Thực hiện an sinh xã hội ở việt nam vì mục tiêu công bằng

Thyc hien an sinh xa hoi is Viet Nam vi muc tieu cong bSng Nguyen Tfaanfa Ogt' ' Tnrtmg Dai hgc San khiu - Difn inh Tp Hfi Chf Minh Email: dattriethoc@gmail.com Nhin ngiy 26 thing nim 2016 Chdp nhgn dang ngiy thing 10 nim 2016 T6ra tat: An sinh xa hfi (ASXH) la mft nhihig hinh thdc phan phoi co bdn Trong nhiing ndm qua, vifc thuc hifn ASXH da d?it dugc nhihig tuu nhit djnh, vi da gop phin cai thifn ddi sfing ngudi ngheo, gidm bit binh ding vd bat cong, gop phan thuc day sir phat trien xa hgi Song vifc thirc hien ASXH bgc lp nhifiu hgn che nhu: mfic df bao phCi cua hf thing bao hiem xa hgi (BHXH), bao hifim y tl (BHYT) thap, chinh sdch BHYT nhieu bat cgp, quy BHXH chua quan ly hifu qua, chua can doi ttong phdn bo tai chinh thyc hifn ASXH NhSm thyc hifn tot hon ASXH va qua thyc hifn cong bang xa hgi tot hon, cin phai: ndng cao muc df bao phu cda hf thing ASXH; nang cao nang lire quan ly nha nude, hoan thifn hf thong phdp ludt doi v6i h? thong ASXH; can bdng ttong phan bo ngufin I\rc tai chinh; co chinh sach c\i thfi doi vdi nhom phi chinh thirc; tdng cudng tuyfin truyin, ndng cao nhgn thi;c cua ngudi dan ve cdc chinh sach ASXH Tfi khod: Cfing bdng xa hfi, an sinh xd hfi, Viet Nam Abstract: Social security is one of the basic forms of disttibution In recent years, the implementation of social security has received certain achievements, for its conttibutions to improving the lives of the poor, reducing inequality and injustice, and to the social development Yet, the implementation also revealed many things to be improved such as the low coverage of the social and health insurance systems, inadequate heahh insurance policies, ineffective management of the social insurance iiind, and the imbalanced financial allocation In order to better implement social security to better perform social equity, we need to improve the coverage of the social security system, the capacity of state management, and the legal homework on the social security system It is necessary to balance the allocation of financial resources, promulgate specific policies for the informal sector and sttengthen the sensitisation to and raising the awareness by the people of social security policies Keywords: Social equality, social security, Vietnam Nguyfin Thanh D?it Mddau ddng Tfauong binfa va xa fadi, Kho bgc Nhd nude Vifc phdi hgp gifia ngdnh Lao dgng Hf thdng ASXH la mft ttong cdc phuemg Thuong binh vd xa fadi va ca quan BHXH thfic phan phdi cua cai eua xa hfii cho cdc ngdy cdng cfadt cfafi Difiu gifip tdng ca nhdn Mgt ttong nhung ngudn thu nhdp cudng han cdng tdc kilm tta, giam sdt vifc ma moi ngudi nfadn dugc tfi xd hfi Id thu thi hanh Bg ludt Lao dgng vd thuc hifn cdc nhdp qua hf thdng ASXH Vi vdy, xem chfi df BHXH cho ngudi lao dgng d khu xet su pfadn phdi cd cdng bdng hay khfing, vyc kinh te ngodi qudc doanh; tang eudng chfing ta can phdi xem xfit sy hudng thy cfia qudn ly nha nude vfi vifc ky kit hgp ddng mdi ngudi khfing ehi qua sy phdn phdi trye lao ddng, dang ky thang luong, bdng luang, tilp tfi qud trinh sdn xuit (ehdng hgn tu thda udc lao ddng tdp thfi; xfi ly vd ngan luong md ngudi lao dfng dugc hudng), ma chgn nhifiu doanh ngfaifp