DIEN DAN LY LUAN :.;»!; NHRN THirC V€ Xfl HOI HOR HOni DONG Gino DUC, V Tc'd mdc rn HICN NRV • • • • TS NGUYfeN MINH PHUONG'*' X a hdi hda eae boat ddng giao dye, y tl la mdt ehu truong ldn efla Dang va Nha nude ta, bude dau da dat duge nhirng ket qua nhat djnh vile huy ddng eae ngudn lye xa hgi dap ung nhu eau cang tang cfla cae tang Idp nhan dan Tuy nhiln, tbyc te linh vyc van cdn nhieu ban ehe, vudng mac ma mdt nhung nguyen nhan co ban va quan trgng la nhan thflc ve xa hgi hda edn ehua thdng nhat, thdng sudt d eac cap, eae nganh eung nhu toan xa hgi nguyen nghTa tieng Anh, "socialization" thudng dugc dimg theo nghTa "tap thi hda", "dat dudi che cdng ddng", "quan ly hay dieu khien (cfla nha nudc) nhan danh xa hgi" tflc la nhung gi duge xa hdi hda thi phai duge ebinh phfl eung cap miln phf Chang ban, "socialized medicine" hay la "y te (dugc) xa hdi hda" cd nghia la sy cham sde y tl duge chfnb phfl cung cap miln phf cho ngudi dan^^l Thic hai, xa hgi boa duge sfl dyng de chi sy tang eudng chfl y quan tam, sy tham gia Cho den nay, ve ndi ham khai niem xa hdi rgng rai cfla xa hgi (eae ea nhan, nhdm, td boa d nude ta edn nhieu quan niem khac chfle, egng ddng ) vl ea vat ehdt va tinh nhau, tham cbi trai nguge Ve eo ban, than vao mgt sd boat dgng ma trude dd ehi xa bdi hda duge sfl dung vdi hai nghTa ehinh duge mgt don vi, mdt bg phan hay mdt Thii nhdt, xa hdi boa duge dinh nghTa la nganb chflc nang nhdt dinh thye hien; la "lam eho trd tbanb chung cfla xa hgi"^'\ mdt phuang cham banh dgng efla eac cdp, Quan niem xuat phat tfl lich sfl phat eae nganb, eac td chfle xa hdi, tfl vi md din trien san xuat efla nhan loai, xa bdi boa vT md nham phat huy ndi lue, huy ddng chinh la qua trinh chuyen biln tfl mgt nen edng ddng, hay huy ddng vdn xa hgi tfl san xuat ed tinh chat ca nhan, tu hiru sang nhan dan, theo eo ehe: Dang lanh dao, Nha mdt nin san xuat mang tinh ehdt cdng nude quan ly, nhan dan lam chfl; Nha nudc cgng, cdng bun Cung chinh tfl dd, theo va nhan dan cflng lam Theo dd, ndi dung cfla xa hdi bda giao dye duge giai thfch la: '*' Vien Khoa hoc t6 chirc nha nuoc, Bo Npi vy "Phat triln giao due la sy nghiep efla Nha LY L U A N C H I N H TR! 10-2010 87 nudc va toan dan; Nha nudc gifl vai trd chfl dao phat trien sy nghiep giao dye; Da dang bda eac loai binh trudng va binh thflc giao dye; Khuyen khich, huy dgng va tao dilu kien dl td chflc, ca nhan tham gia phat triln giao dye; Mgi to chflc, gia dinh va edng dan cd trach nhilm cham lo sy nghiep giao due"'''' Theo each tilp can nay, nhilu ngudi cho rdng, "xa hgi bda giao due cd nghTa la nha nudc phai tao khdng gian xa hgi, luat phap va cbinh tri cho viec hinh tbanb mdt khu vyc giao dye ma d day cflng cd quyen ddng gdp vi sy nghiep giao due, tbyc bien sy canh tranh ve chat lugng giao dye, tflc la giao dye phai thugc vl xa hgi"^''^; bay diin dat each khac la: "xa hgi hda giao dye trudc bet phai la xa hdi hda khdng gian va quyin tham gia giao dye, quan ly nha trudng, thiet ke chuong trinh va trien khai cac boat dgng giao dye cfla tat ca cac tbanb phan xa bgi"*^\ Ddng thdi, "xa