DAM BAO AN SINH XA H O I VI MUC TIEU PHAT TRIEN CON NGUdl VIET NAM: DINH H U ' C N G M O HINH VA GIAI P H A P J DANG NGUYEN ANH" Mordau An sinh xa hpi (ASXH) theo nghTa rpng la sy bao dam thuc hien cac quyin dl nguoi dugc an binh, bao dam an ninh, an toan xa hpi Theo nghia hep, khai niem ASXH la su bao dam thu nhap va dilu kien sing thilt ylu cho ca nhan, gia dinh va cong dong trucmg hpp bi giam, bi mit thu nhap hay gap phai nhtmg rui ro khac; cho nhiing nguoi gia co don, tre em ml coi, nguoi tan tat, nhimg nguoi ylu thi, nguoi bj anh huong boi thien tai dich hpa O Viet Nam, ASXH tro mpt nhiing tru col ca ban he thing cac chinh sach xa hpi dugc Dang va Nha nuoc ta quan tam xay dyng ASXH la nhan tl dam bao cong bang xa hpi Thuc tien phat trien da cho thiy ASXH co vai tro rit Ion viec khac phuc nhu'ng he luy ciia phan hoa xa hoi, tang cuong gin kit xa hpi su ding thuan va dam bao on dinh chinh tri Tuy nhien, he thong ASXH cua Viet Nam hien chua phat triln tuong xiing voi da phat trien ciia xa hpi, va so voi doi moi tu ve mo hinh kinh tl, viec dSi moi tu ve mo hinh ASXH vd giai quyet cac van de xd hoi sinh cham vd thieu ben viing O nuoc ta, ASXH van dugc coi la trach nhiem ciia Nha nuoc, chua thu hut dugc cac phan kinh te, cac chii the va nguon lye khac cho cong tac nay, xa hpi hoa kem, dieu kien va nang lye ty vuon len cua nguoi dan thap Trong do, nguon lye ho trg ciia Nha nuoc nham thyc hien ASXH ban che, chii yeu dya vao ngan sdch cong, voi dien che phii thap, ti le tham gia thap va muc huong thap Cac hinh thiic b^o hiem chua dap ung dugc nhu cau da dang ciia nguoi dan va chua doi moi de theo kip sy phat triln ciia kinh te thj truong Ben canh do, cong tac ASXH dang bpc Ip nhirng thieu hut cac dich vu co ban khong dugc bao cap nhu truoc Viec hpc hanh, kham chiia benh nha 6, di lai, viec lam, diu doi hoi phai tra tiln va dong phi Tuy nhien, chat lugng cac dich vu xa hgi nhin chung thip, vin khong it tieu cue, phien va rao can doi voi nguoi dan viec tiep can cac dich vu Trong do, nhieu riii ro rinh rap nhu dau 6m, tai n^, thien tai, mit miia, dich benh, luon la nhiing cu soc doi voi nguoi ngheo, cac nhom ylu thi, de dga tinh mang va ASXH ciia nguoi dan Nhieu nhom dan cu khong co kha ' PGS.TS.; Vi^n Xa h^i hpc, Vi?n Han lam Khoa hpc Xa hpi Vi?t Nam NghlSn ctiu Con ngtfdl sS4(73) 2014 23 Dam bdo an sinh xd hpi nang ung truoc nhiing rui ro thien tai va biln dong kinh tl - xS hoi (hO ngheo, hp can ngheo, nguoi dan tpc, lao dpng di cu, tre em ngheo, tre em mo coi, tre em bi bo roi, nguoi gia co don, nguoi khuylt tat, ngucri co HTV/AIDS, ) Truoc yeu ciu noi tren, nghien cuu xay dyng mo hinh va dinh huong chinh sach ASXH o Viet Nam la hit siic cip thilt, phii hgp voi muc tieu va dinh huong phat triln bin viing, tiln toi viec hoan thien mo hinh ASXH nuoc ta nhirng dieu kien va thach thiic moi cua boi canh quoc te Chuc nang va cac nguyen tac cff ban cua an sinh xa hoi He thing ASXH co ba chiic nang co ban la: i) Phong ngila rui ro ii) Giam thilu rui ro va iii) Khic phuc rui ro Cac chuc nang khong loai trir ma bo sung, ho trg cho nhim muc dich Quan ly nii ro Tren thuc tl, mo hinh ASXH mang tinh dan xen ca ba chuc nang Phong ngica rui ro: Chiic nang phong ngira rui ro la chiic nang quan trpng hang diu cua he thing ASXH Chiic nang doi hoi viec bao ve toan bg cac vien xa