau thuan ve vile xdc ddng den tudi nghi hflu edn nhieu khd khan dinh ddi tfldng eho nhdm ehinh sdch Bin canh dd, sd Iflpng ngfldi lao dpng hfldng Theo quy dinh cua Luat BHXH (2014), ddi BHXH mpt Ian ed xu hfldng gia tang eung la tfldng duac xae dinh du dilu kiln hfldng ehe nguyen nhan dan tdi nhilu NCT tfldng dp hflu tri la doi tfldng cd thdi gian tham gia lai se khdng du dieu kiln hfldng ehl dp hflu ddng BHXH tfl du 20 nam va den tudi nghi tri hflu, ddi vdi nam Id 60 tudi, doi vdi nfl Id 55 tudi Nhfl vay, nfl ngoai dd tudi 55 da dflpc - Sfl phdi hpp thflc hiln chinh sdch cua cdc edquan tinh la ngoai dp tudi lao ddng, nhflng ddi Theo bdo cdo tong kit hit nam 2017 cua ehilu vdi Luat NCT (2009) thi van chfla du Uy ban Qudc gia vl NCT Viet Nam, tai mdt dilu kiln de dfldc tinh la NCT Vi vay, cdc nha so ndi, cap fly dang, chinh quyln dia phfldng, hoach dinh ehinh sdch ASXH danh cho NCT ed sd ehfla nhdn thfle day du trach nhiem cua d nflde ta eung can lflu y den bat cap de minh thfle hien chinh sach phap luat tranh xdy thilu sdt, bd quin ddi tfldng ddi vdi NCT, thilu quan tdm, chi dao, chfla - Thu nhap cua NCT xdy dflng dfldc k l hoach boat ddng cu the, coi Viet Nam la dat nfldc cd nhilu truyin edng tac NCT chi Id nhflng boat ddng phong thdng tdt dep ve gia dinh, dd ed r^t trao Bin canh dd, ngudn Ifle danh eho cdng nhilu NCT hien dang tfl lao dpng kilm sdng tdc NCT cdn ban chi Vi vay, viec cae dia hoac sdng dfla vdo eon ehau Tinh den thdng phfldng khdng xay dflng ke ho^ch cu the se 6/2018, ed khoang 1,7 trilu NCT, xap xi 16% rat khd de huy ddng nhflng ngudn Ifle khdc tong so NCT tai nfldc ta, nhilu ngfldi ngoai xa hdi, md sfl hd trp eua Nha nfldc lai sd dd dang dfldc hfldng che dO hflu tri - la cd han khoan tiln trd cap hdng thdng, la cho dfla eua rat nhieu ngfldi lao ddng vl gia NCT du dilu kien hfldng Ifldng hflu Cdng tae tuyen truyen, phd biln ehinh sach, luat phap ehfla dflpc thfldng xuyen, lien t u c ddc bilt ddi vdi mdt sd dia phfldng mien tham gia ddng BHXH tfl du 20 nam trd lln nui, dieu kien kinh te - xa hdi edn khd khan Vdi tudi thp ngdy eang tang eao nhfl hien nay, Mdt sd bd nganh, dia phfldng ddi vdi viee ehinh sdch BHXH Id sfl quan tdm cua Nha trien khai ehinh sdch NCT edn cb^im, ehfla nflde ddi vdi thu nhap ciia NCT Mdt sd ngfldi chu ddng long ghep eae hoat ddng eua nganh dd tudi lao ddng hien da nhan thflc vdi cdng tdc NCT, trien khai cua nhieu ddn vi 55 I Tap chi Khoa hpc Npi vu KINH NGHIEM-THUC TliN /// khdng ddng bd, kip thdi, Mpt so giai phap hoan thien chinh sach ASXH doi vdi NCT khde, trfldc hit, can ndng eao chat Iflpng hi Qua thflc t l thflc bien ehinh sach ASXH ddi vdi NCT d Viet Nam, thdi gian tdi can tap trung nghiln eflu, sfla doi, bd sung mdt sd npi dung chinh sau: tinh eho NCT Day la dieu kien tien quyet - Md rdng ddi tUdng tham gia Chinh sach ASXH da eang hodn thiln, the hien ro vai trd, mat tieh cflc cua minh vile ban ehl rui ro, dam bao an todn thu nhap va eupe sdng cho cdc vien xa hdi, dae biet doi vdi NCT thdng y te, chdm sdc sfle