Đẩy mạnh thực hiện chính sách bảo hiểm y tế toàn dân đến năm 2020 trên địa bàn tỉnh hà tĩnh (tt)

MỤC LỤC tttttttt LỜI CAM ĐOAN tttttttt tttttttt DANH MỤC CÁC CHỮ VIẾT TẮT tttttttt tttttttt tttttttt tttttttt tttttttt DANH MỤC CÁC BẢNG BIỂU tttttttt tttttttt tttttttt ttttttt DANH MỤC SƠ ĐỒ, BIỂU ĐỒ tttttttt tttttttt tttttttt tttttttt tttttttt TÓM TẮT LUẬN VĂN tttttttt tttttttt tttttttt LỜI MỞ ĐẦU tttttttt t ttttt t tttttttt CHƢƠNG 1: KHUNG LÝ THUYẾT VỀ THỰC HIỆN CHÍNH SÁCH BẢO t ttttt t 1ttttt ttt ttt ttttt tttt tttt ttt tttt t ttt ttttt ttt tttt t t tttt tt ttt tttt t t ttttt t 1ttttt ttt HIỂM Y TẾ TOÀN DÂN 11 1ttttt ttt tttt tttt tttt tttt ttttt ttt 1.1 Khái quát chung sách Bảo hiểm y tế toàn dân 11 t ttttt t tttt tttt t tttt tt 1ttttt ttt ttttt ttt ttt ttttt 1ttttt ttt t ttttt t ttttt ttt ttt ttttt t tttt tt ttt ttttt 1.1.1 Sơ lƣợc đời phát triển sách Bảo hiểm y tế 11 1tttttt tt 1ttttt ttt ttt tttt t 1tttttt tt t ttttt t t tttt tt ttt ttttt ttttt ttt 1tttttt tt ttttt ttt t tttt tt ttt ttttt 1tttttt tt tttt tttt 1.1.2 Đặc điểm, mục tiêu, ngun tắc vai trị sách Bảo tt ttt ttt t tt ttt tt 1tttttt tt ttttt ttt ttt tttt t tttt tttt 1ttttt ttt ttttttt t tttt tttt 1ttttt ttt ttt ttttt 1tttttt tt ttttt ttt tttt tttt 1tt ttttt t hiểm y tế toàn dân .12 tttttttt t ttttt t tttt tttt 1.1.3 Triển khai sách Bảo hiểm y tế toàn dân .14 tttt tttt 1.2 tttttt tt tttt tttt 1tttttt tt ttt ttttt 1tttttt tt tttt tttt t ttttt t tttt tttt Nội dung sách Bảo hiểm y tế tồn dân 17 ttttttt t ttttt ttt ttt ttttt 1ttttt ttt t ttttt t ttttt ttt ttt tttt t 1tttttt tt ttt ttttt 1.2.1 Xây dựng kế hoạch thực sách 20 ttt ttttt ttttt ttt 1tttttt tt ttttt ttt tttt tttt tttt tttt 1ttttt ttt tttt tttt 1.2.2.Phổ biến, tuyên truyền sách 21 ttttt ttt t ttttt t 1tttttt tt 1ttttt ttt tttt tttt 1.2.3 Phân công, phối hợp thực sách .23 tttt tttt t ttttt t 1tttttt tt ttt ttttt tttt tttt tttt tttt 1tttttt tt tttt tttt 1.2.4 Duy trì sách 25 tttt tttt 1tttttt tt ttttt ttt tttt tttt 1.2.5 Điều chỉnh sách 25 tttt tttt t ttttt t 1ttttt ttt tttt tttt 1.2.6 Theo dõi, kiểm tra, tra thực sách 26 tttt tttt t ttttt t tttttttt tttttt tt t ttttt t 1ttttt ttt ttttt ttt ttttt ttt t tttt tt ttttt ttt 1.2.7 Đánh giá, tổng kết, rút kinh nghiệm 27 tttt tttt ttt tttt t tttttttt 1tttttt tt t ttttt t t ttttt t tttt tttt 1.3 Các tiêu chí đánh giá kết thực sách Bảo hiểm y tế toàn dân ttttt ttt 1tttttt tt ttttttt t ttttttt t ttttt ttt tttttttt ttttt ttt 1ttttt ttt ttttt ttt t tttt tt ttttt ttt t ttttt t ttt ttttt tttttt tt tttttttt ttt tttt t tttt tttt .27 1.4 Các yếu tố ảnh hƣởng đến việc thực sách Bảo hiểm y tế tồn tttt ttt t t tttt tt tttt tttt tttt tttt t ttttt t 1tttttt tt tttt tttt ttttttt t ttt ttttt t tttt tt t tttt tt ttttt ttt tttt tttt tttt tttt tttt tttt tttt tttt dân .30 1.4.1.Năng lực quản lý nhà nƣớc 30 t tttt tt tttt tttt t ttttt t tttttt tt t ttttt t 1.4.2.Hệ thống tổ chức, thực 31 ttt ttttt t ttttt t 1tttttt tt t tttt tt 1tttttt tt 1tt ttttt t 1.4.3.Mức đóng, mức hỗ trợ 34 ttt ttttt t ttttt t t tttt tt 1tttttt tt 1.4.4.Phạm vi quyền lợi, mức hƣởng 35 t ttttt t tttttt tt ttttt ttt tttttt tt 1ttttt ttt 1.4.5.Phƣơng thức toán 36 ttt tttt t t ttttt t 1tttttt tt 1.4.6 Tổ chức cung ứng dịch vụ y tế 36 tttt tttt tttt tttt tttt tttt t ttttt t 1tttttt tt ttt tttt t t ttttt t ttttt ttt 1.4.7.Sự hiểu biết ngƣời dân 37 1ttttt ttt ttt tttt t tttttttt tttt tttt 1tttttt tt 1.5 Kinh nghiệm triển khai sách Bảo hiểm y tếtoàn dân .37 t ttttt t ttttt ttt 1tttttt tt ttt ttttt ttttt ttt tttt tttt 1ttttt ttt t ttttt t ttttt ttt ttt ttttt t ttttt t 1.5.1 Kinh nghiệm triển khai 37 tttt tttt t ttttt t ttt ttttt ttttt ttt 1.5.2 Bài học rút 39 tttt tttt t ttttt t ttttt ttt 1tttttt tt 1tttttt tt CHƢƠNG 2: THỰC TRẠNG TRIỂN KHAI CHÍNH SÁCH BẢO HIỂM Y TẾ tttttt tt tttttttt t ttttt t tttttttt ttt tttt t tttttttt 1tttttt tt ttttt ttt tttttttt ttt ttttt ttttt ttt tttt tttt TẠI TỈNH HÀ TĨNH .40 ttttttt t t tttt tt t ttttt t 2.1.Tổ chức hệ thống Bảo hiểm y tế tỉnh Hà Tĩnh 40 1ttttt ttt 1ttttt ttt ttttt ttt tttt tttt ttttt ttt ttt ttttt tttttt tt tttt tttt tttt tttt 1ttttt ttt 1ttttt ttt 2.1.1 Khái quát hình thành phát triển 40 1 ttt ttttt tttttt tt ttt ttttt ttttt ttt t ttttt t 1ttttt ttt ttttt ttt t ttttt t 2.1.2 Chức năng, nhiệm vụ quyền hạn 41 t tttt t ttttt t ttt ttttt 1tttttt tt 1tttttt tt 1ttttt ttt ttttt ttt tttt tttt 2.1.3 Bộ máy tổ chức hoạt động .42 t ttttt t ttttt ttt ttttt ttt ttttttt t 1tttttt tt 1tttttt tt ttt tttt t 2.2 Thực trạng triển khai sách Bảo hiểm y tế tồn dân tỉnh Hà Tĩnh tttt tttt ttttt ttt tttt tttt tttttttt tttttttt tttt tttt tttttt tt tttttttt ttttttt t tttttttt ttttt ttt ttt ttttt tttttttt tttttttt tttttt tt ttttttt t 1ttttt ttt giai đoạn 2013 – 2015 44 tttttt tt tttt tttt t ttttt t ttttt ttt 2.2.1.Xây dựng kế hoạch triển khai sách 44 ttttt ttt 1ttttt ttt ttttt ttt tttt tttt tttttt tt ttt tttt t 1tttttt tt 2.2.2 Phổ biến tuyên truyền sách .47 tttt tttt 1tttttt tt ttt tttt t 1tttttt tt 1tttttt tt tttt tttt 2.2.3 Phân công, phối hợp tổ chức thực sách 49 ttt ttttt t ttttt t tttt tttt 1tttttt tt tttt tttt tttt tttt tttt tttt 1tttttt tt ttttt ttt 2.2.4 Duy trì điều chỉnh sách .56 ttt tttt t ttttttt t 1tttttt tt ttt ttttt t tttt tt ttttt ttt 2.2.5 Đánh giá, kiểm tra, giám sát .58 tttt tttt ttttt ttt ttt tttt t ttt ttttt tttttt tt 2.3 Kết triển khai sách Bảo hiểm y tế toàn dân địa bàn tỉnh Hà ttttt ttt ttttt ttt ttttt ttt tttttt tt ttttttt t 1ttttt ttt t tttt tt ttt tttt t tttt tttt tttttt tt tttt tttt 1ttttt ttt 1tttttt tt t tttt tt tttttt tt 1tttttt tt t tttt tt 1tttttt tt Tĩnh .59 2.3.1 Kết địa bàn tỉnh Hà Tĩnh 59 tttt tttt 1ttttt ttt 1tttttt tt ttt tttt t ttt tttt t tttt tttt ttttt ttt ttttt ttt 2.3.2 Kết điều tra đơn vị nghiên cứu 63 tttt tttt 1ttttt ttt 1tttttt tt ttt ttttt ttt tttt t ttttttt t