hpi co dugc viec lam, thu nhap, sinh kS on dinh va hon nGa co kha nang han che dugc rui ro va tu bao ve minh truoc nii ro - Giam thiiu rui ro: La chiic nang co ban thii hai ciia ASXH, giii vai tro quan trpng sau rui ro xdy Day la chiic nang ling va tao sue bat cho cac doi tugng bj tac dpng nii ro Cac hinh thiic trg giiip chu yeu duoi dang "v6 dieu kien" hon la "co dieu kien" va mang tinh phiic Igi nhieu hon la quan he thi truong - Khac phuc rui ro' La chiic nang thir ba ciia ASXH nham muc dich bao ve an toan cho nguoi dan bg gap phai rui ro ma khong the khac phuc dugc, nham giiip ho khong hi roi vao hoan canh ban ciing hoa Day dugc coi la "phao ciiu sinh" tam thai nham muc dich tao sue bat cho cac doi tugng tham gia khoi phuc cupc sing va hoa nhap vao cong dong sau nii ro xay Ve cac nguyen tac ASXH, mac dii cac mo hinh ASXH cua cac qulc gia co thi khac song he thong ASXH deu dugc to chiic va van hanh dya tren hai nguyen tic: 1) nguyen tac dong - huong va 2) nguyen tac khong dong gop (ma dya vao su trg giiip cua nha nuoc va cong dong) Nguyen tac dong - huong la hinh thuc ASXH ma nguoi lao dpng tham gia vao he thong phai dong gop tai chinh thong qua sy tich luy vao cac quy ASXH dl co thi huong trg cap an sinh het tuoi lao dpng hoac phai chiu nhirng riii ro cupc song Tru cot bao hiem dua tren nguyen tac dong gop ASXH khong dong gop la nguyen tac ma nguoi tham gia vao he thing khong phai dong gop tai chinh Tuong ting voi nguyen tic la try cot trg giiip hay bao trg xa hpi Day la sy bao dam, trg giiip ciia nha nuoc, ciia cong dong va nguoi dan cho nhiing doi tugng bi lam vao canh ban cung, khong co kha nang ty lo lieu cugc song thuong nhat ciia ban than va gia dinh Tim hieu mot so mo hinh an sinh xa hoi tren the gioi Viet Nam cin tham khao kinh nghiem qulc te vl xay dyng he thing ASXH Co thi NghiSn ctiu Con ngudl s64(73) 2014 Ding Nguyen Anh torn tat nhihig mo hinh ASXH nhu sau: i) M6 huih an smh Xa hpi chu nghia, tieu bieu la Lien x6 cii, hoac cac nuac Dong Au truoc day, dac trung la Nha nuac bao cap toan bo ASXH voi nguyen tac co ban la binh quan phan phoi Mo hinh huong vao khac phuc lui ro thong qua boat dpng tra giiip/bao tra xa hpi :•,, ii) Mo hinh ASXH cua Tay Au chimg muc nhat dinh co tinh dinh huang, theo do, Nh& nuac bdo dam an sinh cho nguoi dan dua tren nguon thue dong gop cixa toan xa hpi vao ngan sach nha nuoc; Chiic nang phong ngija va giam thieu rui ro dupe nhan manh, van hanh theo nguyen tac minh bach Tinh nhan van cua mo hinh ASXH Tay Au i^t cao Tuy nhien, nhuac diem ciia mo hinh la kha ton kem ve tai chinh va co su lo ngai khd nang bSn viing ciia m6 hinh co cau dan so chau Au da tra nen gia coi va cac dong nguoi nhap cu gia tang iii) Mo binh cua Hoa Ky theo nguyen tac dong - huong tren ca sa he thong bao hiem nham dam bao tai chinh cho ASXH, nhung qua huang vao ca nhan va thi truang Mo hinh kho dat dupe su cong bang ASXH, nhit la Imh vuc y d, kham chiia benh iv) chau A, Nhat Ban dua tren phuong thiic truySn thdng vol vai tto quan trpng cua cac cong ty, cac tap doan kinh te Ion voi che dp lam viec suot dai Day la mo hinh nhin m ^ chiic nang phong ngira va khac phuc rui ro theo dinh huang phat buy vai tro tip th^ va ch^ dp bao hi6m su6t doi Trong nhieu thap nien, phiic loi xa hpi cua nguoi dan Nh$t Ban diing vao loai cao tren thj giai, song cung nhu