bdi hda giao dye khdng cd nghTa la nha nudc chuyen giao hay phd thac nhiem vy hien djnh cfla minh cho eae ca nhan, td chflc, doanh nghiep, ma la tao dilu kien de toan xa bdi tham gia vao giao dye, cho nd dap flng tdt rrbat nhu cau cfla mgi tbanb viln xa hgi, cho cung duge din tmdng, cung cd dilu kiln hudng co hgi vao ddi nhu nhau"*^^ Nhu vay, cd the hieu quan niem xd hgi hod gido due, y ti Id qud trinh huy dong su tham gia dudi cdc hinh thicc khdc ciia cdc chil the vd egng ddng xd hgi, ddng thai tdng cudng vai trd eiia Nhd nudc ddi vdi gido due, y ti nhdm ndng eao chdt lugng vd mo rgng doi tugng thu hudng, gop phdn thuc hien cong bdng xd hgi ddng gdp vd thu hu&ng cdc dich vu gido due, y te 88 Nbung phan tieh tren cho thdy khai niem xa bdi bda giao due, y tl d Viet Nam mang mgt y nghTa khac bdn so vdi khai niem "socialization/socialize" cfla cae nudc phuang Tay "Xa hgi bda giao dye d Viet Nam la mdt each tilp can, mgt each thflc dugc ap dyng dl giai quylt nhftng vdn de dac thfl cfla rieng giao due Viet Nam"^^\ Giao dye, y te Viet Nam vdn la cac dich vy xa hgi Nha nude dam bao hoan toan va chilm vai trd ddc tdn viec td chflc cung flng sudt ca mgt thdi ky kha dai tbyc bien md binh quan ly kinh tl - xa hgi dat nudc theo CO che tap trung, bao cap va cbi kbi bat dau cdng cugc ddi mdi, dat nudc chuyen sang phat trien theo eo ebl kinh t l nhilu tbanb phan, cae djeh vy xa bdi mdi dugc xa hgi hda, tflc la ed sy tham gia efla xa hdi va cac td chflc ea nhan Dilu dd khac ban vdi cac nudc phuong Tay la noi ma giao dye, y te tu nhan xuat bien dau tiln sau dd mdi binh tbanb eac hinh thflc td chflc efla nha nude Vdi bam nghTa nhu vay nen cd y kiln cho rang, djch thuat ngfl "xa bdi bda" tieng nudc ngoai, chang ban tieng Phap, phai chuyin tbanb "mobilisation", tflc la dgng vien, ldi cudn chfl khdng the djch la "sociahsatian"^^\ ,, ,,.,, ),,., , Tbyc te hien d nudc ta xay tinh trang mgt sd nha nghien efln, xuat phat tfl quan nilm xa hgi hda theo nghTa thfl nhat, khdng tan tbanb, tham chi phan ddi viee sfl dyng xa bdi hda theo nghTa thfl bai, "trong xa bdi bgc, xa bdi hda khae ban ve nghTa vdi "xa hgi hda" dang bi lam dyng sach bao thdng thudng Tbyc chdt "xa bdi hda" tren cac phuong tien thdng tin dai chflng nghTa la "tu nhan bda"; va day la sy danh trao khai niem, hay khdng dam ggi sy LY LUAN CHINH TR! 10 - 2010 vat bdng chinh ten cfla nd"^^' Hay tmdng hgp khac la dya vao nguyen nghia cfla tfl "xa hdi hda" va can cfl vao mgt sd bien tugng lech lac, biln tudng, nhan danh xa hdi hda de kinh doanh kiem lgi qua trinh cung flng djch vu xa hdi, cd y kiln cho rang cym tfl "xa hgi hda" d Viet Nam "cang cang bj sfl dyng mgt each than nhien theo nghTa ngugc lai - theo nghTa day ganh nang tai ebinh len vai edng dan, va trao cho tu nhan dam nhilm mdt sd ITnh vyc thudc bdn phan nha nudc phai quan ly, dac biet la giao dye, dao tao"^"'l Tbyc hien cdng cugc ddi mdi dat nudc, kinh te bude dau cd bude phat trien, song nhieu van de xa bdi, dd ed giao dye, y te dat nhieu van dl bflc xflc can giai quyet Trude tinh binh dd Dang va Nha nudc da ed nhilu chfl