kfau vye ngodi cdn qua su pfaan phfii d hf tfafing phfic Igi qudc doanh cd hanfa vi vi pfaam vl pfadp lu|it xa hpi vd ASXH Vdy d Viet Nam hifin nay, BHXH ddm bao cdng bdng xd hgi (CBXH) Vfi BHYT: "Dfin cudi 2015, cd 64,6 fafi thfing ASXH cd tfadnfa tuu va hgn chfi gj, lara the ndo de thye hifin tdtfacmASXH, qua trifu ngudi tham gia BHYT, dgt ty le bao pfafi 71,4% ddn sfi Trong thang diu ndm dd bao dam tdt hom cfing bdng? Dd la vdn dfi 2016, dd ed ttfin 70,8 trifiu ddi tugng tham md bdi vifit dfi c ^ tdi gia, tang khodng 0,83% vd vdn dang tieh cyc trien khai cdc gidi phdp de dat mue tifiu 78% dan sfi cd BHYT cufii nam nay" Ty lfi Thanh tuu thijTc hifn ASXH cho thdy vific trien khai cdc ehinh sdch He thdng ASXH d nude ta ttong nhiing BHYT dd dgt nhifiu kfit qua thugn lgi, ndng nam qua da dgt duge tfadnh tyu ttfin tdt ed dan bao phfi toan dan Dgi hgi Dang XII nhdn dinh: "Chdt lugng khdm, chiia bfinh cac try cdt eua hf thdng ASXH Vfi BHXH: theo thfing kfi cfia Bg Lao dugc nang len, iing dyng nhifiu tfaanfa tyu ddng Thuang binh va Xa hdi, dfii tugng kfaoa hpe ky tfauat cao Dd tich eye trien tham gia BHXH tinh dfin thdng 10 nam khai nhieu gidi phap giam qud tdi bfnh vien 2015 dgt ttfin 12,07 trifu ngudi, chilm tten vd dgt kfit qud budc ddu Tap tnmg xay 23% lyc lugng lao dgng (trong dd, tham gia dyng hf thong cdc bfnh vifin tuyfin huyfin, BHXH bit bude tren 11,85 trieu ngudi, tuyfin tinh vd tuyen cudi Dpi ngu can bf y tdng ttfin 2,25 trifiu nguoi so vdi cudi nam tfi phat trifin ca vl sfi lugi^ vd chdt lugng 2010; tham gia BHXH ty nguyfin ttfin 223 Ddy mgnh cai each hanfa cfainh, nang cao y nghin ngudi, tdng ttfin 148 nghin nguoi so dfic va dfii mdi ca cfafi tdi chinfa dfii vdi ede vdi cuoi nam 2010) [9] Sd lifu thdng kfi dan vi sy nghifp y te cfing lap, budc dau cfao thiy ty If ngudi dan tham gia BHXH thyc hifn 16 trinh tinh dfing, tinh du gia tri ngdy cang tdng; quyen lgi ngudi lao ddng dicfa vu y tfi cung vdi hd ttg cho ddi tugng cang dugc ddm bdo; edng tdc chi ttd chinh sdch, ngudi ngheo Cac co sd y tfi tu da CO sy phdi hgp ttdeh nhifm nfaip nhdng nhan, y hpc cfi truyfin va cdng nghifp dugc giiia CO quan BHXH vd edc nganh Lao dugc kfauyfin khich phat trien Tdng cudng 37 Khoa hgc xd hfi Viet Nam, s6 (110) - 2017 qudn ly chat lugng va gid thudc chfia bfinfa" [3, tt.239-240] Vfi fafi thdng bao hilm thdt nghifp (BHTN): dfin nam 2015 ed tten 9,9 ttifu ngudi tfaam gia BHTN, tang 3,6 trifu ngudi so vdi cuoi ndm 2010 Tinfa tfi tfadng 01/2011 dfin cufii nam 2015 cd trfin 2,07 trifiu lugt ngudi dugc hudng trg cap tfadt nghifip Tfing ndm 2011-2015 ca nude dd tao vifc ldm cho khodng 7.827 nghin ngudi; tuyfin mdi dgy nghe gdn 9.171 ngfain ngudi, tdng trfin 20% so vdi giai doan 2006-2010; ty lfi fagc cd vifc ldm sau tfit nghifip dgt khoang 70% [9] Sfi lugng ngudi tham gia BHTN nhu ttfin cho thiy tinh uu vifit cfia tru cpt ndy ttong hf thfing ASXH, gdp phdn ddm bao CBXH Thuc hifn edc quy dinh vfi BHTN cho ngudi lao ddng nhdm giai quyfit kip thdi nhfing khd khan eho ngudi lao dfng bi mdt vific lam, i ^ i vifc Id ca sd quan ttgng dfi ngudi lao dgng hod nhap vdo tfai trudng lao ddng va cd sinfa kl Ngodi vific trifin kfaai pfaoi fagp vdi edc trung t§m va trudng day ngfafi tu vin vific