khde, phdng benh, kham, chfla benh va quan ly cac benh man anh hfldng tdi chat Iflpng eham sdc sfle khoe eho NCT Tang cfldng eae boat dpng tfl van ve nguyen nhdn, phfldng phap phdng benh, ehfla benh va hfldng dan vl cham sdc nhflng binh thfldng mae phai d ngfldi eao tuoi tuoi nhfl: huyet dp, dai thdo dfldng, tim mach Phdt trien cdc dich vu cham sdc sfle khoe, phuc hdi ehfle nang va khuyin khich hoat ddng kham, chfla benh mien phi cho NCT Ddi vdi vile ddm bao thu nhdp va cudc sdng cho cae viln xa hdi, chinh sach BHXH ngdy cang mang lai nhilu quyln Ipi tham gia, md rdng tdi nhieu ddi tfldng Cd thi ndi chinh sach ASXH la chinh sach nhdn van, mang lai Idi ich cho ngfldi lao ddng ndi ehung va NCT ndi rieng Xay dflng va phat trien hinh thflc cham soc Chinh sdch ddng BHXH khdng chi de NCT dfldc hfldng che dp hflu tri, chinh sach y tl , de moi ca nhan cd thi chu dpng ddi phd thu nhap bi suy giam hoac bi mat cae rui ro, dm dau, tai nan lao dpng, tudi gia, ma cdn tao nguon thu de dam bdo can bang quy benh eho ngfldi dan ndi ehung cung nhU sfle khoe, phuc hdi chflc nang eho ngfldi cao NCT dfla vao cdng ddng To ehfle kham silc khoe dinh ky, lap sd theo ddi, tfl van dieu tri benh thdng thfldng eho ngfldi cao tai dja phfldng, ndi cfl tru, D l dam bao quyln Idi dflde kham, ehfla NCT ndi rieng, Chinh phu da quan tam tdi vile day manh thiic hien BHYT todn dan Day Id chinh sdch cd the giup nhflng NCT eo hodn canh khd khan van dfldc dam bao dflpc vile cham sdc sfle khde va kham benh, chfla - Tdng cUdng dau tU ve linh vUc y te, cham binh dm dau Nhflng ddi tfldng NCT sdc site khde dflde hfldng trp cap hflu tri ddng thdi se dflpc Hiln nay, ddi song vat chat va tinh thdn cap the BHYT Tuy nhien, van cdn mdt bo eua NCT d nhieu ndi van nhilu khd phan khdng nhd nhflng NCT cd hoan canh khan, thilu thdn, nhat Id d ndng thdn, vflng khd khdn, khdng ndi nfldng tfla, thudc dien sau, vflng xa Vi vdy, can thilt phai cd nhieu ngheo, khdng ed Ifldng hflu, khdng ed trp cap giai phap nhdm nang eao sflc khde ca vl the va cung khong cd BHYT chat va tinh than eua NCT, de hp sdng vui, Gid hda dan sd tao thdeh thfle Idn, doi sdng khde, phat huy dflpc vai trd cua minh hdi phai xay dflng ehinh sach cham sdc sflc gia dinh va xa hdi khde NCT dfla tren edng ddng, thay the d£n De NCT dat dflpc mue tieu sdng lau, sdng yeu td gia dinh Hien nay, nflde ta cung da 56 I Tap chi Khoa hpc Npi vu VCfc KINH NGHliM-THUC TliN ( bat dau xay dflng h i thdng cham sdc NCT II NCT cd hpc van vd ehuyen mdn ngdy cdng vdi mdt so nha dfldng lao cua nhd nfldc, tang la cd hdi de khuyen khich nhflng ngfldi nhien theo bao cdo gan day cua Uy ban Qudc eao tuoi ed ki nang, kinh nghiem nghe nghilp gia NCT, cac nha dfldng lao phu thudc cung tham gia lao ddng, dao tao the he tre se vdo kinh phi ciia nha nflde eho nen ed sd vat tao dfldc hilu flng tich cflc ea va mat kinh te, chat edn thieu thdn, trinh dd chuyen mdn, xa hdi, dac biet eae nganh ma hpc qua nghilp vu, ky nang eham sdc NCT eiia can thflc hanh la ehu ylu thi vile vfla tao