tttt tttt ttttttt t ttt ttttt 2.4.Các nhân tố tác động đến thực sách BHYT tồn dân địa bàn tttt tttt 1ttttt ttt ttt ttttt tttttt tt ttt ttttt ttt tttt t 1ttttt ttt 1tttttt tt ttt ttttt tttt tttt ttt tttt t 1tttttt tt 1ttttt ttt 1ttttt ttt tỉnh Hà Tĩnh 68 t ttttt t t ttttt t 2.4.1 Năng lực quản lý nhà nƣớc .68 tttt tttt ttt tttt t ttttt ttt ttt ttttt ttttttt t ttt ttttt 2.4.2 Hệ thống tổ chức, thực .70 tttt tttt tttt tttt ttt ttttt t ttttt t ttt ttttt ttt tttt t 2.4.3 Mức đóng, mức hỗ trợ 71 tttt tttt tttt tttt ttt ttttt ttt tttt t t ttttt t tttt tttt tttt tttt 2.4.4 Phạm vi quyền lợi, mức hƣởng 71 tttt tttt ttt ttttt ttttttt t 1tttttt tt ttttttt t t ttttt t 2.4.5 Phƣơng thức toán 74 tttt tttt tttt tttt ttt ttttt t ttttt t 2.4.6 Tổ chức cung ứng dịch vụ y tế 75 tttt tttt tttt tttt tttt tttt t ttttt t 1tttttt tt ttt tttt t t ttttt t ttttt ttt 2.4.7 Sự hiểu biết ngƣời dân 77 tttt tttt t ttttt t tttt tttt ttttt ttt 1ttttt ttt ttt tttt t 2.5 Đánh giá chung cơng tác triển khai Bảo hiểm y tếtồn dân tỉnh Hà ttttt ttt 1tttttt tt tttt tttt ttttt ttt t ttttt t t ttttt t tttt tttt tttt tttt ttt ttttt t ttttt t ttt tttt t ttt tttt t t ttttt t ttttt ttt t ttttt t 1tttttt tt 1ttt ttttt Tĩnh .78 2.5.1 Những mặt đạt đƣợc .78 tttt tttt t ttttt t ttt ttttt tttt tttt 2.5.2 Những mặt hạn chế .79 tttt tttt t ttttt t ttt ttttt tttt tttt ttttt ttt 2.5.3 Nguyên nhân hạn chế 80 tttt tttt 1tttttt tt tttt tttt tttt tttt ttttt ttt CHƢƠNG 3: GIẢI PHÁP ĐẨY MẠNH THỰC HIỆN CHÍNH SÁCH BẢO t tttt tt 1tttttt tt tttttttt 1tttttt tt ttttt ttt t ttttt t ttt ttttt ttt ttttt t ttttt t ttt ttttt 1tt ttttt t HIỂM Y TẾ TOÀN DÂN TẠI TỈNH HÀ TĨNH 82 1ttttt ttt tttt tttt tttt tttt ttttt ttt ttt ttttt ttttt ttt tttt tttt ttttt ttt 3.1 Quan điểm, mục tiêu đẩy mạnh thực sách Bảo hiểm y tế toàn ttt ttttt ttt ttttt tttt tttt ttt tttt t tttttt tt tttttttt tttt tttt 1ttttt ttt tttt tttt ttttt ttt tttt tttt ttttt ttt tttt tttt tttt tttt ttttt ttt tttt tttt dân .82 3.1.1 Căn đề xuất quan điểm, mục tiêu 82 tttt tttt 1tttttt tt ttt ttttt t ttttt t tttt tttt t tttt tt 1ttttt ttt t ttttt t 3.1.2 Quan điểm mục tiêu tỉnh Hà Tĩnh đến năm 2020 85 tttt tttt ttt tttt t 1ttttt ttt ttttt ttt t tttt tt ttt ttttt tttt tttt ttttt ttt ttttt ttt ttt tttt t ttt ttttt 1ttttt ttt 3.2 Giải pháp để đẩy mạnh thực hiệnBảo hiểm y tế toàn dân tỉnh Hà Tĩnh t ttttt t tttttttt t ttttt t t tttt tt ttt ttttt t tttt tt t tttt tt tttt tttt t ttttt t ttttt ttt tttt tttt t tttt tt tttt tttt t ttttt t tttt tttt tttt tttt 1tt ttttt t đến năm 2020 88 t tttt tt ttt ttttt 3.2.1.Tăng cƣờng công tác lãnh đạo, đạo, phối hợp tổ chức thực 88 1tttttt tt ttt ttttt 1tttttt tt 1tttttt tt ttt tttt t tttt tttt ttttt ttt t tttt tt tttt tttt ttttt ttt tttt tttt tttt ttt t tttt tt 3.2.2.Đẩy mạnh cơng tác tun truyền, vận động tồn nhân dân việc thực ttt ttttt tttt tttt tttt tttt 1tttttt tt t tttt tt tttt tttt ttt tttt t ttt tttt t t tttt tt t tttt tt ttt ttttt tttt tttt ttttttt t 1tttt tttt sách Bảo hiểm y tế toàn dân .89 ttt tttt t 1tttttt tt ttt ttttt ttttt ttt ttt tttt t ttttt ttt tttt tttt 1tttttt tt 3.2.3.Nâng caochất lƣợng hệ thống cung cấp dịch vụ y tế, bảo đảm quyền t tttt tt ttt tttt t ttttt ttt 1tttttt tt 1ttttt ttt tttt tttt t ttttt t ttt ttttt ttttt ttt ttttt ttt ttt ttttt tttt tttt 1ttttt ttt ttt tttt t lợi cho ngƣời tham gia Bảo hiểm y tế 91 ttttt ttt t tttt tt ttt ttttt 1tttttt tt tttttt tt ttt ttttt 1tttttt tt tttt tttt 3.2.4 Nâng cao chất lƣợng đội ngũ cán bộ, công chức, viên chức .92 tttt tttt ttt tttt t ttt ttttt ttttt ttt t ttttt t t ttttt t tttt tttt tttt tttt ttttt ttt t ttttt t ttt ttttt ttttt ttt tttt tttt 3.2.5.Thực tốt công tác thi đua khen thƣởng, tra, kiểm tra 93 tttt tttt 1ttttt ttt 1ttttt ttt ttt ttttt ttt ttttt ttt tttt t tttt tttt 1tttttt tt 1ttttt ttt tttt tttt ttttt ttt 1tttttt tt 3.3 Kiến nghị 95 t ttttt t tttt tttt 3.3.1 Đối với Chính phủ 95 tttt tttt ttttt ttt t tttt tt 1tttttt tt 3.3.2 Đối với Bảo hiểm xã hội Việt Nam 95 tttt tttt ttttt ttt t tttt tt ttt ttttt 1tttttt tt ttttt ttt ttttt ttt ttttttt t 3.3.3 Đối với tỉnh Hà Tĩnh 96 tttt tttt ttttt ttt t tttt tt ttt ttttt ttt ttttt Kết luận 97 tttttt tt Tài liệu tham khảo 99 tttttt tt t ttttt t ttttt ttt 1tt ttttt t PHẦN MỞ ĐẦU tttttttt tttttttt Tính cấp thiết đề tài tttttttt tttttttt tttttttt 1tttttttt tttttttt tttttttt Sức khỏe vốn quý ngƣời Có sức khỏe, ngƣời ” “ “ tttt tttt ” “ t ttttt t ” “ 1tttttt tt ” ttt tttt t “ ”.” tttt tttt t ttttt t 1ttttt ttt tttt tttt ” 1ttttt ttt ttt tttt t ttt ttttt t ttttt t ttttt ttt 1tttt tttt có hàng trăm ƣớc mơ, khơng có sức khỏe ngƣời có mơ ƣớc tttttttt ttttttt t tttt tttt 1tttttt tt ttttt ttt 1tttttt tt 1ttttt ttt tttt tttt ttt tttt t ttttt ttt tttt tttt ttttt ttt tttttt tt ttttttt t tttttt tt ttt tttt t ttt ttttt “đƣợc khỏe” Trong sống đại ngày nay, lúc hết, ttttttt t tttt tttt ttt ttttt 1ttttt ttt “ 1ttttt ttt ” ttt tttt t “ ” ttt tttt t “ ” ttt ttttt “ ” ttt ttttt “ ” tttttt tt “ ” tttttt tt “ ” “ t tttttt ” ttt ttttt “ ” tttttt tt “ ” ttttt ttt “ ” nhận thấy sức khỏe ngƣời đứng trƣớc thách “ ” “ ttt ttttt ” “ tttttttt ” “ ttt tttt t ” “ tttttttt ” “ tttt tttt ” “ tttttttt ” “ tttttttt ” “ ttttt ttt ” “ tttttttt ” “ tttttttt ” “ ttttt ttt ” “ ttttttt t ” “ tttttt tt thức nguy nhƣ: môi trƣờng sống bị đe dọa nghiêm trọng, dịch “ ” tttttttt “ tttttttt ” “ tttttttt ” “ tttttt tt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttt tttt ” “ tttttttt ” “ ttttttt t ” “ tttttttt ” “ tttttttt ” “ tttttttt ” 1tt ttttt t tttt tttt 1tttttt tt ” 1tttttttt bệnh , thiên tai ngày xuất nhiều , vệ sinh an toàn thực phẩm không “ ” “ 1ttttt ttt ” tttt tttt “ ” “ tttt tttt ” “ ttttttt t ” “ 1ttttt ttt ” ttt ttttt “ ” “ 1tttttt tt ” “ 1tttttt tt ” “ 1tttttt tt ” ttt ttttt “ ” ttt ttttt “ ” “ 1tttttt tt ” ttttt ttt “ ” tttt tttt “ ” 