Diic, Phap, Y, mo hinh niy t6 kem bSn vftng b6i canh dan so gia dang la ganh nang doi voi Nhat Ban v) Mo hinh ASXH ciia Han Qu6c buy dpng dupe nhiSu chu the (Nha nuac, doanh nghiep va nguoi lao dpng, cong d6ng, gia dinh, cac to chiic phi chfnh phu, phi Ipi nhu^, ) tham gia Mo hinh kk thita dupe nhihig uu diem cua cac nuoc di truoc, ket hpp cong tu, huang vao chirc nang giam thieu nil ro va chii trpng dau tu cao (10% GDP) uu tien phat tri^n cac dich vu phiic Ipi xa hpi danh cho nguai cao tu5i, ngucri khuylt tat, tre em va phiic loi gia dinh Dam bao miic sinh boat t6i thieu cho nguoi nghto va nhOng khong c6 kha nang tu kiSm s6ng Tuy nhien, hien Han Qu6c cang dang phai ling vol ti le sinh rit thjp, gia hoa dan s6 nhanh va nhihig van de xa hpi m6i sinh (tu tii, thit nghiep co ciu, gia dinh da van hoa) vi) Mo hinh ASXH cua An Dp chu trpng lucmg buu cong chiic, mSc dii dp che phu ASXH thap, ti le nguai lao dpng tham gia chua nhik, dac biet la cac doi tupng tu nguy?n Van hanh cho he thdng ASXH chu ySu ngan sach Chinh phii lien bang va ddng g6p ciia cac doanh nghiep Chinh phu quy dinh moi du an xay dung va phat trien CO ser ting phai trich % t6ng kinh phi Si lap Quy phiic loi cho nguai lao dpng, dim bio ASXH bang quy vii) Mo hinh ASXH cua Trung Qu6c kha gi6ng vol Viet Nam, bao gom ba hpp phan 14: H? thdng bao hilm xa hpi (vai loai: bao hiim buu tri, bao hiem that nghiep, bao hijm y tj ca bin, bao hi6m thai san, va bao hilm tai nan lao dpng); He thong phuc Ipi NlMinalu Con nguttsU 4(73) 20H 25 Ddm bdo an sinh xd hoi xa hgi ma chu ylu la cac boat dong ciiu trg, cim tl, trg cip cho nguoi dan M6 hinh ASXH cua Trung Qulc da dugc thi truong hoa song mot chimg myc nhat dinh vin mpt sl ylu tl bao cap tii mo hinh truoc day Tuy nhien khac voi Viet Nam, bao hilm y tl a Trung Quoc da dat mirc che phii toan dan tir nam 2010 Luat ASXH dugc thong qua va chinh thiic thyc hien tir 1/7/2011 la mot buoc ngoat Ion Bao hilm him tri cho nong dan (dia bao) la mot dot pha moi dugc ap dung mo hinh ASXH Tmng Qulc, theo do, ngucri nong dan dugc huong trg cip buu tri vl gia Day la cit I5i cua mo hinh ASXH cua Trung Quoc Tuy nhien, chit lugng dich vu ylu kem la mot kho khan, thach thirc o quoc gia Hon nira, voi dan sl dong, dien tich trai dai, bit binh ding Ion, xung dot xa hpi gia tang nen khong phai dia phuong nao ciing thuc hien dugc cac hoat dpng ASXH Xem xet cac mo hinh ASXH cua cac qulc gia phat triln cho thiy xu huong chung tren thi gioi la ASXH diu huong toi viec bao dam an toan cho cac cong dan va cac nhom ngheo, ylu thi Mac dii khac ve each tiep can nhung cac mo hinh ASXH cua cac nuoc deu co y tuong chung khuyen khich su tham gia cua nguai dan vd doanh nghiep vdo cdc hoat dong an sink Thyc hien che dp bao hiem suot doi cho cong dan la mpt uu viet, mac dii co the kho theo duoi doi voi cac nuoc ngheo nhu Viet Nam Nha nuoc chi dong vai tro viec tao khung kho luat phap ve an sitih, viec dieu hanh true tilp cac hoat dpng se lam sy chu dpng tham gia vao he thong M6 hinh ASXH ciia cac quoc gia tren the gioi deu huong theo nguyen tac dong - huong, lay so dong bii cho so it, sy bao cap ciia nha nuoc la can thiet nhung co gioi ban Neu dugc quan ly chat che minh bach thi se ben vtmg Thuc trang mot so van de an sinh xa hpi ff Viet Nam hien Thyc hien tien bp va cong bang xa hpi timg buoc va tirng