truang, cbinb sach ldn phat trien sy nghiep giao due, y te, mdt nhiing chfl truang dd la tbyc hiln xa hgi boa cac boat ddng giao dye, y te Mae dfl chua sfl dyng khai niem xa hdi hda, nhung Chiin luge dn dinh vd phdt then kinh te - xd hgi den ndm 2000 duge thdng qua tai Dai hdi VII efla Dang da khdi xudng tu tudng khai thdc mgi tiem ndng cita todn xd hgi tham gia phdt trien gido due vd ddo tgo Nghi quyet sd 04NQ/HNTW (khda VII) 14-1-1993 da chfnb thfle de xuat chfl tmong "da dang boa cac hinh thflc dao tao", "cham sde sfle khoe ngudi dan la traeh nhiem efla toan xa hdi va phuong ebam "Nha nudc va nhan dan cflng lam", da dang boa cac binh thflc td chfle cham sdc sflc khoe dd y te nha nude la chfl dao, tan dung mgi tilm nang sEn cd nudc va md rdng hgp tac qude tl LY LUAN CHINH TR! 10-2010 Chfl truong xa hdi bda giao dye, y te tilp tyc duge Nghi quyet Dai hgi VIII, IX cfla Dang lam rd ban: xa hgi bda cdng tac giao dye la buy dgng toan xa bdi lam giao dye, dgng vien eae tang lap nhan dan gdp sflc xay dung nen giao dye qude dan dudi sy quan ly cfla Nha nudc; cae cbinb sach xa hgi dugc tien banh theo tinh than xa hgi boa, dl eao trach nhiem efla chinh quyen cae cap, buy dgng cac ngudn lye nhan dan va sy tham gia cfla cac doan the nhan dan, eac td chflc xa bdi Nghi quyet Dai hgi X khang djnh Nha nudc tiep tyc tang ngudn lye, dau tu tap trung cho eac chuang trinh muc tieu qude gia ve giao dye, y tl ddng thai phat buy tri tue va cac ngudn lye vat chat nhan dan, cfla toan xa hdi dl cflng Nha nudc giai quyet cac van de xa hgi va cham lo phat triln cac ITnh vyc djch vy cdng cgng Dy thao cae Van kiln trinh Dai hdi XI cfla Dang tiep tyc neu yeu eau hoan thien CO che, ebinh sach xa hgi hda giao dye, dao tao tren ca phuang dien: ddng vien cae ngudn Iyc xa bdi; phat buy vai trd giam sat cfla cdng ddng; khuyen khfeh eae boat ddng khuyen hge, khuyen tai, xay dyng xa hgi hge tap, tao dieu kien dl ngudi dan dugc hge tap sudt ddi; tang dau tu nha nudc ddng thdi vdi day manh xa hgi hda cae boat dgng y te Tren co sd quan diem efla Dang, eae eo quan nha nude da ban banh cae chfl truang, chfnh sach day manh xa hgi hda eae boat ddng giao dye va y te Nghj quylt sd 90/CP 21-8-1997 efla Chfnh phfl vl phuang hudng va chfl truong xa bdi boa cac boat ddng giao dye, y te va van boa da nlu rd cac ngi dung xa hgi bda Theo dd, "xa bdi 89 boa cac boat dgng giao dye, y te, van boa la van dgng va td chflc sy tham gia rgng rai cfla nhan dan, cfla toan xa bdi vao sy phat triln cac sy nghiep dd nhdm tflng bude nang cao mflc hudng thy vl giao dye, y te, van boa va sy phat triln ve thi chat va tinh thdn cfla nhan dan Xa hgi boa la xay dung cgng ddng trach nhiem cfla cac tang Idp nhan dan ddi vdi viec tao lap va cai thien mdi trudng kinh tl, xa hgi lanh manh va thuan lgi cho cae boat dgng giao dye, y te, van hoa d mdi dja phuang, day la egng ddng trach nhiem cfla Dang bg, Hgi ddng nhan dan, Uy ban nhan dan, cac doan tbi qudn chflng, cac td chflc kinh te, cac doanh nghiep ddng tai dja phuang va cfla tflng ngudi dan " Tren co sd danh gia kit qua tbyc bien xa