1ttttt ttt đƣợc kiểm soát chặt chẽ … Và ốm đau xảy đủ khả “ ” ttttt ttt “ ” tttttt tt “ ” ttttttt t “ ” ttt ttttt “ ”” ” “ ttt ttttt ” ttt tttt t “ ” ttttttt t “ ” t ttttt t “ ” t ttttt t “ ” ttttttt t “ ” ttttt ttt “ ” ttt ttttt “ ” tttttt tt “ ” tttttttt “ ” 1tttttt tt “ ” tttt tttt “ ” để trang trải khoản chi phí khám chữa bệnh , đặc biệt “ ttttt ttt ” “ ttt tttt t ” “ t ttttt t ” “ ttttt ttt ” “ ttttt ttt ” “ 1tttttt tt ” “ ttttt ttt ” “ 1ttttt ttt ” “ 1tttttt tt ” “ tttt tttt ” “ ttttt ttt ” “ ttt ttttt ” “ tttt tttt ” “ ttttt ttt ” “ tttt tttt ” 1tttttt tt ngƣời nghèo, ngƣời yếu xã hội Và vƣớng mắc “ ” “ tttttttt ” “ ttttttt t ” ttttt ttt “ ” “ tttttttt ” “ tttttttt ” “ ttttttt t ” “ ttttttt t ” “ ttttttt t ” “ tttttttt ” “ tttttt tt ” “ tttttttt ” “ tttt tttt ” “ tttttt tt ” “ ttttttt t ” 1ttttttt t phần đƣợc giải , hỗ trợ sách mang tên Bảo hiểm y “ ” tttt tttt tế “ ” “ ” ttt ttttt “ ” t tttt tt “ ” tttttttt “ ” “ tttttttt ” ttttt ttt “ ” tttt tttt “ ” ttttt ttt “ ” tttt tttt “ ” 1ttttt ttt “ ” ttttt ttt “ ” tttttttt “ ” t tttt tt “ ” tttttt tt “ ” tttttt tt “ ” 1ttttttt t ttttttt t Nhà nƣớc ta xác định “Bảo hiểm y tế “ ” “ tttt tttt ” “ ttt tttt t ”” “ ttttt ttt ” “ ttt tttt t ” “ tttttt tt ” ” t tttt tt “ tttttt tt ” “ tttttt tt ” “ ttttttt t ” tttt tttt ttt ttttt ttt tttt t t ttttt t t tttt tt sách quan ” “ tttttttt ” “ tttt tttt ” “ ttt ttttt ” “ ttt ttttt ” tttt tttt trọng hệ thống sách an sinh xã hội, mang tính cộng đồng chia “ ” ttttttt t “ ” ttttt ttt “ ” tttt tttt “ ” ttt ttttt “ ” tttttttt “ ” 1tttttt tt “ ” ttt tttt t “ ” t tttt tt “ ” ttt ttttt “ ” ttttttt t “ ” tttttttt “ ” tttt tttt “ ” 1tttttt tt “ ” ttt ttttt “ ” 1tttttt tt “ ” 1ttttttt t sẻ sâu sắc đƣợc áp dụng lĩnh vực khám chữa bệnh chăm sóc sức “ ” tttttttt “ ” “ tttt tttt ” “ ttttttt t ” “ ttttt ttt ” “ ttttttt t ” “ ttt ttttt ” “ tttt tttt ” “ ttt ttttt ” “ tttt tttt ” “ 1ttttt ttt ” “ ttt ttttt ” “ tttt tttt ” “ tttttttt ” 1ttttt ttt “ ” “ tttttttt ” 1ttttt ttt khỏe cho ngƣời, khơng mục đích lợi nhuận , Nhà nƣớc tổ chức thực “ ttttt ttt ” ttttttt t “ ” tttt tttt “ ” tttttt tt “ ” “ tttttttt ” tttt tttt “ ” tttttttt “ ” 1tttttt tt “ ” tttt tttt “ ” tttttttt “ ” ttttt ttt “ ” ttttt ttt “ ” t ttttt t “ ” tttt tttt “ ” tttt tttt “ ” tttt tttt “ ” đối tƣợng có trách nhiệm tham gia theo quy định Luật Bảo “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” ttttt ttt “ ” tttttt tt “ ” ttttt ttt “ ” tttttttt “ ” ttttt ttt “ ” tttttttt “ ” ttttt ttt “ ” tttttttt “ ” tttttttt “ ” ttttt ttt “ ” tttttttt “\\“ ” 1tttttttt hiểm y tế”.Theo đó, Nghị Đại hội đại biểu toàn quốc lần thứ XI rõ : “ ttttt ttt ” tttttt tt “ ” tttttt tt “ “ t tttt tt ” t ttttt t ttttttt t “ ” tttttt tt “ ” tttt tttt “ ” ttttttt t “ ” ttttt ttt “ ” ttttt ttt “ ” “ ttttt ttt ” 1ttttt ttt “ ” ttttttt t “ “ t tttt tt ”” ttttt ttt “ ” ttt ttttt “ ” “Đổi hồn thiện đồng sách bảo hiểm y tế, khám , chữa ” tttttttt “ ” tttttttt “ ” tttttttt “ ” t ttttt t “ ” ttttt ttt “ ” tttt tttt “ ” tttttttt “ ” tttttttt “ ” tttt tttt “ ” ttttttt t “ ” tttttttt “ ” ttttttt t “ ” tttttttt “ ” “ tttttttt ” “ ttttt ttt ” 1ttttt ttt bệnh viện phí phù hợp; có lộ trình thực bảo hiểm y tế toàn dân”[ “ ” “ ttt tttt t ” “ ttttttt t ” “ ttttt ttt ” “ ttttt ttt ” “ t ttttt t ” “ ttttt ttt ” ttttt ttt “ “ tttttttt ” “ 1tttttt tt ” “ 1tttttt tt ” “ ttt ttttt ” “ tttttttt ” “ t tttttt ” “ ttttttt t ” “ tttttt tt ” “ ttt ttttt 1tt ttttt t Văn kiện đại hội đại biểu toàn quốc lần thứ XI, 2011] “ ” ttttt ttt “ ” tttt tttt “ ” “ ttt tttt t ” 1tttttt tt Năm 2013 , “ ” ” tttt tttt “ “ 1tttttt tt ” tttt tttt “ ” tttt tttt “ ” tttt tttt “ ” tttt tttt “ ” t ttttt t “ ” t ttttt t ” ttt ttttt Chính phủ ban hành Quyết định phê duyệt đề án lộ 1ttttt ttt “ ” “ ttt ttttt ” “ tttt tttt ” “ ttt tttt t ” ttt ttttt “ ” “ 1ttttt ttt ” tttt tttt “ ” “ 1tttttt tt ” “ t tttt tt ” “ ttt ttttt ” “ t ttttt t ” 1tttttt tt “ ” 1ttttt ttt trình tiến tới BHYT toàn dân đến năm 2015 , định hƣớng tới năm 2020 với “ ” tttt tttt “ ” 1ttttt ttt “ ” 1tttttt tt “ ” t tttt tt “ ” tttt tttt “ ” ttttt ttt “ ” 1tttttt tt “ ” ttt ttttt “ ” “ t ttttt t ” ttttt ttt “ ” “ ttt ttttt ” “ tttt tttt ” t tttt tt “ ” ttttt ttt “ ” mục đính sâu sắc mở rộng phạm vi bao phủ bảo hiểm y tế tỷ lệ dân “ ” 1ttttt ttt “ ” 1ttttt ttt “ ” tttt tttt “ ” ttt tttt t “ 1tttttt tt “ ” ttt tttt t “ ” ttt tttt t “ số tham gia bảo hiểm y tế , “ ” tttttttt “ ” “ 1ttttt ttt ” “ tttttttt ” “ ttttt ttt ” “ t ttttt t ” “ tttttttt “ ”” ” tttt tttt “ ” tttttt tt “ ” ttttt ttt “ ” ttttt ttt “ ” ttt ttttt “ ” ttttttt t “ ” ttt ttttt “ ” ttttt ttt “ ” t ttttt t “ ” tttt tttt “ ” tttttt tt “ ” ttttttt t “ phạm vi dịch vụ y tế đƣợc thụ hƣởng “ ttttt ttt “ ttttt ttt ” “ tttttt tt ” tttt tttt “ ” ttttttt t “ ” tttttttt “ ” t ttttt t “ ” tttttttt “ ” t tttt tt “ ” ttt tttt t “ ” ttt ttttt “ ” ttt tttt t “ ” 1tt tttt tt ” 1tt tttt tt 1ttttttt t giảm tỷ lệ chi trả từ tiền túi ngƣời sử dụng dịch vụ y tế, góp phần tạo “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” ttttt ttt “ ” tttttttt “ ” ttttttt t “ ” ttt ttttt “ ” tttttttt “ ” ttttttt t “ ” ttttt ttt “ ” tttttttt “ ” ttt tttt t “” “ tttttttt ” tttttttt “ ” tttttttt “ ” ttttt ttt “ ” 1tttttttt nguồn tài ổn định cho cơng tác chăm sóc sức khỏe nhân dân theo “ ” 1tttttt tt “ ” ttttttt t “ ” ttt ttttt “ ” ttttt ttt “ ” ttttt ttt “ ” ttt ttttt “ ” ttttttt t “ ” tttttttt “ ” 1ttttt ttt “ ” tttttttt “ ” “ tttttttt ” ttttttt t “ ” ttt tttt t “ ” tttttt tt “ ” hƣớng công bằng, hiệu quả, chất lƣợng phát triển bền vững Đây định “ ” 1tttttt tt “ ” t ttttt t “ ” tttt tttt “ ” ttttt ttt “ ” ttttt ttt “ ” ttttt ttt “ ” 1ttttt ttt “ t ttttt t “ ” t ttttt t “ ” tttttttt “ ” t ttttt t “ ””” “ ” ” tttttttt “ ” 1ttttt ttt 1ttttt ttt hƣớng quan trọng “ để thực mục tiêu bảo