chinh sach phat trien la chu truong Ion, nhat quan cua Dang va Nha nuoc Viet Nam, the hien ban chat tot dep ciia che xa hpi chii nghTa Chien luge ASXH giai doan 2011 - 2020 ciia Viet Nam da neu ro: "An sinh xa hpi la su bao dam ma xa hpi cung cap cho mgi vien xa hpi thong qua viec thuc thi he thong cac co che chinh sach va bien phap can thiep truoc cac nguy co, riii ro co the dan den suy giam hoac mat di nguon sinh ke" (Vien Khoa hpc lao dpng va x3 hpi, 2009) Chien luge nhan manh viec phat trien he thong an sinh xahpi da dang, cang mo rgng va hieu qua; phat trien manh he thong bao hiem, nhu bao hiem xa hpi, bao hiem that nghiep, bao hiem tai nan lao dpng va benh nghe nghiep; khuyen khich va tao dieu kien thuan Igi de nguoi lao dpng tiep can va tham gia cac loai hinh bao hiem; thyc hien tot cac chinh sach uu dai va khong ngimg nang cao miic song doi voi nguoi c6 cong; mo rpng cac hinh thiic ciru trg doi voi cac doi tugng kho khan Duong nhien, de co dugc mot mo hinh ASXH hieu qua thi cin ca mot qua trinh lau dai Cdc quoc gia phat triln Tay Au nhu Diic, Phap, Thuy Diln phai mat hang tram n^m moi CO dugc he thing ASXH tien tiln va phat triln hoan thien nhu Tuy nhien, cac hoat dpng an sinh nhilu bat cap, thieu dong bp va li^n kit quii trinh triln khai thuc hien He thing ASXH nude ta vin nhieu han chi, di^n bao 9^ NghiSn ciiu Con ngudl s64(73) 2014 Ddng Nguyen Anh phu hep, mot b6 phan nguoi dan, nhit la dong bao dan tpc thieu so kho khan tiep can cac dich vu xa hgi co ban, miic ho trg thap, ket qua dat dugc bao dam ASXH chua ben vihig Co the nhan thdy qua thyc trang giam ngheo chua ben virng, ti le c$n ngheo va tai ngheo rat cao, ti le ngheo viing dong bao dan tgc thieu so khong CO xu hucmg giam Bat binh dang xa hpi va phan boa giau ngheo cang Ion giu^ cac nhom dan cu Nghich ly hien la ti le che phii ciia bao hilm tu nguyen thap nii ro, bat trac cang gia tang cupc song ma khong dugc bao hiem Dac thu cua mo hinh ASXH o Viet Nam hien la cac boat dong Nha nuoc bao cap va thuc hien Nha nuoc dam nhiem hai chiic nang: vira la nguoi ban hanh chinh s^ch vira la nguoi thyc hien chinh sach thong qua bg may cua minh dia phuong, can bp chinh quyen viia xet duyet doi tugng trg giiip xa hgi, vua thuc hien viec chi tra trg cap Vi?c xac dinh doi tugng ASXH hien dua vao qua nhieu tieu thiic khac va thieu thing nhat: liic thi dya vao viing mien noi cu tni, thi dya vao dieu kien kinh te, thu nhap, liic thi dya vao tuoi, tinh trang siic khoe, benh tat, thi lai dya vao tinh trang vi$c lam, Nhiing phuong thiic tren dan den sy triing eheo va lang phi nguon luc, khong hieu qua boat dong ASXH Nhan thirc ciia cac cip chinh quyen dia phuong va nguoi dan ve ASXH noi chung c6n ban chi Day khong dugc coi la ITnh uu tien chinh sach va thyc tiln Nhilu hi$n tugng khong binh thuang diln bien (vi du: benh vien cong, kham chiia benh tu, kham chiia benh duoi danh nghia nha nuoc, tham chi benh vien Ion ciia nha nuoc, trang thilt bi tu nhan diu tu khong dam bao chat lugng, cau chuyen nhan ban xet nghiem, cip triing hon trieu the bao hilm y tl dien cac co so y te nha nu6c) Nguin lye tai chinh dl thuc hien ASXH chii ylu la tir ngan sach Nha nuoc bi ban chi, su dong gop ciia nguoi dan la rit it Nguoi dan vin chua y thiic dugc nguyen tac co dong - CO huong boat dong bao hilm Mirc dp che phii, dong gop va