lam, gidi tfaieu vific lam, ho ttg fagc ngfal cfao ngudi tfait ngfaifp cQng tgo sy cdng bdng dfii vdi nhom can ttg gifip ndy Ve trg giiip xd fafi, uu ddi ngudi cd cdng: tinh dfin ndm 2015, ca quan BHXH dd ttg cip thudng xuyen eho khoang 2,643 trifiu dfii tugng, tdng gin 1,8 lin so vdi cufii ndm 2010 Ngdn sacfa trung uong chi ttg cdp xd hfii hang thdng cho dfii tugng bao trg xd hfi tgi cgng ddng tdng nhanh, ndm 2015 khodng tren 11,6 nghin ty ddng, tdng gin gap Ian so vdi ndm 2010 Tinh dfin cd nude ed 408 co sd ttg gifip xd hdi, nudi dudng, chdm sdc trfin 41,4 nghin dfii tugng bdo trg xd hdi (trong do, sd dfii tugng ngudi ldn, tte em bj khuyfit tat, tdm thin ehilm tdi 56,5%) [9] Co quan BHXH chi tta diy dii, kip thdi ttg cip uu ddi thudng xuyen eho tren 1,4 trifiu ngudi cd cfing; thyc hifn day dfi cdc chinh sach vfi cfadm soc sfic kfade, im ddi gido dye vd cde chinh sdch uu ddi khdc ddi vdi nguoi cd cdng Cdc phong ttdo "dfin on ddp nghia", "uong nude nfad ngudn", "xa, pfauong ldm tdt cdng tdc tfauong binh, lift sy, ngudi cd cdng" dugc phdt trifin sdu rfng d tat ca cdc dia phuomg; huy dfng nhifiu ngufin lue ttong xd hgi, cfng dfing de ehdm sdc ddi sfing vgt chat, tinh thdn cho nguoi cd edng vdi cdch mgng Giai doan 2011-2015, ca nude dd huy ddng tten 1.250 ty dfing xdy dyng Quy den om dap nghTa; xdy mdi khodng 46 ngfain nfad tinfa ngfaTa; sfia chiia ttfin 43 nghin nhd vdi tten 10,6 nghin ty dong; cd gan 11 nghin ba me Vifit Nam anh cdn sdng dugc edc co quan, dan vj nhgn cham sde, phung dudng Den cufii nam 2015 cd 98,5% hf gia dinh ehinh sach ed mfic s6ng bdng ho^e cao han mfic sfing trung binh hd dan nai eu tni, tdng thfim 8,5% sd hg so vdi nam 2010; 98% xd, phudng lam t i t cfing tde thuang bmh, lift sT vd ngudi cd cdng, tang them 6% sfi xa/phudng so vdi nam 2010 [9] Cdc kfit qua tfayc hifn chinh sdcfa ttg giiip xa hfi, uu ddi ngudi ed edng thfi hifn tinh nhan vdn sau sde sy trg gifip eua xa hfi Ddy dugc xem la nhdm yfiu the, de bj tfin tfauong vd tfaifit tfadi can sy bdo ttg va cfaia sfi nfait Ve gidm ngheo: vdi hifu qud tfi ngufin lyc ddu tu cua cdc chinh sdch, chucmg trinfa, dy an ve gidm ngfaeo, ty If hfi ngfafio ea nude dd gidm tfi 14,2% cu6i ndm 2010 xufing cdn 5,97% cudi ndm 2014 (ttong edc huyfn ngheo giam cdn 32,59%); cufii nam 2015 ty If fafi ngfaeo gidm cdn dudi Nguyen Thanh Bjtt 4,5%, gidm binh quan 2%/iidm (cdc huyfn ngfaeo gidm binh qudn 5%/nam, khodng 28%) [9] Kfai ty lfi faf ngheo giam thi su gidn each vfi thu nhdp gifia cdc ting ldp ddn eu dugc tfau hep CJ ndng thfin cdc xa ngfaeo duge edi thifn ro rft Ngudi ngheo dugc ho trg cdi thifin mfit bude vfi difiu kifin sdng; dugc tifip can tdt horn cdc chinh sdch vd ngudn luc ve vdn fafi trg cfia Nfad nude va cfng dfing; nfad dd ddi sdng cfia hg dugc ndng lfin Nhin ehung, ede chinh sdch ASXH dd hudng dfin nhifiu dfii tugng hom Dfii vdi ehinh sdch BHXH, ddi tugng tham gia ngdy cdng duge md rfing dfin cdc thanfa pfain kinfa tfi faudng den bao pfafi toan dan Cdc cfafi huu tri^ thai sdn, dm dau, tfi tuit dugc quy dinh cu thl Tdi cfainh cfia quy BHXH vfi thu, ciii va ddu tu dugc quan ly tap trung, chat che, cfing khai, minfa hgcfa, hgcfa todn dfic i^ vdi ngdn sdcfa nfad nude Cdc quy dinfa cua Lugt BHXH da dugc sfia