hiểm y tế toàn dân , bƣớc “ ” ttt tttt t “ ” 1tttttt tt “ ” ttttt ttt “ ” t tttt tt “ ” t tttt tt “ ” tttt tttt “ ” t ttttt t “ ” tttttttt “ ” tttttttt “ ” tttt tttt “ ” ttttttt t “ ” ttttttt t “ ” t ttttt t “ ” “ tttt tttt t tttt tt ” t ttttt t “ ” 1ttt ttttt đạt tới công CSSK Và đây, khái niệm “Bảo hiểm y tế “ ” ttttttt t “ ” ttttt ttt “ ” tttttt tt “ ” t ttttt t “ ” tttt tttt “ ” ttt tttt t tttttt tt ” ttttt ttt ” ttt ttttt ” t tttt tt ” “ tttttttt ” tttttttt “ ” tttt tttt ” tttt tttt “ ” ttttt ttt “ ” tttttttt “ ” tttt tttt tồn dân” đƣợc hình thành triển khai cách sâu rộng với phạm vi điều “ ” tttttttt “ “ tttt tttt ” ttt ttttt “ ” tttt tttt “ ” 1tttttt tt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” ttttt ttt “ ” tttttt tt “ ” 1ttttt ttt “ ” tttttt tt “ ” tttttttt “ ” tttt tttt “ ” tttttttt “ ” 1ttttttt t chỉnh toàn quốc “ ” t tttt tt “ ” t ttttt t “ ”” ttt ttttt “ ”” ” “ Hà Tĩnh có dân số khoảng 1,3 triệu ngƣời với 53% độ tuổi “ ” tttttt tt “ ” ttttt ttt “ “ ttttt ttt ” tttt tttt “ ” tttttttt “ ” tttttttt ” tttttttt ttt ttttt “ ” tttttttt “ ” ttttttt t “ ” tttttt tt “ ” ttttt ttt “ ” tttttttt “ ” tttttt tt “ ” 1tttttttt lao động Tính đến 31/12/2015 , tồn tỉnh có 72% dân số có thẻ BHYT, thấp “ ” tttttttt “ ” “ ttttt ttt ” tttt tttt “ ” 1ttttt ttt “ ” “ tttt tttt ” tttttt tt “ ” tttt tttt “ ” tttt tttt “ ” ttt tttt t “ ” tttt tttt “ ” ” t tttt tt “ ” tttt tttt mức bình qn nƣớc (76%), điều cho thấy thách thức để tiến tới “ ” “ tttttttt ” “ ttttt ttt ” “ tttttt tt ” tttttt tt “ ttttttt t ” “ tttttttt ” “ tttttt tt ” “ ttttt ttt ” “ tttttttt ” “ ttttttt t ” “ tttttttt ” “ ttttttt t ” “ tttttttt ” 1tttttttt BHYT toàn dân địa bàn tỉnh Hà Tĩnh lớn Với mục tiêu đặt “ ” ttt ttttt “ ” ttt ttttt “ ” t tttt tt “ ” 1ttttt ttt “ ” ttt ttttt “ ” t ttttt t “ ” 1tttttt tt “ ” tttt tttt “ ” tttt tttt “ ” ttttt ttt “ ” ttt tttt t “ ” “ tttt tttt “ t ttttt t Nghị 21 - NQ /TW, Bộ Chính trị Quyết “ ” “ ttttttt t ” “ ttttttt t ” “ tttttttt ” 1ttttt ttt “Phấn đấu đến năm ” “ ttt ttttt ” “ tttttt tt ” “ ttttt ttt “ ttttttt t “ ” “ ttttt ttt ” “ ttt ttttt ” ttttt ttt “ ” ” tttttttt tttttt tt “ “ ” 2020 , có 80 % dân số ” tttt tttt ” ” ttttttt t “ ” “ tttttt tt ” “ tttttttt ” “ ttttttt t ” “ t ttttt t ” “ tttttt tt ” ttttttt t ” tttttt tt tttttttt “ “ ” tttt tttt “ ” ttt tttt t “ ” ttttt ttt “ ” ttt tttt t “ ” tttt tttt định Chính phủ : ” t tttt tt “ ttt ttttt ” “ tttttt tt ” “ ttt ttttt ”” tham gia bảo hiểm y tế” ttttt ttt “ ” “ ttt ttttt ” “ tttttttt ” ttttttt t “ ” “ tttttttt ” “ tttttttt 1tttttttt tttttttt tttt nhƣng tỷ lệ bao phủ BHYT tồn dân địa phƣơng cịn thấp, tốc độ tăng “ ” “ 1ttttt ttt ” “ tttttt tt ” “ ttttttt t ” “ tttttt tt ” ttttt ttt “ ” ttt tttt t “ ” “ t ttttt t ” 1ttttt ttt “ ” tttt tttt “ ” “ tttttt tt ” ttt ttttt “ ” “ t tttt tt ” “ tttt tttt ” “ t ttttt t ” tttt tttt “ ” tttt tttt chậm , năm 2013 đạt 67% đến năm 2014 , đạt 70% đến năm 2015 đạt “ ” tttttttt “ ” “ ttttt ttt ” tttt tttt “ ” ttt ttttt “ ” tttt tttt “ ” ttt ttttt “ ” ttttt ttt “ ” tttt tttt “ ” “ tttt tttt ” ttttt ttt “ ” tttt tttt “ ” tttttttt “ ” tttt tttt “ ” t ttttt t “ ” tttttt tt “ ” 1ttttttt t 72% , so với mức bình quân nƣớc năm 2015 76% Xuất phát từ thực tế “ ” “ ttttt ttt ” “ tttttt tt ” tttttttt “ ” t ttttt t “ ” t ttttt t “ ” t ttttt t “ ” tttt tttt “ ” t ttttt t “ ” t tttt tt “ ” t ttttt t “ ” tttttttt “ ” “ tttt tttt ” tttttttt “ ” ttt ttttt “ ” ttt tttt t “ ” ttttt ttt “ ” 1tttttt tt , chọn đề tài nghiên cứu “Đẩy mạnh thực sách Bảo hiểm “ ” “ tttttt tt ” tttttttt “ ” t ttttt t “ ” 1ttttt ttt “ ” tttttttt “ ” ttt ttttt “ ” 1tttttt tt ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt y tế toàn dân đến năm 2020 địa bàn tỉnh Hà Tĩnh” Đây đề tài “ ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” tttttttt “ ” “ 1tttttttt t ttttt t “ ” tttttttt “ ” tttttttt “ ” ttt tttt t “ ” mang tính cấp thiết, có ý nghĩa mặt khoa học thực tiễn Đề tài “ ” “ tttt tttt ” “ tttttt tt ” “ ttttttt t ” “ tttttttt ” ttttt ttt “ ” “ tttttttt ” “ ttttttt t ” “ ttttttt t ” “ tttt tttt ” “ ttt tttt t ” “ tttt tttt ” “ tttt tttt ” “ tttt tttt “”” “ tttttttt ” “ t tttt tt ” “ tttttt tt 1tttttttt ” 1ttt ttttt đƣợc chọn nhằm giải hai vấn đề: “ ” tttt tttt t ttttt t 1tttttt tt ttttt ttt tttt tttt “ ” tttt tttt “ ” ttttt ttt “ ” tttttttt “ ” ttttt ttt “ ” ttttttt t “ ” 1tttttt tt “ ” - Đánh giá ” thực trạng thực sách Bảo hiểm ” y tế tồn dân nói ttt tttt t “ ttttttt t ” “ t ttttt t ” tttttttt “ ” 1tttttt tt “ ” t ttttt t “ ” t tttt tt “ ” t ttttt t “ ” ttt ttttt “ ” tttttt tt “ ” 1tttttt tt “ ” ttt tttt t “” tttttttt “ ” tttt tttt “ ” 1tttttt tt “ ” t ttttt t “ ” 1ttttttt t chung địa bàn tỉnh Hà Tĩnh nói riêng giai đoạn 2013-2015 “ ” t ttttt t t ttttt t t tttt tt t tttt tt 1tttttt tt “ ” tttt tttt “ ” ttt ttttt “ ” tttttt tt “ ” tttt tttt “ ” ttt ttttt “ ” 1tttttt tt “ ” 1tttttt tt “ ” tttt tttt “ ” tttt tttt “ ” tttttttt “ ” ttt ttttt “ ” “ ” - Đƣa giải pháp nhằm đẩy mạnh thực “ Bảo hiểm y tế” 1tttttt tt t ttttt t “ ” t ttttt t “ ” “ t ttttt t ” 1tttttt tt “ ” tttttt tt “ ” 1ttttt ttt “ ” ttt ttttt “ ” “ ttttt ttt ” tttt tttt “ ” ttttt ttt “ ” “ ttt ttttt ” “ 1ttttt ttt ” “ tttt tttt ” “ ttt ttttt ” toàn dân địa bàn tỉnh Hà Tĩnh , hƣớng tới mục tiêu đƣợc Chính phủ “ ” giao “ “ tttt tttt ” ” 1tttttt tt “ ” tttt tttt “ ” ttttt ttt “ ” t ttttt t “ ” ttttt ttt “ ” “ 1tttttt tt ” “ 1ttttt ttt ” tttt tttt “ ” “ ttttt ttt ” ttt ttttt “ ” “ tttttt tt ” ttttt ttt “ ” t tttt tt “ ” t ttttt t “ tttt tttt ” 1tttt tttt tttttt tt 2.Tổng quan nghiên cứu đề tài tttttttt tttttttt tttttttt tttttttt tttttttt tttttttt Bảo hiểm y tế (BHYT) “chính sách lớn hệ thống an sinh “ ” tttttttt “ ” “ tttttt tt ” ttttttt t “ ” ttttt ttt “ tttt tttt ” tttttttt “ ” ttttt ttt ” t ttttt t “ ” ttt tttt t “ ” t