mirc huong diu thip Cac loai hinh bao hilm xa hpi han chi, chua da dang hoa, thu tuc thmih toan nhilu tro ngai, ti le tham gia khong cao Nguoi dan chua mSn ma voi bao hiem y tl chit lugng kham chiia benh bao hilm nhieu han che, chua dap ling dugc nhu ciu cua doi tugng tham gia Mirc dp trg giup xa hpi thuong xuyen so voi dan so va so voi dii tugng bao trg xa hgi thip, moi chilm khoang 1,5% dan sl va 9% dien dii tugng cin dugc bao ve Hiu hit nhiing bien phap ciiu trg cua nha nuoc din cham Khi xay thien tai, tai nan cin rit nhilu thoi gian dk phan irng kip va khic phuc hau qua Nhieu truong hgp de xfiy tii vong rli moi ph^n irng, hi trg, chi dao, Luoi ASXH nuoc ta chua che phu dugc khu vuc kinh tl phi chinh thuc, day la khu vyc thu hut hang chuc tri?u lao dpng phi thong va la nguIn sinh kl cho nhimg nhom thu nhap thap, de hi ton thuong Tinh trang lam viec khong co bao hilm, khong hgp ding diln bien tai khu vyc NghlSn cAi Con ngtM s6 4(73} 2014 Ddm bdo an sinh xd hpi Cac doanh nghiep va chii su dung lao dong trin tranh, no dgng va chay i dong bao hilm xa hgi ph6 biln va keo dai nhilu nam qua Hien co toi 60% doanh nghiep cham dong bao hilm xa hpi va 30% no bao hilm xa hgi Hoat dgng cua Qiiy bao hilm xa hpi chua bin vimg, thilu minh bach, nguy co v5 quy tuong lai gan la kho hanh khoi Tiln luong tang vl sl lugng nhung tiln luong thuc tl khong tang, tham chi giam gia ca sinh hoat leo thang va siic mua ciia ding ngi te ylu di Khong the coi nhe thach thiic gia hoa dan s6, Viet Nam da chinh thiic buoc sang giai doan gia hoa dan sl tir nam 2011 Sl nguoi tir 65 tuli tro len chilm - 8% dan s6 Binh quan moi nam co 600 nghin nguoi buoc vao tuli gia Toe dp gia hoa dan s6 va ganh nang kinh te - xa h6i cua qua trinh chic chin gay ap lye len he thong ASXH va do phai co nhihig su chuin bi va ung thich hgp Ngay tir bay gio, ViSt Nam cin chuin bj cho thach thiic cua dan so gia Cac dich vu xa hpi co ban bao gim y te, giao due, nha o, nuoc sach, ma b^t ky ca nhan hay ho gia dinh nao ciing can din cugc song hang thieu ve so lugng, ylu vl chit lugng, nhat la tai khu vyc nong thon, vimg sau, viing xa, lai bi phSn tan vl nguIn lye nen viec phii hgp voi he thong ASXH khong thuc sy hieu qua Nguoi dan gap rit nhilu kho khan va rao can xin viec lam, xin hgc hay kham chiia benh Xa hgi thilu tin tuong vao chit lugng y te, giao due va viec lam hien nay, cang lam cho cac dich vu co chat lugng tro nen khan hiem, kho tiep can chi phi cao, rao can Ion Do d6, long tin ciia nguoi dan vao cac djch vu xa hgi, bao hiem y te hi giam Slit, quyin Ipi ciia nguoi dan tham gia bao hiem y te bi vi pham nghiem trpng Trong liic nhiing bien phap bao ve ciia he thong ASXH ban che tren thyc te thi nguai dan chi co the dya vao su trg giiip cua gia dinh Co che bao trg truyen th6ng thong qua sy ho trg ciia gia dinh, dong hg va cong dong m6i gap rui ro, kho khan Tuy nhien, sy bien doi ciia cac gia tri dao diic, cau tnic gia dinh, tinh trang ran nut moi quan he dong hg, mau thuan gia dinh va xung dot cong dong gia tang kha nang chia se riii ro va hi trg lan cang tra nen han che Gia tri san se trach nhiem va thyc hien cong bang xa hgi dang hi coi nhe Mo hinh bao trg xa hgi truyin thong dya vao gia dinh, than tgc va cong dong bi suy yeu nhieu chua dugc thay thi bai mot mo hinh ASXH mai, phu hgp voi xa hgi hien dai Quan diem