ddi cang pfafi hgp vdi Bg ludt Lao ddng vd nguyfin vgng cfia nguoi lao dgng Chinh sach BHYT dd timg budc md rgng cac ddi tugng va ddm bdo quyfin lgi cfia ngudi tham gia BHYT, thl faifn tinfa cdng bdng hem Vific td chue khdm chfia bfinh eho ngudi ed the BHYT duge quy dinh cy thl vdi chit lugng djch vu tot horn BHYT dd that sy ttd try cdt quan ttgng faf thdng ASXH, tgo thudn lgi cho ngudi ngheo va ngudi tfau nh|ip thdp ttong vifc tifip can cae dicfa vu y tfi Cac cfainh sach BHTN dugc trifin kfaai cd faifu qua tren todn qudc Ca quan BHTN cd sy phfii hgp ch^t chfi vdi cdc trung tdm va trudng dgy nghe de trifin khai cdng tdc tu van vifc ldm, gidi thifu vifc lam, fao ttg fagc ngfae cho ngudi thit ngfaiep Cfal dQ cfao ngudi lao dgng tfaat ngfaifp dugc gidi quyet ddy dfi, dfing tfadi gian Cac cfainfa sdcfa bao ttg thudng xuyfin va dot xudt dd cd nhung tdc dgng hfit sfic to ldn dfin nhdm ngudi ylu thl Cac cfainfa sdcfa tfai faifn qua cdc ehl df ttg gifip khdc (vfi tdi ehinh, ehdm sdc sfic khoe, phuc hfii chfic ndng, hgc vanfaod,fagcngfal, tgo vific ldm ) Nfaa nude dd ed nfaifiu ehinh sdch tao dieu kifin thudn lgi dl cde tfi chfic xa hpi va ed nhdn (tfi chfic phi chinh phfi, cae doanh nghifp) tifin hanh hogt dgng tfi thifn gifip cde dii tugng kfad khdn Cde chinfa sdch uu dai ddi vdi ngudi cd edng vdi dit nude thfi hifn duge tinh thin "ufing nude nhd ngufin", "dfin on dap nghia"; gdp phin dn dinh, ndng cao ddi sfing vdt cfadt vd tinfa thdn eho gia dinh ngudi ed cfing; ddm bdo mfic sfing cua gia dinh ngudi cd cdng cd mfic sdng bdng hode cao ban mfic sfing cfia cgng ddng nai cu tni Cae chinfa sach giam i ^ f i o duge thuc hifn theo faudng diu tu cd ttgng tdm, ttgng difim nfadm giam ngheo nhanh vd bfin vihig, nhdt la doi vdi nhihig dia bdn khd khdn, viing ddng bdo ddn tdc vd mifin nui Cdc cfainfa sach ASXH tilp tue duge hodn thifn ttfin edc ITnfa vye lao dgng, vifc ldm, BHXH, BHYT, bdo ttg xd fadi; dd gdp phin cdi thifin ddi sdng ngudi ngheo; gidm bat binh ding vd bit cfing; gdp phdn 6n dinfa, tfafic day sy phdt ttien xd hfii Han che thyc faien ASXH Thu nhdt, mice dg bao phu cua h^ thdng BHXH, BHYT cdn thdp Dfii vdi BHXH, ty If tham gia (kl cd hinfa thfic bit bugc d khu vuc ehinh thuc va ty nguyfn d kfau vye phi cfainfa tfauc) mdt du Khoa hgc xahfi Vift Nam, so (110)-2017 cd tang len nhung cdn thdp Theo bao cdo giam sat thyc hifn Ludt Bao liifim xd hfii nam 2015 cua Tdng Lifin dodn Lao dgng Vift Nam, d tinh Hd Nam, Nam Dinh, Phil Yen, Khanh Hda, Ddng Thdp vd An Giang, ty If bao phfi BHXH binh qudn cfia tinh dugc gidm sat la 13% luc lugng lao dfng tham gia BHXH (chi khodng 6,9% ddn sfi ttfin dia bdn tinh); cfi 100 doanh nghifip hoat dfing tfai chi cd 40 doanh nghifip dang ky ddng BHXH [10] Ty If bao phfi thap ndy nhifiu nguyfin nhdn khae nhau, ttong nguyfin nhdn ldn nfaat la cdc doanh nghifp ehua thue hifn tdt nghia vu ddng BHXH eho ngudi lao dgng Ben cgnfa dd, cdc ehinh sdeh eho ddi tugng phi ehinh thfic tham gia BHXH cdn hgn chfi Mgt bf phdn ldn lao dfng phi chinh thfic (nhu lao dgng thdt nghifp, lao dfng ttong cae hfi gia dinh, lao dfng ttong nfing nghifip, lao dfng ty do, lao dgng ldm tfaue, ngudi cao tudi ) khfing tham gia cdc quy BHXH; ggp rfii ro hp chu yfiu dua vao gia