ttttt t “ ”” ttttt ttt “ ”” ttttt ttt “ ”” tttttttt “ ” t tttt tt “ xã hội, có ý nghĩa nhân đạo, nhân văn ƣu việt, hƣớng tới mục tiêu “ ” “ tttttttt ” ttttttt t “ ” “ tttttttt ” tttttttt “ ” “ tttttttt ” “ t ttttt t ” “ ttttt ttt ” tttt tttt “ ” “ t tttt tt ” ttttttt t “ ” tttttttt “ ” t ttttt t “ ” “ tttttttt ” 1tttttt tt “ ” ttttttt t “ ” “ 1tttttt tt ”” 1ttt ttttt ” 1tttttttt cơng lĩnh vực chăm sóc sức khỏe nhân dân” Bảo hiểm y tế “ ” “ ttttttt t ” “ tttt tttt ” “ tttttt tt ” “ t ttttt t ” “ ttttt ttt ” ttt tttt t “ ” “ ttttttt t ” tttttt tt “ ” “ ttt ttttt ” ttttt ttt “ ttttt ttt “ ” ttttt ttt “ ” “ t tttt tt ” tttt tttt “ ” tttttt tt “ ” toàn dân chủ trƣơng, lộ trình sách tổng thể BHYT , “ ” tttttttt “ ” tttttt tt “ ” tttttttt “ ” “ ttttt ttt ” ttt ttttt “ ” “ tttt tttt ” ttttttt t “ ” tttttttt “ ” ttt tttt t “ ” ttttttt t “ ” “ ttt ttttt ” ttttttt “ ” “ tttttttt ” t tttt tt “ ” 1tttt tttt 1ttttt ttt đƣợc đề vào năm 2013 với mục tiêu cụ thể toàn dân tham gia BHYT , “ ” ttttt ttt “ ” ttt ttttt “ ” tttttt tt “ ” tttttt tt “ ” t ttttt t “ ” tttt tttt “ ” tttt tttt “ ” 1ttttt ttt “ ” tttttt tt “ ” tttt tttt “ ” tttt tttt “ ” ttttt ttt “ ” ttttt ttt “ ” tttt tttt “ ” ttt ttttt “ ” ttttttt t “ ” đƣợc san sẻ chi phí khám chữa bệnh khơng may gặp rủi ro “ ” ttt tttt t “ ” 1tttttt tt “ ” ttttt ttt “ ” ttttttt t “ ” ttttt ttt “ ” tttttttt “ ” ttttttt t “ ” ttt ttttt “ ” 1tttttt tt “ ” t ttttt t “ ” ttttt ttt “ ” ttt ttttt “ ” tttttttt “ ” ttttttt t “ ” ttttt ttt “ ” tttttttt “ ”” Và thấy, đánh giá, nhận định sách Bảo hiểm y tế “ toàn “ ” tttttt tt “ ” tttt tttt “ ” t ttttt t “ ” ttttttt t “ ” tttttt tt “ ” 1tttttt tt “ ” tttttttt “ ” 1tttttt tt “ ” 1tttttt tt “ ” tttttttt “ 1tttttt tt “ ” ttttt ttt “ ” ttttt ttt “ ” ttttt ttt “ ” tttttt tt “ ” tttttttt “ ” ttt ttttt “ 1ttt tttt t 1ttttttt t ” 1tttt tttt dân ” vấn đề mới, chƣa đƣợc đề cập nhiều tài liệu nghiên “ ” tttttttt “ ” “ tttttttt ” “ ttt ttttt ” “ t ttttt t ” “ ttttt ttt ”” “ tttttttt ” “ ttttt ttt ” “ tttt tttt ” “ 1tttttt tt ” “ tttttttt ” “ tttttt tt ” “ ttt ttttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” cứu , luận văn thạc sỹ hay tiến sỹ Cá nhân xin đƣợc nêu số nhận định “ ” “ tttttttt ” tttttt tt “ ” tttttt tt “ ” ttttttt t “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” “ tttttttt ” tttttttt “ ” ttttt ttt “ ” tttttttt “ ” ttttt ttt “ ” ttttt ttt “ ” tttttttt “ ” tttttttt “ ” tttttt tt “ 1tttt tttt ” 1ttttttt t viết, đánh giá tạp chí có phân tích sâu “ ” “ tttttttt ” “ ttttttt t ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ ttt ttttt ” “ tttttttt ” “ ttttt ttt ” “ tttttttt ” “ tttttttt ” “ tttttttt ” “ tttttt tt ” “ ttttttt t ” “ ttttttt t ” “ tttttt tt ” “ tttttttt ” “ ttt ttttt ” 1tttttttt BHYT toàn dân “ ” ttt ttttt “ ” ttt tttt t “ ” Ngay từ năm 1992 , Điều 39 Hiến pháp nƣớc Cộng hòa xã hội chủ nghĩa ” “ ” ttttt ttt ” ““ ” “ ttt ttttt ” “ ” ttttt ttt “ ”” ” ““ 1tttttt tt ” t tttt tt “ ” ““ ” ttttt ttt ” tttttttt “ ” ” ” 1ttttt ttt “ ” ” tttttttt “ ” ” tttt tttt “ ” ” ” “ ttttt ttt ” “ 1ttttt ttt ” ” “ tttttttt ” ” t ttttt t “ ” 1tttttt tt Việt Nam ghi : “thực Bảo hiểm y tế , tạo điều kiện để ngƣời dân ” “ ttttt ttt ” “ tttttt tt “ ” ”” tttttttt “ ” ” “ ttttt ttt ””” ” ttt tttt t tttttttt “ “ ” ttt ttttt ” ” “ 1ttttt ttt ” ” tttt tttt “ ”.” ” ”” ” “ ttttttt t ” tttttt tt “ ” ” tttt tttt “ ” ” “ tttttt tt ” ” t ttttt t “ ” ” tttt tttt “ ” ” “ tttttt tt ” ” đƣợc chăm lo sức khỏe đƣợc tiếp tục khẳng định Hiến pháp sửa đổi ” ”” tttttt tt “ ” tttt tttt “ ” ” “ ttttttt t ” ” ttttt ttt “ ” ” ” tttttttt ttttttt t ” “ ” tttt tttt “ ” ” tttttttt “ ” ” “ tttt tttt ” ” “ ttttttt t ” ” “ tttt tttt ”” tttttttt ” tttttttt ” tttttttt ” tttttttt ” 1tttttttt năm 2013 : thực bảo hiểm y tế toàn dân , có sách ƣu tiên chăm sóc ” tttt tttt ttttt ttt ” “ tttttt tt ” tttt tttt “ ” ttttt ttt “ ” “ ttttt ttt ” t tttt tt “ ” tttttttt ” tttt tttt “ ” ttttt ttt “ ” “ ttttt ttt ” ttt ttttt “ ” 1ttttt ttt “ ” 1tttttt tt “ ” t ttttt t “ ” ttttttt t “ ” tttt tttt “ ” sức khỏe cho đồng bào dân tộc thiểu số, đồng bào miền núi, hải đảo “ ” tttttt tt “ ” tttttt tt “ ” ttttt ttt “ ” tttttt tt “ ” tttttttt “ ” tttt tttt “ ” ttttttt t “ ” tttttttt “ ” “ tttttttt ” ttttttt t “ ” tttttttt “ ” ttttttt t “ ” tttttt tt “ ” “ tttttttt ” tttttttt “ ” tttttttt “ ” 1tttttttt vùng có điều kiện kinh tế xã hội đặc biệt khó khăn” Trong luận văn này, “ ” t tttt tt “ ” tttt tttt “ ” tttt tttt “ ” tttt tttt “ ” tttt tttt “ ” ttttt ttt “ ” ttt ttttt “ ” tttttt tt “ ” ttttt ttt “ ” tttttttt “ ” tttt tttt “ t ttttt t “ “ tttt tttt ” 1tttttt t “ ” tttt tttt “ ” ttt ttttt “ ” “ tttttttt ” 1ttttt ttt đề cập chi tiết khía cạnh tỷ lệ dân số tham gia BHYT địa bàn hay “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” tttttttt “ ” t ttttt t “ ” ttttttt t “ ttt ttttt “ ” tttttttt “ ” tttttttt “ ” tttttt tt “ ” tttttt tt “ ” ttttt ttt “ ” “ tttttttt ” t ttttt t “ ” tttttttt “ ” tttttttt “ ” ttttt ttt “ ” 1tttttttt mức độ bao phủ ngƣời dân tham gia BHYT , yếu tố dịch vụ y “ ” tttttttt “ ” tttttttt ““ ” tttt tttt “ ” ttttttt t “ ” tttttttt “ ” ttttt ttt “ ” tttttttt “ ” tttt tttt “ ” ttttt ttt “ ” tttttttt “ ”” “ tttttttt ” ttttttt t “ ” tttttttt “ ” tttttt tt “ ” tttttttt “ ” tttt tttt “ ” 1tttttttt tế , mức hƣởng sách đƣợc đánh giá khía cạnh yếu tố ảnh hƣởng “ ”” “ tttttttt ” 1tttttt tt “ ” 1tttttt tt “ ” t ttttt t “ ” t tttt tt “ ” ttt ttttt “ ” 1tttttt tt “ ” 1tttttt tt “ ” tttttttt “ ” ttt ttttt “ ” ttttttt t “ ” t ttttt t “ ” 1tttttt tt “ ” ttt tttt t “ ” 1tttttt tt “ ” Theo viết “Tiến tới bao phủ Bảo hiểm y tế toàn dân Việt Nam” “ “ ttt ttttt “ tttt tttt ttttttt t “ ttttt ttt “ 1tttttt tt “ ttt ttttt “ 1tttttt tt “ ttt ttttt “ t ttttt t “ tttttt tt “ 1tttttt tt “ tttt tttt “ 1tttttt tt “ ttttt ttt