dilu bp cdn thieu va yeu Do vay, de giai quylt khd kien eho NCT tham gia lao dpng, vfla la hinh khan nay, can td chflc \%i mang Ifldi eung cap thfle dao tao tiet kiem cd hieu qua Ngoai ddi dich vu y te cung nhfl ed chi tdi chinh y te, tfldng NCT cd hpc van, doi vdi ngfldi gia cd dae bilt la BHYT, nang cao khd nang tiep can khd nang vd ed mong muon lao ddng, can co cua toan dan, ddng thdi cd phflpng an dilu chinh sach tao dilu kiln va giai quyet viee chinh tudi hflu lam - Thuc day chinh sdch viec 1dm Cac chinh sdch ve vile lam can linh boat, Mue tieu dau tien cua chinh sdch viec lam phu hpp, thuc day NCT vfla tri dflde sfle danh eho ddi tflpng NCT Id bdo ddm thu nhap khde, vfla ed thu nhap, thay ddi quan niem va tdi thilu va giam ngheo bin vflng cho nhdm thai dp xa hdi vl gia hda, nhin nhan NCT la ngfldi NCT khong ed Ifldng hflu hay nhflng nhflng viln ed ddng gdp tieh eflc eho trp cap xa hdi khae xa hdi Khi dan sd gia di nghia la sd Ifldng ngfldi - Xdy dUng he thong cd sd dU lieu ve NCT tham gia vao Iflc Ifldng lao ddng eung ed xu Hiln nay, Nha nflde ta dang ehu trpng din hfldng giam theo vd cd tdc ddng khdng tdt tdi vile day manh phdt triln he thdng thdng tin, nin kinh tl Vdi tdc dp gid hda ddn sd d nflde dfl lieu chung cua ea nfldc Vi vay vile lflu trfl ta top nhanh nhat the gidi, thi tdc ddng Cd sd dfl lieu vl NCT la biln phdp bat kip vdi cfla nd tdi nin kinh t l edn manh me hdn Tuy xu tbI, dam bao dflpc vile lflu trfl, khai thac nhien, dieu eung khdng ban ehi mang lai vd sfl dung thdng tin quan ly NCT Vile hoan nhflng tac ddng tieu eflc Ban chat eua sfl gid thiln he thdng cd sd dfl lieu cua NCT mang hda dan sd la ty sudt ngfldi trIn dd tudi lao lai nhflng Idi ich vd cflng thilt thflc nhfl: quan dpng Idn hdn ngfldi dfldi dp tudi 15, dilu dd ly thdng tin cd bdn, cdc ngudn trp cap, tinh ddng nghia vdi Iflpng dan sd cd kinh nghilm, trang sfle khde, Khdng cd nhflng thong tin kien thfle Idn Trong dieu kiln hiln nay, tuoi chinh xae, cap nh4t ve NCT thi khdng the cd thp trung binh cua ngfldi tang cao ddng nhflng danh gia xae dang vl cac van dl kinh nghia vdi chat Ifldng sfle khde NCT cung te, xa hpi va sflc khde cua ngfldi eao tudi Day dflpc cai thien ro ret De sfl dung tdi da ngudn se la dau vdo quan trpng eho vile dl xuat eae nhan Ifle dilu kiln ty II tham gia lao ehinh sach, ehflpng trinh thilt thfle, ed trpng ddng giam dan, can phai ed nhflng chinh sach tdm va hilu qud cho viec khai thdc, nghiln hd trd viec 1dm ddi vdi NCT hieu qua Viee ty eflu chuyin sau vl NCT, ylu cau dat 57 I Tap chi Khoa hpc Npi vu KINH NGHIEM-THUC TliN /// hiln Id can nhflng nghiln cflu chuyen sau cd chat Ifldng de ed ed sd xay dflng nhflng chinh sach can thiep tdt nham dap flng nhu cau eua NCT va xu hfldng dang gia hda dan sd cdng nhanh Do vay, can thiet lap he thong ed sd dfl lieu dd cd eae dilu tra, nghien cflu thfle t l va sd lieu thdng kl tfl nhieu ngudn khac vl NCT d nhieu cap khdc nhfl cap qudc gia, cap vflng, dia phflpng va cap cd sd Nhflng cd sd dfl lieu khdng chi tao dieu kien