va giai phap ve an sinh xa hoi & Viet Nam Viet Nam can dinh huong phat trien he thong ASXH toan dien voi cac chiic nSng phong ngira, giam thieu va khac phuc nii ro, huong den bao phu toan dan, bao dam miic song toi thieu, trg giiip cho cac nhom doi tugng yeu the, nhat la nguoi ngheo, ngu6i di cu, dong bao dan tpc 5.1 Quan diem i) ASXH CO vai tro khong chi don thuin la giai phap bii thuang Va khic phuc kh6 khan cho doi tugng, ma la dau tu vao phat trien nguoi Mo hinh ASXH ciia nuoc ta giai doan 10 nam tai cin thi hien ro muc tieu phat trien vi ngucri, coi trpng quyin ASXH Muc tieu co ban la nang cao che phu ASXH, bao dam cho moi ngu6i 28 NghlSn ciiu Con ngudl s64(73) 2014 Ddng Nguyen Anh dan deu co quyen tham gia va huong Igi; chia se Igi ich va nang cao trach nhiem ca nhan Mo hinh ASXH ciia Viet Nam can tro phuong tien phong tranh va bao ve timg ca nhan-truoc nhiing riii ro va sy yeu the, dong thai dap ling dugc nhiing tru cot ASXH can co ma cac quoc gia tren the gioi d6u xay dung ii) Mo hinh ASXH d nu6c ta cin huong vao muc tieu dam bao cho mgi nguoi dan co miic song trung binh, on dinh miic song, tranh khong roi vao tinh trang bin ciing hoa, ke ca hoan canh rui ro bat thuong, ban che nhung cii sic phat triln kinh tl xa hgi Mpi nguoi dan deu dugc tiep can ASXH, nhin manh nguyen tic cong bang va ben viing, lay nguoi lam trung tSm cua mo hinh iii) Chu trpng dam bao ASXH cho nhiing doi tugng yeu the, de dam bao mgi nguoi deu binh ddng vd khong bi loai trie ve ASXH Day chinh la sy thyc hien quyen ASXH da dugc Hien phap nam 2013 quy djnh Hien phap da quy dinh ro rang cong ddn co quyen dupe ddm bdo an sinh xa hoi (Dieu 34, Chuang II) Viec bao ve va ho trg cac nhom xa hgi dac thii (tre em, nien, nguai cao tuoi) dugc hien dinh mot dieu chung (Dilu 37) Viec thyc hien bao hiem y te toan dan, bao ve va cham soc siic khoe doi tugng yeu the ciing da dugc ghi ro Hien phap nam 2013 {Dieu 58) iv) Khong thi coi nhe thach thiic gia hoa dan so (binh quan mdi nam nuoc ta co 600 nghin nguoi buoc sang tuoi 60) Hau het nguoi cao tuoi dang ty tao cong an viec lam khu vyc nong nghiep vai thu nhap thap va khong on dinh K.ha n5ng tiep can cac dich vu cham soc siic khoe co chit lugng gianh cho nguoi cao tuoi thap Trong d6, tuli thg khoe manh ciia Viet Nam khong cao, trung binh mli nguai cao tuoi Viet Nam phai chju 14 nam bi benh tat ting so 72 nam sing ciia minh Cac chucmg yinh trg giiip xa hpi hien chua chii trpng nhieu den nguoi cao tuoi - doi tugng ma hau bet khong thi tham gia vao cac chucmg trinh cac quy dinh nghiem ngat hoSc miic hu6ng thip Ganh nang dan sl gia cho gia dinh va xa hpi la rat Ion 30 - 40 nam toi Ngay hi bay gi6, Viet Nam cin chuin bi cho thyc trang dan sl gia, chac chin se gay ap lye len he thing ASXH va do phai co nhiing sy chuin bj va img thich hgp 5.2, Giaiphdp i) Chinh sach ASXH phai dugc dat ngang tim voi cac chinh sach kinh te va phai dugc chii trpng uu tien phat triln ding thoi voi phat trien kinh te, phii hgp voi kha nSng nguIn lye tirng thai ky Nang cao nhan thiic va thai cua cac nha hoach dinh chinh sach cac cip va cua toan xa hgi vl cac thach thirc lien quan den van de ASXH, cin chii trpng vai tro cua cac hiep hpi, tl chiic chinh tri, xa hdi ty nguy?n hong xay dyng va tuyen truyin dh cac chinh sach va cac cbuong trinh ASXH dugc thilt kl phii hgp nhim