tttt tttt “ Ngân hàng giới WB, “Trong năm đầu thập kỷ 1990, chi phí y “ “ tttttttt “ ttt tttt t “ tttttt tt “ t ttttt t “ tttttttt ttttttt t “ t ttttt t “ ttttt ttt “ ttt tttt t “ tttt tttt tttttt tt “ “ tttttttt “ tttt tttt tttttttt “ “ tttttttt 1tttt tttt 1tttttttt tế từ tiền túi chiếm tới 70% tổng chi tiêu cho y tế, dẫn đến tác “ “ ttttttt t “ t ttttt t “ ttttttt t “ ttttt ttt “ ttt ttttt “ ttttttt t “ t ttttt t “ ttt ttttt “ tttt tttt “ ttt ttttt “ ttt ttttt “ ttt tttt t “ tttttttt “ t ttttt t “ t tttt tt “ 1tttttt tt “ t ttttt t 1ttttt ttt động xấu vấn đề bình đẳng bảo vệ tài Trong 20 năm sau đó, “ “ ttttt ttt “ ttt ttttt “ tttt tttt t ttttt t “ “ tttt tttt “ ttt ttttt “ ttt tttt t “ tttt tttt “ tttttt tt “ ttt ttttt “ tttttttt “ 1tttttt tt “ t ttttt t “ tttt ttt “ 1tttttt tt “ tttt tttt “ 1tttttt tt loạt cải cách bƣớc làm tăng mức bao/ phủ BHYT tới nhóm “ “ tttttttt “ t ttttt t “ ttttttt t “ tttt tttt “ ttt ttttt tttt tttt “ “ ttt ttttt “ tttttttt “ ttttt ttt “ ttttt ttt “ tttttt tt “ t ttttt t “ 1tttttt tt “ tttttt tt tttttt tt “ 1tttt tttt đối tƣợng dân cƣ khác Năm 2008, Quốc hội thông qua Luật BHYT nhằm tạo “ “ tttttttt “ ttt ttttt “ ttttt ttt “ t ttttt t ” ttttttt t “ tttt tttt “ “ 1ttttt ttt “ ttttt ttt “ tttt tttt “ ttttt ttt ttttt ttt “ “ t tttt tt “ ttttt ttt “ 1tttttt tt “ ttttt ttt 1tttttt tt chƣơng trình BHYT quốc gia, giúp BHYT trở thành chế để “ “ tttttttt “ ttttt ttt thực “ “ ttttt ttt “ tttt tttt “ t tttt tt “ t ttttt t “ tttt tttt “ tttttttt “ tttttttt “ ttt ttttt tttt tttt “ “ t ttttt “ ttttt ttt “ 1tttttt tt “ tttt tttt tttt tttt bao phủ chăm sóc sức“ khoẻ tồn dân Q trình thực bao phủ “ t ttttt t “ t tttt tt “ tttt tttt 1tttttt tt “ “ 1tttttt tt 1tttttt tt “ “ ” “ tttt tttt 1ttttt ttt “ ”” “ t ttttt t “ ttt ttttt “ ttttt ttt “ ttt ttttt tttt tttt “ “ tttt tttt 1ttttt ttt toàn diện Việt Nam đạt đƣợc kết đáng kể, nhờ tăng nhanh tỉ “ “ tttttttt tttttttt “ “ ttttt ttt tttttttt “ “ tttt tttt ttt ttttt “ “ tttt tttt tttt tttt “ “ tttttt tt “ tttttt tt “ ttt tttt t “ ttttt ttt “ tttttttt “ ttt ttttt ttttt ttt “ tttt tttt “ 1tttttttt lệ tham gia áp dụng mơ hình có bên chi trả chế BHYT “ tttttttt “ “ ttttt ttt “ tttttttt “ tttttt tt “ tttttt tt tttt tttt “ “ ttttt ttt “ ttt ttttt “ tttttttt “ tttttttt “ tttttt tt “ ttt tttt t “ tttttttt “ tttttttt “ tttttt tt “ t tttt tt ttt ttttt 1tttt tttt “ 1ttttt ttt Chính phủ cam kết đảm bảo nguồn kinh phí đủ để đạt đƣợc mục “ t ttttt t “ t tttt tt “ “ t ttttt t t tttt tt “ “ tttt tttt tttt tttt “ “ ttt ttttt “ tttttt tt “ tttt tttt tttt tttt “ ttttttt t “ tttt tttt “ “ t tttt tt t ttttt t “ 1ttttt ttt “ “ ttt ttttt tiêu đề chƣơng trình Tuy nhiên, Việt Nam cịn nhiều thách thức đáng “ “ ttt ttttt “ ttt ttttt ttt ttttt “ “ ttttt ttt “ ttttt ttt “ tttt tttt “ t ttttt t ““ ttt tttt t “ tttttt tt 1ttttt ttt “ “ ttt tttt t ttt ttttt “ ttt tttt t “ “ ttt ttttt kể nâng cao tính cơng với tỷ lệ ngƣời dân có thẻ BHYT cịn thấp Tỷ “ “ ttttttt t “ tttt tttt ttttt ttt “ ttt ttttt “ ttt ttttt “ “ tttt tttt “ ttttt ttt tttt tttt “ “ tttttt tt “ ttttttt t “ ” tttttt tt “ 1tttttt tt “ lệ tham gia thấp kể nhóm đối tƣợng phải tham gia bắt buộc theo quy “ tttttttt “ tttt tttt “ “ tttttttt ttttt ttt “ tttt tttt ttttttt t tttt tttt 1tttttt tt tttttttt ttttt ttt tttttttt t ttttt t tttttttt tttttttt ttttttt t tttttttt 1ttt ttttt 1tt ttttt t 1tttttt tt 1ttttttt t định (nhóm lao động thức) nhóm hộ cận nghèo có gia tăng 1tttttt tt “ ” ttt ttttt “ ” tttttttt “ ” 1tttttt tt “ ” t ttttt t “ ” ttttt ttt tttt tttt “ ” ttttt ttt “ ” 1tttttt tt “ ” ttt ttttt “ ” tttttt tt “ ” tttttttt “ ” tttttt tt “ ” ttttt ttt “ ” tttttttt “ ” 1ttttttt t hỗ trợ mức phí từ ngân sách nhà nƣớc Các phân tích đƣợc nêu cụ “ ” ttttt ttt “ ” ttttt ttt “ ” ttttt ttt “ ” tttttt tt “ ” ttt ttttt “ ” 1tttttt tt “ ” tttt tttt “ ” ttttt ttt “ ”” “ ttt ttttt ” ttttt ttt “ ” ttt tttt t “ ” tttt tttt “ ” 1tttttt tt “ ” t tttt tt “ ” t ttttt t “ ” tttt tttt “ thể Báo cáo chung Tổng quan ngành Y tế năm 2013 , 2014 , đề cập “ ” tttt tttt “ ” tttttt tt “ ttttt ttt ““ ” tttt tttt “ ” ” 1ttttt ttt “ ” t ttttt t “ ” ttt tttt t “ ” 1ttttt ttt “ ” t ttttt t “ ” tttt tttt “ ” ttt tttt t “ ” ttt ttttt “ ” ttttt ttt “ ” ttt ttttt ” tttttt tt “ ” tttt tttt “ ” 1ttt ttttt ” 1ttttttt t đến Bảo hiểm y tế , đặc biệt năm 2013 với chủ đề chăm sóc sức khỏe tồn “ ” ttt ttttt “ ” “ 1ttttt ttt ” “” tttt tttt “ ttt ttttt ”” “ ttttt ttt ” “ t tttt tt ” “ tttt tttt ” t tttt tt “ ” 1ttttt ttt “ ” “ t ttttt t ” tttt tttt “ ” tttt tttt “ ” tttt tttt “ ” ttttt ttt “ ” tttt tttt “ ” ttt ttttt “ dân , báo cáo đề cập sâu sắc đến kết đạt đƣợc nhƣ “ ” “ tttttttt ” “ tttttttt ” “ ttttttt t ” “ ttttt ttt ” “ ttt tttt t ” “ tttttt tt ” “ 1ttttt ttt ” tttttttt “ ” tttt tttt “ ” “ tttt tttt ” “ tttttttt ” “ t ttttt t ” “ ttttt ttt ” tttttttt “ ” “ t ttttt t ” “ ttt ttttt khó khăn , vƣớng mắc việc triển khai thực BHYT toàn dân “ ” 1ttttt ttt “ ” tttt tttt “ ” “ 1ttttt ttt ” “ 1tttttt tt ” ttttt ttt theo Nghị 21 -NQ /BCT “ ” ttttt ttt “ ttt tttt t “ ” ttttt ttt “ ” tttttt tt “ ” “ ” “ “ ” “ 1tttttt tt ” “ ttttt ttt ” ttttt ttt “ ” “ tttt tttt ” ttt tttt t “ ” ttt ttttt “ ” 1tttttt tt “ ” “ 1tttttt tt ” 1tttttt tt ” 1ttttt ttt ” 1tttt tttt t tttt tt Với mục tiêu gia tăng số ngƣời dân có thẻ BHYT cho giai đoạn 2013-2020: “ ttt ttttt t ttttt t ttttt ttt tttt tttt t tttt tt tttttttt ttt ttttt phấn đấu đạt tỷ”lệ bao phủ.BHYT 70% dân số năm 2015 đạt tỷ lệ tttt tttt ttt tttt t tttttt tt ttttttt t tttttt tt 1tttttt tt ttttttt t ttttttt t ttt tttt t t ttttt t ttttt ttt ttttt ttt tttt tttt tttttt tt ttttt ttt tttttttt bao phủ 80% năm 2020 , giảm tỉ lệ chi trả tiền túi tổng chi phí bảo tttttttt ttt ttttt tttttttt 1ttttt ttt 1tttttt tt ” 1tttttt tt ttttt ttt tttttt tt ttttttt t tttttttt ttt ttttt