dinh faogc ty lo Nfaa nude khdng co khd nang chi tta cho tat cd cac nhdm ddi tugng ndy nhung nfadm ndy lgi ein nhit sy trg gifip ciia xd hfi thfing qua hf thfing ASXH Ddi vdi BHYT, theo bdo cao cfia BHXH Vift Nam 2015, ty lfi bao phu BHYT cde dia phuang khdng dfing dfiu, nhifiu tinh, cd ty lfi tham gia BHYT thdp hom mfic binh qudn chung cita cd nude Dfin hit thang nam 2015, co 31 dia phuong cd ty if bao phfi BHYT dgt dudi 70% dan sd todn tinh, ttong cfi din 15 tinh, thdnfa phfi mdi bao phfi dugc dudi 60 % dan sd Vdi mye tifiu din cufii nam 2016 ndng mfic che phfi lfin 78% thi vin chua thfi bao phfi dugc todn ddn tham gia BHYT BHYT la cho dya an sinh thilt ylu ddi vdi ngudi ddn, vifc cfaua bao phu hit 40 BHYT toan ddn Id han ehl ddng kfi ttong thyefaifinCBXH Thu hai, chinh sdch BHYT cdn nhieu bdt cap Hifn nay, tinh ttgng qud tdi d cdc bfnh vifn tuyin qugn/huyfn va cde bfnh vifin chuyfin khoa da dugc cdi thifn tot ban nhung chua dap iing nhu cau eiia nhdn ddn khdm cfaiia bfnfa Sfi ngudi khdm chfta bfnh tang nfaanh so vdi mfic phdt triln cfia cac bfnh vifn Trong mgng ludi y tl phudng, xa tgi vin chua khdng djnh dugc vai trd co sd mft each diy dfi Tinfa trang qua tdi pfa6 bien d cdc bfinh vifn ldn Ngudi cd the BHYT chiia bfnh van phdi ddng mdt sd khodn ehi pfai kfafing hgp ly (nhu cdc dich vu ky thugt mdi, edc chi phi bfnh vifn thyc hifn ty chfi tdi chinh ) Van su phdn bift ddi xfi gifia dfii tugng thu hudng BHYT voi cde doi tugng khac tai he didng edc bfnh vifin dugc ddng ky tfaam gia khdm chfia bfnh Chat lugng kham cfafia bfnfa cho nfadm tfaam gia BHYT tfaudng kem hom so vdi nhdm sfi dung dich vu y tfi Nhihig ngudi tham gia BHYT khdm chfia bfnh d cde bfnh vifn tu nhan tid khfing dugc chdp nhdn cung cdp dich vy theo thfi Mdt khdc, cd quy dinh todn cde chi pfai tgi tuyen tten dugc tru vdo cae bfnh vifn nhgn ddng ky khdm chiia bfnh ban dau, nfin ede bfinh vifn cd ddng ky ban ddu thudng mudn giu bfnh nhan lai (khfing cho hodc gdy khd khdn cho bfnh nhdn chuyen lfin tuyfin khae) Bfinh nhdn cd nhu ciu dieu tri tgi tuyin kfadc noi dang ky ban ddu kfao xin duge giiy chuyen vifn bode ngai phai chd dgi lau nfin cd xu hudng di khdm chfta bfnh vugt tuyen, ttdi tuyfin Vifc ho ttg kinh phi cho dfii tugng hgc sinh, sinfa vien tfaudng rit ehdm va nhifiu khfi Vdi Nguyfin Thanh Dgt nhiing bat cap trfin, cfing vdi su tdc dfng cua ea chfi kinh te thi trudng vdo ITnh vyc y tfi, neu cdc chinfa sdcfa BHYT kfadng duge cdi tfaifin tfai sS khd thuc hifn tdt facm cdng bing xd fagi (CBXH) BHYT TTiu ba, giip BHXH cfnca qudn ly hieu qud Hifn quy BHXH dang cd nguy ca vd edn dii tfau ehi ma nguyfin nfadn cfainfa la cfai nhieu faon tfau Sfi thu chfi yfiu cdn cfi vao sfi luang dugc ky ttong hgp dfing lao dgng (cfafi kfafing can cfi vdo sfi luomg tfauc hnh) Mgt bf phan ldn doanh nghifp cfi tinh ng dgng BHXH hodc trdn ddng BHXH ciing Id bieu hifn yeu kem cua qudn ly quy BHXH Theo sd lifu tfadng kfi 2014, "cfai cd 150.000 doanfa ngfaiep (DN) tfaam gia BHXH, ttong kfai ea nude cd 300.000 DN dang faogt dgng Sd ngudi tfaudc difn pfaai nop BHXH bit bugc khodng 16 trifiu nhung chi cd gin 11 trifiu nguoi ddng BHXH, ldm cho sd thit thu len den 56.000 ti ddng" Mac dfi ndm 2015, tinh trang ng, ttdn ddng BHXH giam