cho vile xay dflng vd hoaeh dinh cac chinh sdch va chfldng trinh qudc gia ddnh cho NCT ma edn tao dieu kien giam sat viee thflc hien Ke hoaeh hanh ddng ve NCT - Cd phfldng dn hpp ly dilu chinh tudi nghi hflu Tai Vilt Nam hien nay, tudi nghi hflu dang Id 55 ddi vdi nfl vd la 60 doi vdi nam Binh quan tudi nghi hflu thap hdn rat nhieu nfldc khdc tren thi gidi (d Phdp la 62, tai Ha Lan la 67, Dflc la 67, ) Qudc hdi da tam thdi khdng xem xet phUOng an tang tudi nghi hflu nam 2017, nhiln, Uy ban Thfldng vu Qudc hdi dl nghi Chinh phu can khan trfldng xay dflng Id trinh nang tuoi nghi hflu eho cac nhdm ddi tflpng theo quy dinh tai Bp luat Lao ddng, dl dam bao eho vile dieu chinh chinh sdch Luat BHXH dfldc ddng bp, thdng nhat Tren thfle te hien ed rat nhilu nguyen cham sde sfle khde eua NCT Viet Nam dang mdt tdt hdn Vile tang tudi nghi hflu khdng chi la si( niu keo giai doan dan sd vdng Khi tinh hinh sfle khde vd tudi thp eiia ngfldi ddn cdng dflde cai thien thi NCT se ddng vai tro cfia ngudn nhan Ifle doi dao, chat Ifldng cao, co nang Iflc, kinh nghilm, trinh dp la Ipi the 16n de khai thac tfldng lai Hdn nfla, k^o ddi thdi gian lao ddng cung ddng nghia vdi vile ed ed hdi keo dai thdi gian tham gia dong BHXH Dilu cd Idi NCT lue nghi hflu se dfldc hfldng mflc trd cap cao hpn Dong thdi cung tao dieu kiln eho vile can doi thu, chi quy BHXH Phfldng dn tdng tuoi nghi hflu la dieu tat yeu, nhien can kiln nghi deco Id trinh dilu chinh tudi nghi hflu phii hop tren cd sd nghiln cflu dilu kiln xa hpi, viec lam de dfla Id trinh thflc hiln ddi vdi tflng ddi tfldng TAI LIEU THAM K H A O Ban Tuyen giao Trung lidng, Yu Cdc van de xd hdi (2015), De an An sinh xa hoi cho NCT Bp Y te (2002), Bdo cdo ket qud dieu trayle Qudcgia 2001-2002, Nxb Y hpc Ha Npi, tr.33-38, 343-363 Vien Lao khoa (2001), Nghiin cdu tinh hinh sde khde binh tdt cua ngUdi eao tuoi tai cong dong nhdn d^n din vile can dilu ehinh tudi nghi - Nguyen Van Tap, Trfldng Viet Dung, Dio hflu Dau tien ed the ke tdi tuoi thp binh Van Dung, "Nhu cdu, khd ndngtiep edn vdsiidiini qudn cua ngfldi dan dang tang Theo sd lieu dich vu y tecua NCT tai 28 xd ndng thdn 02 cua Diln dan Kinh t l the gidi thi vao nam ndm 2000-2001", Tap chi Y hpc thflc hdnh, BQ V 2016, tuoi thp binh quan cua ngfldi Viet Nam te So 09 (487), 2004, Tr.15-47 la 75,6 tuoi Dilu cho thay thdnh qud eua 58 I Tap chi Khoa hpc Npi vu - Quoe hdi, Luat Ngitdi cao tuoi (2010), Ha Ngi ... nang eham sdc NCT eiia can thflc hanh la ehu ylu thi vile vfla tao dilu bp cdn thieu va yeu Do vay, de giai quylt khd kien eho NCT tham gia lao dpng, vfla la hinh khan nay, can td chflc \%i mang... la 67, ) Qudc hdi da tam thdi khdng xem xet phUOng an tang tudi nghi hflu nam 2017, nhiln, Uy ban Thfldng vu Qudc hdi dl nghi Chinh phu can khan trfldng xay dflng Id trinh nang tuoi nghi hflu eho... ngfldi dan dang tang Theo sd lieu dich vu y tecua NCT tai 28 xd ndng thdn 02 cua Diln dan Kinh t l the gidi thi vao nam ndm 2000-2001", Tap chi Y hpc thflc hdnh, BQ V 2016, tuoi thp binh quan cua