tttttt tt ttttt ttt tttt tttt 1tttttt tt t tttt tt ttttt ttt tttt tttt hiểm xuống 40% vào năm 2015 đƣợc phân tích cụ thể qua viết tttttttt tttttt tt ttt ttttt tttttt tt tttttttt tttttt tt ttttt ttt ttttttt t ttttt ttt ttttttt t ttt ttttt tttt ttt t tttttt tt ttttttt t tttttttt “Thúc đẩy tiến trình thực bảo hiểm y tế tồn dân góp phần bảo đảm an t tttt tt ttttt ttt tttt tttt ttt ttttt 1ttttt ttt ttttt ttt ttt ttttt tttt tttt tttttttt ttttt ttt tttt tttt ttt tttt t tttttt tt ttttt ttt ttt ttttt ttt tttt t sinh xã hội phát triển bền vững đất nƣớc”[Tạp chí Cộng sản, 2014] tttttttt ttttttt t tttttttt tttttt tt t ttttt t ttt ttttt tttttttt ttttt ttt ttttt ttt ttttt ttt ttttt ttt ttt ttttt ttt tttt t tttt tttt ttttt ttt 1tttt tttt 1tttttttt 1tttttttt 1tttttttt 1tttt tttt 1ttttt ttt Mục tiêu viết đánh giá việc thực BHYT Việt Nam đƣa ttt ttttt ttttt ttt ttttt ttt t ttttt t tttttttt tttttttt tttt tttt ttt tttt t tttttttt tttttt tt t tttt tt tttt tttt 1ttttt ttt t ttttt t ttttt ttt tttt tttt tttt tttt tttt tttt giải pháp tiến tới mục tiêu bao phủ toàn dân với quan điểm đóng góp ttt ttttt tttttttt tttt tttt ttt ttttt tttttt tt t ttttt t tttttt tt ttttt ttt 1tttttt tt 1tttttt tt 1ttttt ttt tttt tttt ttt ttttt t ttttt t ttt ttttt tttt tttt cho tiến trình sửa đổi bổ sung luật BHYT Bài viết phân tích trạng tiến tttt tttt ttttt ttt t tttt tt tttt tttt tttttttt ttt ttttt ttttt ttt ttttt ttt 1ttttt ttt tttttt tt tttttttt ttttt ttt t tttt tt tttttttt ttttt ttt t ttttt t trình thực hai mục tiêu Đề án thực lộ trình tiến tới BHYT 1tttttt tt tttt tttt ttttt ttt ttttt ttt 1tttttt tt tttttt tt tttt tttt ttt ttttt “ tttt tttt t ttttt t 1tttttt tt ttt tttt t tttttttt ttt ttttt tttttttt ttttttt t toàn dân Đã đánh giá đƣợc khả sẵn sàng Việt Nam để đạt đƣợc ” tttttttt “ tttttt tt tttttt tt ttt ttttt ttttttt t ttt tttt t ttt tttt t tttt tttt tttt tttt tttttt tt tttttt tt tttttttt ttttt ttt tttt tttt tttt tttt ttt ttttt mục tiêu đề ra, thách thức phải đối mặt lộ trình đạt đƣợc bao ttttt ttt ttttttt t ttt ttttt tttt tttt tttttttt ttttttt t tttttt tt ttttttt t tttttttt tttttttt tttttttt tttttt tt ttttt ttt tttttttt tttttttt tttttt tt ttt ttttt phủ toàn diện nhƣ cải cách thiết yếu để vƣợt qua thách thức t ttttt t tttt tttt ttttt ttt ttt ttttt t ttttt t ttt tttt t ttttttt t tttt tttt tttttt tt ttt tttt t t ttttt t t ttttt t ttt ttttt ttt ttttt t tttt tt ” 1tttttt tt 1tttt tttt 1ttttttt t 1tt tttt tt 1tttttttt 1tttttttt tttttttt Nhƣ vậy, qua viết trên, nhận thấy việc triển khai Bảo ttttt ttt tttttttt 1tttttt tt ttt ttttt tttttttt tttttttt t ttttt t “ tttt tttt 1tttttt tt 1ttttt ttt tttttttt ttttttt t tttt tttt tttttttt hiểm.y tế toàn dân cần thiết, phù.hợp với nhu cầu toàn xã hội ttttt ttt tttttttt tttt tttt ttttt ttt 1tttttt tt tttttttt tttt tttt tttttt tt t tttt tt tttttttt tttttt tt tttttttt ttt ttttt tttttttt ttt ttttt ttttt ttt ” tttttttt 1tttttttt Mở rộng độ bao phủ, đặc biệt nhóm khó tiếp cận nhƣ đối tƣợng cận “ ttttt ttt ttt ttttt 1tttttt tt 1tttttt tt t ttttt t ttttt ttt 1ttttt ttt ttttttt t ttt ttttt tttt tttt ttttt ttt tttt tttt 1tttttt tt ttttttt t ttt ttttt 1tttttt tt tttttt tt tttt tttt nghèo ngƣời lao động khu vực khơng thức thách thức ttttt ttt 1ttttt ttt ttt ttttt tttttttt tttt tttt 1tttttt tt 1ttttt ttt 1tttttt tt 1tttttt tt t tttt tt tttttt tt 1tttttt tt ttttt ttt 1tttttt tt Chính phủ tổ chức thực hiện, đòi hỏi gia tăng hỗ trợ từ ngân sách 1ttttt ttt ttt tttt t ttt tttt t tttt tttt ttt ttttt tttt tttt tttt tttt ttt tttt t tttt tttt ttttt ttt tttttt tt tttt tttt t tttt tt t ttt ttt ttt ttttt 1ttttt ttt tttt tttt Nhà nƣớc bao cấp tồn phần phí BHYT cho ngƣời cận nghèo Để đáp ứng 1tttttt tt tttt tttt t tttt tt 1ttttt ttt tttt tttt tttt tttt tttt tttt ttt tttt t 1tttttt tt ttttt ttt tttt tttt ” ttt ttttt tttt tttt t ttttt t 1ttttt ttt mục tiêu sách Chính phủ nêu Đề án tổng thể để tiến nhanh ttt ttttt ttttttt t tttt tttt tttt tttt ttt tttt t 1ttttt ttt ttttt ttt tttt tttt ttttt ttt ttt ttttt 1tttttt tt tttttt tt tttt ttt tttt tttt t ttttt t tttttt tt tới mục tiêu bao phủ tồn diện Việt Nam nói chung tỉnh Hà Tĩnh nói tttttttt 1tttttt tt tttttttt t ttttt t tttt tttt tttttt tt t ttttt t tttttttt t ttttt t ttttttt t t ttttt t 1tttttt tt ttt ttttt ttt ttttt 1ttttt ttt riêng, cần phải đánh giá thực trạng điều chỉnh thể chế BHYT Đề xuất cải ttttt ttt t tttt tt tttt tttt ttt ttttt tttttttt ttttt ttt tttt tttt tttt tttt t ttttt t 1tttttt tt ttt tttt t tttt tttt ttttt ttt 1tttttt tt tttt tttt cách cụ thể giải pháp cần thiết để thực đƣợc khuyến.nghị nhƣ: Mở tttttttt t tttt tt ttttt ttt tttt tttt tttttttt ttttt ttt tttt tttt tttttttt ttt ttttt t tttt tt ttttttt t t tttt tt tttttt tt tttttttt tttttttt rộng bao phủ BHYT theo chiều rộng; Tăng cƣờng công bằng, bảo vệ tài chính; tttttttt tttttttt ttt ttttt t ttttt t ttttttt t tttt tttt tttttt tt ttt ttttt tttt tttt ttttt ttt ttttttt tttttttt tttttttt tttttttt Tạo chế tài bền vững cho BHYT; Tăng cƣờng“cơng tác tổ”chức, quản tttttttt ttt ttttt tttt tttt tttttttt t ttttt t ttt ttttt ttt ttttt tttt tttt ttttt ttt tttt tttt tttt tttt tttttttt tttttt tt lý quản trị BHYT Hơn nữa, địa bàn Hà Tĩnh, địa phƣơng tttttttt tttt tttt ttt tttt t ttttttt t ttttt ttt ttt ttttt tttt tttt tttttttt ttttttt t tttttttt 1ttttt ttt t tttt tt 1tttttt tt ttttttt t tttttttt ttt ttttt 1ttt tttt t 1tttttt tt 1ttt tttt t tttt tttt 1tttttt tt 1ttttt ttt 1tttt tttt 1tttt tttt tttt tttt 1tttt tttt tỉnh nghèo dải đất miền Trung có bƣớc khởi sắc kinh tế mà ttttttt t 1tttttt tt ttt ttttt t tttt tt tttt tttt t ttttt t t ttttt t tttt tttt 1tttttt tt t ttttt t 1ttttt ttt 1ttttt ttt ttt ttttt ttt ttttt ttt tttt t tttt tttt t tttt tt 1tttt tttt kinh tế khơng cịn đơn nơng nghiệp canh tác mà có 1ttttt ttt ttt ttttt ttt tttt t ttttt ttt 1tttttt tt ttt tttt t ttttt ttt