dang ke nhung vin edn ty lfi ldn khfing ddng BHXH Tfaeo bdo cao cfia Tdng Lifin dodn Lao dgng Vift Nam, nam 2015 cd tinh giam sat tinh ttang ng dgng, ttdn ddng BHXH, BHYT cfia cde DN dien phd bien d tat ca cdc tinh, pfad Tdng sfi ng cua tinh gidm sat la ttfin 433 ti ddng Ti lfi trung bmh sd DN ddng ky tham gia BHXH ttfin tfing sfi DN ddng ky hogt dfing chi chifim 40% vd ti If DN ng BHXH trfin sfi DN tham gia ddng BHXH Id 44,9% Nhu vdy, cu 100 DN hoat ddng thi cd gin 80 DN vi pham phdp ludt ve BHXH (60 DN khdng ddng va 18 DN ng BHXH) Ngoai ra, ttong nfaifiu trudng fagp edc cfainh sach tai cfainh cung bi Igi dung "dn chdn" ngudn ngan sdeh nha nude ddnh cho an sinh xa fagi Vi dy, mgt so ngudi khfing ndm ttong difn duge hudng ttg cap nhung khai bdo tfaat ngfaifp dfi fauomg trg cdp; mft sd ngudi di ldm de kifim tfau nhdp d noi khac nhung khfing bao cao thufi; mgt sfi ngudi sfi dung lao dgng khdng ddng cdc khodn bao hifim cho ngudi lao dfing Thu tu, chua cdn ddi phdn bd tdi chinh thue hi?n ASXH Dfii vdi nhiing hf ngheo, vimg ngheo, vung khd khdn, ddn tgc thifiu sfi, hg kfad tun kifim vific ldm faodc ty sdn xudt ldnh doanh Tdi chinh dugc pfadn bd cfao dfii tugng cfafi yfiu la ttg cip tfaudng xuyen nen kfadng cdi thifin duge nhifiu mfic sfing cua mft bfi phan dan cu ndy Doi vdi nhdm ddi tugng lao dfing phi cfainfa tfafic vd nfadm cgn ngfafio hifn nay, edc chinh sacfa tai cfainh van cfaua khdc pfauc dugettnfatrang ddi sdng bdp bfinfa eua fag, \a hg de tdi ngheo Theo Bdo cdo Piiat trien ngudi Vift Nam ndm 2015 cua td cfauc UNDP, Vift Nam da phdt trifin faf thfing ASXH ea bdn dua tten "quyen" va theo "vdng ddi", hf tfadng cfaia thdnh hai nhdnh ro rang vdi BHXH tuomg ddi hdo phdng cho nhihig ngudi ldm vifc ttong khu vyc chinfa thfic vd ttg giiip xa hfi rdtfagnchfi eho nhung ngudi ngheo nfait Trong kfai cfai tifiu edng cfia Vift Nam cho ASXH ndi chung bdng 2,8% tfing sdn phim qude nfi (GDP), thi rieng pfadn trg gifip xd fafi cfai chilm 0,4% GDP (2013) Tmh ttgng ndy vd difn bao phfi hgn chfi cfia ttg gifip xd hfi dd ddn tdi sy "bo sdt nhdm d giiia" (gfim nfadm can ngfaeo va nfadm trung luu ldp dudi thudng lam vifc d khu vyc pfai cfainfa tfauc, nhdm nhiing ngudi chua dfi tifiu chuan dfi dugc nhdn trg gifip xd hgi hode ehua ed khd ndng tifip can bao hiem xa fadi) Do khdng thudc difn bao phfi ciia eac he thdng ASXH nfin nhiing dfii tugng d tinh trgng Khoa hpc xa hfi Vift Nam, sfi (110) - 2017 gidm ngheo bin vdng vd bdo vi cdc nhdm ddi tugng di bi tdn thuang) Cdn ddy mgnh thyc hifn chmh sdch uu dai ddc bifit ddi vdi ngudi ed cfing, thuong binfa, gia fflnfa lift sT, Bd me Vift Nam anh hung, cfainfa sdcfa ttg cap xd hfi eho cdc dfii tugng ylu thl; diy manh phdt triln nhifiu hinh thfic boat dgng dfin on ddp nghia; dfii mdi phuang phap tiep cdn xdy dyng ehuang trinh gidm ngfaeo vd ho ttg hg Mgt si giai phap ngheo mgt each ddng bg hom; hodn thifn va da dgng hda cde cfauang trinfa hd ttg dde thii Thu nhdt, ndng cao mue bao phti cua hi cfao cde nhdm doi tugng yeu the, d6ng thai kfauyfin khich sy tham gia ciia cdc to chuc thdng ASXH Bk ndng cao mfic dp bao pfafi ciia fafi xd hfi vdo cdc chuong trinh bdo ttg Thu ba, ndng cao ndng l\cc qudn ly nhd tfaong ASXH cin tgo tfaudn lgi cfao ngudi dan