hgi bda giao dye, y tl, van bda va the due thi thao sau nam tbyc hien Nghj quylt sd 90/CP, Nghj quylt cfla Chinh phfl sd 05/NQ-CP 18-4-2005 ve Ddy mgnh xd hgi hod cdc hogt dgng gido due, y te, vdn hoa vd the due the thao da dl quan dilm, djnb hudng phat trien xa hgi boa cac ITnb vyc giao dye, y tl, van hda, thi dye the thao cung nhu cac giai phap va CO chi cbinb sach ldn Cac djnh hudng day manh xa hgi hda chfl ylu dugc xae djnh la: 1) Nha nudc ddi mdi co ehe chinh sach, ddi mdi phuang thflc co cau dau tu; 2) Chuyen cac CO sd cdng lap dang boat dgng theo co ebl sy nghiep mang nang tinh hanh cbinb bao cap sang co che ty chfl; 3) Phat trien manh cac co sd ngoai cdng lap vdi bai loai binh dan lap va tu nhan; 4)Tang cudng boat dgng tbanb tra, kiem tra Nbung ngi dung co ban cfla xa hgi bda boat dgng giao due, y te bien d nudc ta la: 90 Thic nhdt, xa bdi bda boat ddng giao dye, y tl la buy dgng va khai thac cac ngudn lye xa hgi dl da dang hda eae binh thfle cung ung dich vu giao due, dao tao va cham sdc sflc khde; van dgng toan dan quan tam cham sdc tbi he tre, tao mdi trudng giao dye lanh manh, ty giac ren luyen than the, phdng chong djch benh, gift gin ve sinh, bao ve mdi trudng , vfla tao dieu kien de md rgng doi tugng thy hudng djch vy giao dye, y tl, dac biet la eae ddi tugng cbinb sach, ngudi ngheo, vfla gdp phdn dam bao edng bang xa hgi ddng gdp va thy hudng cac djch vy giao dye, dao tao va cham sde sue khde Dudi gdc khai thac, phat huy ngudn lye, xa hgi boa cac boat dgng giao dye, y te la nhdm khoi day va buy dgng cac tiem nang vl nhan lye, vat lye, tai lye xa hgi, xay dyng cgng ddng trach nhilm viec ddng gdp va cbi tra cho eae djch vy giao dye, y tl; tao lap eac quy khuyen hgc, quy trg giflp bgc phi, vien phi cho bgc sinh, sinh viln, ngudi thdt nghiep, ngudi ngheo , va tbyc biln bao hiem y tl toan dan; khai thac cd bilu qua ngudn lye cfla cae ddi tac nudc ngoai, td chflc qude tl Dudi gde cfla ngudi thy budng djch vu, xa hgi bda boat dgng giao dye, y te phai tao dilu kiln dl cho hg duge tham gia vao vile quan ly cac boat ddng giao due, y te cung nhu xay dyng co che, cbinb sach, giam sat viec cung flng va lya chgn djch vu giao dye, y tl nham tao ngudn lye cd chdt lugng cao ve tri tue, ky nang va sfle khde dap flng yeu cdu cfla xa bdi Dudi gdc cfla ngudi tryc tilp cung flng djch vy, ddi ngu viln chflc giao dye, dao tao va y tl dugc dam bao quyin ty boat ddng nghe nghiep theo quy djnb LY LUAN CHINH TR! 10 - 2010 cua phap luat; dugc phat huy mgi kha nang sang tao nham da dang hda cac binh thflc cung img djch vy nhu cdng lap, ngoai cdng lap, cbinb quy, khdng chinh quy, bd tuc, tai chflc, tfl xa (doi vdi giao due, dao tao); nha nudc, tap thi, dan lap, tu nhan (ddi vdi y te), gdp phan thda man nhu cau da dang, phong phfl va cang cao cfla cac tang Idp nhan dan Thic hai, xa hgi boa boat dgng giao due, y tl ddng thdi tang cudng vai trd efla Nha nudc viec dam bao td chflc va cung flng cac dich vy giao dye, y tl nhdm nang cao bilu qua va chat lugng phyc vy ngudi dan tdt ban Day manh xa bdi bda cac boat dgng giao dye, y te la