dap img nhu ciu cu thi cua nguoi dan ii) Nha nuoc giii vai tro chu dao viec tl chirc thuc hien ASXH, nhung khong hvc tilp lam thay xa hgi, cong ding Tang cuong phan cip de de cao trach nhiem va vai tro cua CO sa, dia phuong Thu gpn diu mli va don gian hoa cac thii tuc, phan cap ngan s^ch, tang cucmg vai tro cua dia phuong viec xay dyng va thuc thi ASXH trpng tam, trpng dilm, phai kit nii hi?u qua cac chuong trinh, du an giam ngheo giira NghtSn ciiu Con ngudl s64(73} 2014 29 Ddm bdo an sinh xa hoi cac bg, ban, nganh, doan thi, va giua cac cap, tranh tinh trang manh miin, phan mang nhu hien Khuyin khich thyc hien chinh sach ASXH duoi hinh thiic xa hgi hoa Dam bao tinh bin vGng, linh hoat, tilt kiem nguon luc dl co thi ling voi dan s6 gi^ Viet Nam 30 - 40 nam toi iii) Xac dinh thing nhit va ro rang dii tugng ASXH theo mot tieu chi thing nhit (vi du a My chi dya tren thu nhap ca nhan) va diing dii tugng Ket noi hieu qua cac chuang trinh, dy an giam ngheo giira cac bg, ban, nganh, doan th8, giiia cac cap quan ly, tranh each lam dan hang ngang rit thilu hieu qua nhu hien Khac phuc tinh trang chong cheo, kho'quan ly, hi trg v6 dieu kien, lang phi nguon lye cong tac xoa doi, giam ngheo va trg giiip xa hgi 5.3 Cdc tru cot an sink xa hpi cff ban i) Bdo hiem xd hoi (bao gom ca bao hiem y te va bao hiem that nghiep) Day la phuong thirc rang huge trach nhiem ciia cac ben tham gia nham gia tang so nguoi tham gia, mo rgng doi tugng cho try cot ASXH tham gia theo huong xa hpi hoa; timg buoc thyc hien nguyen tac d6ng - huong ASXH, tranh bao cap dai tra tang cuong doi tugng yeu the Day manh cong tac tuyen truyen, bien phap luat, chinh sach, che dp ve BHXH, BHYT de can bp, dang vien va nhan dan thay ro y nghia ciia try cot ASXH quan trpng ii) Tra giup/cuu tra xd hoi la try cot thii hai nham khac phyc hau qua cua thien tai, dich benh, tham hpa, nii ro khong luong truoc hoac khong the luong truoc dugc Vi day la try cot ASXH khong co sy dong gop ciia doi tugng thu huong nen mang tinh bao cap ve nguon luc Trg c^p xa hpi cho cac doi tugng kho khan la phuong thiic kha thi dl mo rpng dp bao phu cua luoi ASXH Dong thai, thyc hien uu dai nguoi co cong va trg giiip cac doi tugng chinh sach la mot ngi dung chu ylu ciia hgp phin ASXH Tuy nhien, viec nang cao vai tro cong dong va trach nhiem ciia dia phuong viec thyc hien chinh sach trg giiip cac doi tugng bao trg xa hpi, dii tugng chinh sach la rit cin thilt Tang cuong he thong trg giiip xa hgi cung voi tang truong kinh tl nhim bao dam va nang cao thu nhap cho nguoi dan thong qua tao viec lam va sinh kl iii) Cung cap hieu qua cac dich vu xa hoi tren co so nang cao chat lugng dich vu va kha nang tiep can cho nguai dan Muc tieu chinh ciia mot mo hinh ASXH nang dpng la phat trien dich vu xa hpi ben virng va de tiep can, khong chi bao gIm djch vu bao trg ma cac bien phap phong tranh riii ro va hoa nhap cong ding tit hon Do bo cac rao can hien khien cho chinh sach xa hpi khong din dugc voi nguoi dan Dilu giiip giam dugc chi phi quan ly, ap dung mpt co che quan ly chung cho cac loai hinh dich vy xa hpi CO ban, don gian hoa cac thii tuc hanh chinh, huong toi he thing cung cip dich vu dong bp hem, hoat dpng hieu qua hon Xay dyng va sir dung hieu qua mo Hinh Quy bao trg a cong dong de tao su chu dgng cho cac dja phuong xay rui ro, day cung la yeu