tham gia BHXH; chfi ttgng dfin md nude, hodn thien he thdng phdp ludt ddi vdi rfng cdc ddi tugng tfaam gia BHXH ty he thdng ASXH Cac tinh, phd ein phdi cfafi dfng nguyfin; fa§ ttg mdt pfain pfai ddng BHXH ty nguyfn cho cde ddi tugng cd thu nhdp xdy dyng va ban fadnh ke faoacfa ttiln kfaai thdp; khuyen khich phdt trifin bdo hifim xa tfayc hifn eac chinh sach ASXH tgi dia fadi ty nguyfn dya tren ca sd xafadifaoanfau phuomg vdi nhiing chi tifiu, gidi pfadp cy the bao faifim nhdn thg Cin hodn thifn cac co tfaeo timg nhdm ddi tugng Cin minh bach cfae fao ttg pfai tham gia BHYT mdt each va dom gidn hda cde thu tyc hdnh chuih hgp ly ddi vdi ede nfadm dfii tugng ddn cu Cdn fing dyng edng ngfaf thdng tin, hodn kfadc nfaau; kfadng dugc pfaan bifit doi xfi chinh edc phdn mem dang trifin kfaai ttong giiia ngudi cd the vdi ngudi khong ed the qud trinfa quan ly hf thong ASXH C§n khdm chfia bfnh dich vy; trien khai thudng xuyfin thanfa tta, kifim tta vd ed bifn dfing bf edc gidi pfadp ndng cao chdt lugng pfadp ciing rdn vd trift dfi ttong vifc xfi ly kham cfafia bfinh BHYT, ndng cao chat edc vi phgm vfi BHXH, BHYT, BHTN, bdo lugng khdm bfinh chfia bfnh tgi cde ca sd y ttg xa hfii, xda ddi gidm ngheo Cin diy te, dde bift la tuyfin y tfi ea sd, d cdc vung mgnh chfing tham nhiing, tf ngn mit dSn kho khan, vung ddng bao dan tfc, huyfn chu ttong qudn ly nha nude vl ASXH Cha ngfafio; day mgnh phdt trien co cfafi kfadm huy dfing su tham gia cfia cac th cfafic xa chfia bfnh cua khu vyc y tfi tu nhdn cfao ddi hgi ddn sy khde ttong viec theo doi, danh tugng BHYT (dieu se gdp phdn gidm gia thyc hifn chinfa sach ASXH Day mgnh thifiu tinh trgng qua tdi d cae bfnh vifn cfauang trinfa BHTN, faudng ngfaifp, ddo tao va day ngfae Tgo ea fagi va h6 ttg nhieu tuyen trung uong) hom cho eac nhdm yeu thfi, ngudi dan d Thu hai, cdn md rgng cdc chinh sdch icu vtmg sdu, vung xa dai, xod ddi gidm ngheo (diiu ndy gdp phdn dl bi tdn thuang phdi ddi phd voi edc cfi sfic vd cd khd ndng rit faan che dfi dau tu eho tuong lai Mfic df ttg c ^ xd fadi ciing qud tiiip nen khd tgo sy khdc bift ttong cufc song cua nhiing nguoi cd dfi tifiu chudn thy hudng vd din dfin mft sfi hf qud, ttong cd tinh trgng cdi phfi bien d ttfi em thudc cae hf gja dinh ngheo va cd mue thu nhdp thip 42 Nguyfin Thanh Dat Thd tu, cdn bdng phdn bd ngudn luc tdi chinh Vifc phdn bfi tdi chinh phdi can cfi vdo edc dicfa vy ASXH cung iri^ cdc dilu kifin sdng kfadc vl vung mifin vd mfic thu nhap cfia ddn sd Nfiu cung fing cdc dicfa vu eho vfing giau vi sfic mua cde dich vy ASXH ldn ma bd qufin ede viing ngheo, ngudi ngheo thi se dan dfin bat binh ddng Thyc hifn cfing bang ttong phan bfi ngan sdch thfi hifn qua su minh bach ttong chi ngan sdeh eho cdc try cgt ciia hf tfafing ASXH Vi v^y, can tiep tue ehinh sdch tin dung uu dai dfii vdi nhihig hf ngfaeo cd kfaa ndng lao dgng nfaimg thifiu vdn vfi dau tu sdn xuit kinh doanh Ap dung linh hogt edc phuomg thfic cfao vay tin dung, c i n tfau BHXH cdn cfi vao mfic tien luomg, tien edng thye t l cfia ngudi lao ddng (dieu mgt mat se tdng nguon thu cho quy, ddm bdo dugc quyen lgi cfia nguoi lao ddng; mat khae tao sy binh dang gifia ede ca quan, dom vi nhd nude vd cde co quan dan vi khfing phdi cfia nhd nude) Thic