mgt phuong thflc phat trien sy nghiep giao dye, y te cfla Dang va Nha nudc ta dilu kien phat triln kinh te thj trudng, xay dyng, hoan thien nha nudc phap quyin xa hdi hdi chfl nghTa, chfl khdng don thuan la tang ddng gdp cfla dan de giam bdt ganh nang ngan sach cfla Nha nudc hoac ban ebl vai trd efla Nha nudc Xuat phat tfl vai trd va dac diem cfla cac djch vy giao dye, y te, Nha nude khdng cbi chiu trach nhiem ban hanh cac co cbi, cbinb sach va quy djnh nhirng tilu chuan, djnh mfle, chat lugng, gia, phf djch vy giao dye, y te, ma phai dam bao vile eung flng eac djch vy giao dye, y te ca ban nhu giao dye phd cap, cham sdc sflc khde ban dau, phdng chdng djch benh dap flng nhu cau CO ban, thiet yeu cfla xa hgi Do dd, xa boi hda giao due va y tl ddi bdi vfla khai thac, phat buy, sfl dung cd bieu qua cac ngudn luc xa hgi, ddng thdi tiep tuc tang them va sfl dung cd bieu qua ngan sach Nha nudc dau tu cho ITnh vyc giao dye va y tl; tang cudng trach nhiem tra, kilm LY LUAN CHINH TR! 10-2010 tra cfla cac co quan nha nudc nham khac phuc nhung ban che, ylu kem, tilu eye cfla giao dye, y te, gdp phan nang cao chat lugng djch vy giao dye, y te dap flng tdt ban nhu cau cfla cac tang lap nhan dan Thic ba, day manh va phat trien xa hgi hda giao dye, y tl phai gan lien vdi doi mdi CO ebl, cbinb sach quan ly giao dye, y tl tao dugc mgt khdng gian xa hgi, luat phap va chinh trj lanh manh de phat trien cac djch vy giao due, y te Ddi mdi myc tieu, phuang thflc, co cau va ngudn vdn dau tu cfla Nha nudc theo budng tap trung cho cac muc tilu uu tiln, cac chuong trinh qude gia; bd trg cac vflng sau, vflng xa, vflng ddng bao dan tgc it ngudi; uu dai eac ddi tugng chinh sach va trg giflp ngudi ngheo tren co sd ddi mdi che mien, giam phi theo budng cdng khai, hgp ly va cap tryc tiep cho ddi tugng thy hudng Chuyen manh cac co sd giao due, y tl cdng lap dang boat ddng theo co che sy nghiep mang nang tinh banh chinh bao cap sang CO che ty chfl, ty chju trach nhiem; chuyin mgt sd co sd cung flng djch vy cdng lap sang loai hinh don vj ty trang trai hoac tu tbyc; khuyen khich cac td chflc, ca nhan gdp vdn dau tu phat trien eac co sd djch vy giao dye, y tl; tao dieu kiln cho cac CO sd giao dye, y te ngoai cdng lap dugc tbanb lap, phat triln ca vl quy md va chat lugng Xay dyng co che de ngudi thy budng djch vy dugc lya chgn co sd djch vy, khdng phan bilt edng lap bay ngoai edng lap nham tao mdi trudng canh tranh lanh manh gifla cae loai binh co sd cung flng djch vy Xae djnh he thdng tilu chuan, djnb mflc chat lugng, khung gia, phi cfla cac loai djch vy Ra soat cae djnh mflc kinh te ky thuat de nghien cflu sfla ddi bd sung 91 mdt sd tieu chuan, djnh mflc ITnb vyc sy nghiep giao dye, y te lam can cfl eho eac don vi sy nghiep tbyc bien quyin ty chfl, ty chju trach nhiem Tang eudng boat ddng tra, kilm tra cfla cac co quan nha nudc, xfl ly kjp thdi va nghiem minh eac trudng hgp vi pham nham dam bao sd lugng, chat lugng cac djch vu giao due, y te cung cap cho ngudi dan Nghien cflu ban hanh Quy che giam sat va phan biln xa hgi tao dieu kien phat buy vai trd