cau rat cap thiet nham dam bao ASXH Giai quyet tot ban hieu qua cua cac chinh sach hien tai ve ASXH o cong ding Ve Ip trinh trien khai thuc hien mo hinh ASXH, c6 the chia giai doan nhu sau: 30 NghiSn cUU Con ngudl s64(73) 2014 Dgng Nguyen Anh - Giai doan 1: Cai each mo hinh va cung co he thong voi su dilu chinh linh hoat cac nguon luc va sy tham gia rpng rai ciia cac chu the he thing ASXH Da dang hoa cac nguon tai chinh, nang cao chat lugng dich vu va cong tac thyc hien cac che do, chinh sach BHXH, BHYT Xac dinh diing dii tugng ASXH, dii tugng trg giiip xa hgi Ap dung cong nghe thong tin nham quan ly hieu qua che trg cap, van hanh cua cac quy bao hiem, quan ly nguon luc hgp ly hon va giam sat hieu qua chit lugng boat dpng ASXH - Giai doan 2: Giam dan sy bao cap cua Nha nuoc va tang cuong su dong gop ciia nguoi tham gia de huong den viec can doi ben viing qiiy Day ciing la giai doan tiep can cac chuan myc quoc te ve ASXH Tap trung phat trien cac try cot chinh cua mo hinh ASXH moi quan he gan ket voi nhau, bao gIm chinh sach trg giup xa hgi nham dam bao miic song, thu nhap toi thieu cho nguoi dan, chinh sach BHXH va bao hiem y te cho mpi doi tugng, chu dgng ung voi nhung tac dpng ciia thi truong va bien doi xS hgi Day la nhiing dinh huong phat trien chinh cua mo hinh ASXH a Viet Nam den nam 2020, tam nhin den nam 2030 Tki li^u tham khao Dang Nguyen Anh va cong sy (2013), "An sinh xa hpi a Viet Nam: Djnh huong mo hinh va giai phap", Bao cao ting hgp Nhiem vu nghien ciru cap Bp nam 2011-2013, Vien Han lam Khoa hpc Xa hpi Viet Nam Mai Ngpc Anh (2009), "An sinh xa hpi dii vcri nong dan dieu kien kinh tl thi tnrcmg a Vi?t Nam", Luan an Tiln sT Kinh tl, Dai hpc Kinh tl Quoc dan Ha Ngi D|ng Kim Chung (2010), "He thing chinh sach an sinh xa hgi a Viet Nam: thyc trang va giai phap", Tham lu^n Hpi thao: "Chinh sach, phap luat ve an sinh xa hpi a Viet Nam hi?n nay", Uy ban ve Cac vin dl xa hpi ciia Qulc hoi Ha Ngi Mai Nggc Cuong (2009), Xdy dung vd hoan thien he thing chinh sach an sinh xa hpi a Vi4t Nam, Nxb Chinh trj Qulc gia Ha Npi Nguyin Hifu Dung (2008), "Phat triln kinh tl thj truang dinh huong xa hgi chii nghia va thyc hi?n chinh sach an sinh xa hgi niroc ta" Tap chi Cong san, Sl 155 Vu Van Phuc (2012), "An sinh xa hgi o nirac ta: mot so van de ly luan va thirc tien", Tham luan Hgi thao ciia Hpi ding Ly luan Trung irong ve An sinh xa hpi Ha Ngi, thang 3/2012 Nguyin Danh San (2011), "An sinh xa hgi cho ngirai nong dan", Tham luan tai Hgi thao khoa hgc cua Vi?n Khoa hgc Xa hpi Vi^t Nam va Vien KAS, CHLB Diic, Ha Ngi Vi^n Khoa hpc Lao dpng va Xa hpi (2009), "Chien luge an sinh xa hpi Viet Nam thai ky 2011 - 2020", T9P chi Lao dpng vd Xd hgi, S6 19 NghiSn ciAi Con ngiM s64(T3} 2014 31 ... truang dinh huong xa hgi chii nghia va thyc hi?n chinh sach an sinh xa hgi niroc ta" Tap chi Cong san, Sl 155 Vu Van Phuc (2012), "An sinh xa hgi o nirac ta: mot so van de ly luan va thirc tien",... la nguIn sinh kl cho nhimg nhom thu nhap thap, de hi ton thuong Tinh trang lam viec khong co bao hilm, khong hgp ding diln bien tai khu vyc NghlSn cAi Con ngtM s6 4(73} 2014 Ddm bdo an sinh xd... lan cang tra nen han che Gia tri san se trach nhiem va thyc hien cong bang xa hgi dang hi coi nhe Mo hinh bao trg xa hgi truyin thong dya vao gia dinh, than tgc va cong dong bi suy yeu nhieu chua