ndm, cd chinh sdch cu thi ddi vdi nhdm phi chinh thuc Can ed ehinh sdch giai quyfit hgp ly mfii quan hf gifia nhu cau va khd ndng tham gia faf tfafing ASXH cua nfadm pfai chinh tfafic Nhu cdu tfaam gia bdo biem xa hdi tu nguyen ciia lao ddng nhdm rat ldn, hg ciing mudn ddng cao de hudng mfic eao nhung khd ndng ddng gdp lgi rit hgn chfi Day lai la ddi tugng dang dugc hudng rit it eac ehuang trinh pfafic lgi xa hgi Vi vay, cdn edi edeh manh me thfi tyc tham gia vd toan BHXH (difiu dd sfi tao difiu kifn thuan lgi hem cho ngudi lao dfng nhdm dfi dang tilp can vd tham gia) Chang han, chi sfi dung mgt giiy td nhdt Id cfaiing minh nfadn ddn (theo mau mdi) hodc hg chilu (cip ddi hgn) dfii vdi nhiing ngudi tham gia BHXH ty nguyfn Ian ddu; bd qua cdng doan tham tra ngudn tfau nfadp vdi nfaiing ngudi tfaam gia; ddy mgnh edc chucmg trinh vifc lam, tiep can cac ngudn lyc phdt trifin kinh tl, xa hdi Thu sdu, tdng eudng tuyen truyen, ndng cao nhdn thuc cua ngudi ddn vi cdc chinh sdeh ASXH Tang cudng cfing tdc phoi hgp vdi Bf Thdng tin vd Truyfin thong, cac co quan bdo chi; cd kfi hogch tuyfin truyfin, phfi bifin sdu rdng cae ehinh sach, vdn bdn quy pfaam phdp ludt ASXH din ngudi dan Tuyfin truyen chfi ttgng dfin cdc nfadm ngudi ngheo, nhdm ddn sd trfi, nfadm lao dgng di eu, nhdm dan sd co trinh nhdn tfafic thip d nhimg vung nfing thdn vd vfing kem pfadt trifin Can giiip ngudi ddn nhdn thfic duge ring, tiiam gia BHXH, BHYT, BHTN la lgi ich tuong lai cua chinh minh; vifc khflng ky kit hgp ddng lao dfing vdi chfi sfi dyng lao dpng sfi gay thift hgi eho chinfa minh, ddng thdi tiep tay cfao chfi sfi dung lao dgng vi pfagm phdp lugt Cdn gifip ngudi ddn nhgn thfic dugc ring, nfiu pfadt faifin nfaung bit cap cac cfainh sdeh ASXH, nguoi lao ddng cd the thfing qua cdc kfinh khdc nfaau dfi dfi dgt nguyfn vgng cua minh (nhu gap tryc tifip dai difn co quan cfafic ndng, qua bdo ddi ) Suphdn hfii tryc tiep eua ngudi lao dgng Id yeu td quan ttgng dfi cdc co quan qudn ly tien hanh tim cde gidi phdp khic phuc kip tfadi pfau fagp Cin gifip nguoi ddn thay ddi y thfic f lai, ttdng chd vao nha nude Ket luan Trong he thdng cac hinh thfic pfadn pfadi hifn nay, phan phdi thfing qua ASXH dd 43 Khoa hpc xdhgi Vift Nam, so (110)-2017 dat dugc nhung k i t qud tfailt tfayc gop phan Chfnh tri quic gja (2013), Nhimg thdch thuc thyc hifn CBXH Tuy nfaifin, giai vd gidi phdp ddi vdi ehinh sdeh an sinh xd hpi dogn tiep tfaeo edn tfayc hifin nhifiu gidi phdp ben vOng eho tdt cd mpi ngudi tgi Viit Nam vd Diic, Nxb Chfnh trj qudc gia H i Nfi dfi hodn thifin hf thfing ASXH Cfi nhu vgy thi ehung ta mdi dam bdo CBXH tot ban, [5] Lfi Quoc Ly (Chii bifin) (2012), Chlnh sdch xod ddi gidm nghio thuc trgng vd gidi phdp, qua mdi gift dugc fin dinh vd phdt trien Nxb Chinh tri quic gia H i Nfli ben vflng xa hgi [6] Vu v a n Phdc (ChCi bifin) (2012), An sinh xa hdi d Viit Nam hudng tdi 2020, Nxb Chfnh tri quic gia, H i Ngi Tai lifiu tfaam khao [7] Thu tudng Chinh phii (2013), gwyeV dinh sd 12i5/QD'TTg 23/07/2013 vi chiin luge [1] Mai Nggc Cudng (Chu bien) (2009), Xdy dtmg phdt triin ngdnh Bdo hiim xd hgi Viit Nam vd hodn thiin hi thdng chbth sdch an sinh xd hgi a Viit Nam, Nxb Chfnh iri qu6c gia H i Nfli [2] din ndm 2020 Hk}