cfla eae doan the, td chflc quan chflng, dac bilt la cac hgi nghe nghiep vile tham gia tu van, phan biln, giam djnh xa hgi cac chfl truang chinh sach phap luat liln quan din phat trien giao dye, y te cfla dat nudc Ddng thdi, khuyin khich ngudi dan va cac td chflc xa hgi tham gia giam sat cae boat ddng chuyen mdn, nham nang cao chat lugng dich vy giao dye, y te NANG CAO CHAT LfdNG CONG TAC TlTTI/dNG^ {Tiep theo trang 70) cai cu va cai mdi Cai eu mdt di, eai mdi chua binh dan din sy byt bing ddi sdng van boa va be qua thudng la ddi sdng van boa efla nhan dan bi suy kiet va trd nen ngheo nan Do vay, nhieu gia tri tmyln thdng va gia trj di san van boa quy bau da va dang bj mat di nbanb ehdng, tham cbi, ngd nhan dan den tinh trang chfl nhan cfla nd quay lung lai chdi bd cai vdn ed ve van boa cfla dan tgc minh Trin binh dien xa hdi, nhieu ehuan mye dao dfle va flng xfl gan vdi xa hgi ed tmyen da ldi thai va mat di, nbung eae chuan myc flng xfl cfla xa bdi mdi lai chua djnh binh khiln quan he xa bdi nhiing gia trj dao dfle dl bj lech chuan (1) Vien Ngon ngii hoc: Tir dien Tieng Viet, Tmng tam tir diln hoc, NXB Da Ning, 2002 Sdu la, phdi hgp chae ehe cae binh (2),(10) GS Bill Trong Lieu: NhOng ky di ddng chflng efla edng tae tu tudng (ddi ngfl bao sau cum tic "xd hgi hoa " gido due, VietNamnet cao viln, tuyen tmyln vien; ddi ngu van 22-7-2007 (3) Nhieng ngi dung m&i ciia Ludt Gido due ndmnghe sT; dgi ngfl phdng vien, biln tap viln ); buy ddng ea he thong chinh trj 2005, NXB Tu phap, Ha Noi, 2005, tr.68-69 (4) Nguyin Trdn Bat: Suy tu&ng, NXB Hoi Nha nham phat buy sflc mamb tdng hgp dl tbyc van, 2005, tr.475 bien thang lgi myc tieu: Tay Nguyin hgi (5) Giap Van Duong: Bdn chdt xd hgi hoa gido nhap va phat trien due Tap chi Tia sdng so 5/2010, tr.l5 Bdy la, tiep tyc bd sung, hoan thien chi (6) Theo GS, TS Nguyin Van Nam: do, chinh sach dai ngd de thu bflt, ddng VietNamnet 26-7-2007 vien nhirng ngudi cd trinh do, nang lye ndi (7) PGS, TS Nguyen Loc: Bai tham gia Diin va vilt ve cdng tac d cac ban tuyen giao dan VietNamnet: "Xa hoi hoa": dang bi lam cac cdp; dau m nang cdp co sd vat chdt, dung? VietNamnet 26-7-2007 (8) Xem GS,TS Pham Tdt Dong: Xd hgi hoa phuong tien tae ngbilp theo budng hien dai, tao dieu kien thuan lgi dl dgi ngfl linh vice gido due vd ddo tgo & Viet Nam (9) Mai Huy Bich: Xd hgi hgc gia dinh, NXB nbung ngudi lam cdng tac tu tudng hoan chflc trach cfla minh Chinh trj Qu6c gia Ha Noi, 2003, tr.210 92 LY LUAN CHINH TRI 10-2010 ... cac tiem nang vl nhan lye, vat lye, tai lye xa hgi, xay dyng cgng ddng trach nhilm viec ddng gdp va cbi tra cho eae djch vy giao dye, y tl; tao lap eac quy khuyen hgc, quy trg giflp bgc phi, vien... cfla cdng ddng; khuyen khfeh eae boat ddng khuyen hge, khuyen tai, xay dyng xa hgi hge tap, tao dieu kien dl ngudi dan dugc hge tap sudt ddi; tang dau tu nha nudc ddng thdi vdi day manh xa hgi hda... ky thuat de nghien cflu sfla ddi bd sung 91 mdt sd tieu chuan, djnh mflc ITnb vyc sy nghiep giao dye, y te lam can cfl eho eac don vi sy nghiep tbyc bien quyin ty chfl, ty chju trach nhiem Tang