tttt tttt tttttttt t ttttt t tttttttt 1tttttt tt ttttttt t ttt ttttt ttt ttttt ttt ttttt tham gia công nghiệp khai thác, ngƣời lao động khối doanh nghiệp tttt tttt ttttttt t t tttt tt ttt tttt t tttttttt tttttttt ttttttt t ttttttt t tttttttt ttt tttt t tttt tttt tttttttt 1tttttt tt 1tttttt tt 1tttttttt tăng lên đáng kể, ngƣời lao động khu vực phi thức lớn dần ttttt ttt ttt ttttt tttt tttt ttt ttttt ttt ttttt ttttttt t tttt tttt ttttt ttt ttttt ttt t ttttt t tttttt tt ttt ttttt t tttt tt ttt tttt t t ttttt t 1tttttt tt lên Do sách an sinh xã hội nói chung BHYT tồn dân nói riêng tttttttt ttttt ttt ttttt ttt t ttttt t t ttttt t 1tttttt tt ttt tttt t tttt tttt ttt tttt t tttt tttt tttttt tt tttt tttt ttttt ttt 1tttttt tt tttt tttt ttttt ttt ttt ttttt ttttt ttt ngày cần thiết ngƣời dân, việc trì điều chỉnh ttttttt t sống tttt tttt tttt tttt ttttt ttt ttttt ttt 1ttttt ttt t ttttt t ttt ttttt 1tttttt tt ttttttt t ttt tttt t tttttt tt ttt ttttt tttt tttt t ttttt t 1tttt tttt tttt tttt Mục tiêu nghiên cứu đề tài tttttttt tttttttt tttttttt tttttttt tttttttt tttttttt tttttttt 3.1 Mục tiêu chung t ttttt t tttt tttt 1tttttt tt “ Nghiên cứu thực trạng thực sách BHYT.trên địa bàn tỉnh Hà “ ttt ttttt “ ttt ttttt ttt tttt t ttt tttt t 1tttttt tt 1tttttt tt ttt ttttt ttt ttttt 1ttttt ttt t ttttt t tttttttt ttttt ttt t ttttt t Tĩnh giai đoạn 2013-2015 , đƣa giải pháp kiến nghị nhằm mở rộng phạm tttt tttt ttttttt t ” 1tttttt tt “ 1ttttt ttt ttttt ttt t tttt tt ttttt ttt tttt tttt t ttttt t “ 1ttttt ttt tttt tttt 1ttt tttt t 1ttttt ttt vi bao phủ BHYT, tiến tới mục tiêu BHYT.toàn dân tttt tttt 1ttttt ttt t tttt tt ” ttttt ttt t ttttt t 1tttttt tt 1tttttt tt ttt ttttt tttt tttt ””” 1tttttt tt 3.2 Mục tiêu cụ thể t ttttt t tttt tttt 1tttttt tt 1ttttt ttt *Về lý luận: t ttttt t tttttt tt - Hệ thống hoá sở lý luận thực tiễn sách BHYT BHYT “ tttttttt ttttt ttt t ttttt t ttt ttttt 1tttttt tt t ttttt t ttt ttttt tttttttt ttt ttttt tttt tttt 1ttttt ttt ttt ttttt tttt tttt ttttt ttt tttt tttt ttt tttt t tttt tttt toàn dân ” t tttt tt - Làm rõ nội dung triển khai BHYT tồn dân, tập trung vào tttttttt “ tttt tttt tttttt tt tttt tttt ttttttt t ttt ttttt ttttttt t ttttttt t 1ttttt ttt ttttt ttt tttt tttt ttttt ttt ttttttt t ttttt ttt tttttt tt tttt tttt 1ttttt ttt bƣớc sách 1tttttt tt 1tttttt tt t tttt tt t ttttt t ” 1tttttt tt *Về phân tích, đánh giá: t ttttt t ttttt ttt t ttttt t tttt tttt - Phân tíchthực trạng triển khai sách BHYT toàn dân, vƣớng “ tttttttt t tttt tt ttttt ttt tttttt tt ttttttt t tttttttt 1ttttt ttt 1tttttt tt 1ttttt ttt 1tttttt tt t tttt tt t ttttt t mắc, khó khăn trong“q trình thực BHYT tồn dân địa bàn tỉnh Hà ttt ttttt ttttt ttt ttt tttt t t ttttt t ttttt ttt ttttt ttt t ttttt t t ttttt t tttt tttt 1tttttt tt tttt tttt tttt tttt 1ttttt ttt t ttttt t ttt ttttt 1tt ttttt t Tĩnh thời gian qua ttt ttttt ttttt ttt ” t tttt tt - Đánh giákết quảđạt đƣợc, tồn nguyên nhân tồn việc “ tttttttt 1ttttt ttt tttttt tt ttt ttttt 1tttttt tt tttt tttt tttttttt t tttt tt tttt tttt tttt tttt t ttttt t tttt tttt tttttttt 1ttttt ttt tttttttt thực sách BHYT toàn dân địa bàn tỉnh Hà Tĩnh ttttt ttt t ttttt t 1ttttt ttt ttt tttt t ttt ttttt ttttt ttt 1tttttt tt t ttttt t t ttttt t tttt tttt 1ttttt ttt ” 1ttttt ttt *Về đề xuất, kiến nghị: t ttttt t t tttt tt tttt tttt 1tttttt tt Đề xuất giải phápvà kiến nghị nhằm đẩy nhanh lộ trình tiến tới BHYT “ ttttt ttt ttt tttt t 1tttttt tt t ttttt t tttttttt ttttt ttt ttt ttttt t tttt tt t tttt tt tttt tttt tttt tttt tttt tttt ttt tttt t 1tttttt tt t ttttt t toàn dân địa bàn tỉnh Hà Tĩnh đến năm 2020 t tttt tt ttt tttt t tttt tttt tttt tttt ttttt ttt ttt tttt t ttt tttt t ttttt ttt 1tttttt tt ” ttt tttt t Đối tượng phạm vi nghiên cứu tttttttt tttttttt 1tttttttt tttttttt tttttttt tttttttt 4.1.Đối tượng nghiên cứu t ttttt t 1tttttt tt t ttttt t tttttttt t tttt tt - Đối tƣợng nghiên cứu đề tài sách Bảohiểm y tế tồn dân tttttttt “ ttttt ttt t ttttt t ttt tttt t 1tttttt tt t ttttt t 1tttttt tt ttttt ttt tttt tttt ttt tttt t ttttt ttt t tttt tt tttt tttt t tttttt 1tttttt tt ” - Đề tài tập trung nghiên cứu vấn đề liên quan đến việc tham gia “ tttttttt tttttttt tttttttt tttttttt tttt tttt tttttt tt tttttt tt ttttttt t ttttt ttt ttttt ttt ttttttt t tttttt tt tttt tttt tttttttt tttttt tt 1ttttttt t BHYT đối tƣợng từ hình thức, thủ tục tham gia đến sách thụ tttt tttt tttt tttt tttt tttt tttttttt 1tttttt tt t ttttt t tttt tttt tttt tttt tttt tttt ttt ttttt 1ttttt ttt tttttttt t tttt tt tttt tttt t ttttt t 1tt ttttt t hƣởng ” 4.2 Phạm vi nghiên cứu t ttttt t 1tttttt tt ttttt ttt 1tttttt tt - Về nội dung: Đề tài tập trung nghiên cứu nhóm đối tƣợng.tham gia tttttttt t ttttt t ttttttt t ttttttt t “ ttt ttttt tttttttt tttt tttt ttt tttt t ttt ttttt t ttttt t ttt tttt t t ttttt t tttttttt ttt ttttt tttttttt BHYT theo luật BHYT thuộc Bảo hiểm xã hội tỉnh Hà Tĩnh quản lý ttt tttt t ttttt ttt ttttttt t ttt tttt t tttttt tt tttttttt tttttt tt ttttt ttt tttttttt ttt ttttt ttt ttttt tttttt t t ttttt t tttttttt tttt tttt 1tttt tttt phân tích nội dung sách Bảo hiểm y.tế tồn dân phạm t ttttt t tttt tttt 1tttttt tt ttttttt t 1ttttt ttt 1tttttt tt ttt tttt t tttt tttt ttt ttttt 1tttttt tt ttt ttttt tttttt tt tttttttt tttt tttt 1ttttt ttt tttttttt 1tttt tttt vi bao phủ BHYT tỷ lệ.dân số tham gia BHYT tttt tttt 1ttttt ttt t tttt tt t ttttt t ttt tttt t t ttttt t tttttt tt ttttt ttt tttt tttt t ttttt t ” ttttttt t - Về không gian: Đề tài thực địa bàn tỉnh Hà Tĩnh tttttttt “ tttt tttt tttt tttt tttttt tt t tttt tt tttttt tt 1tttttt tt ttt tttt t tttt tttt tttt tttt 1tttttt tt t ttttt t ” t ttttt t - Về thời gian: Đề tài nghiên cứu, phân tích giai đoạn 2013-2015 tttttttt “ tttt tttt 1tttttt tt tttttttt tttt tttt tttttttt tttt tttt ttt ttttt 1ttttt ttt t ttttt t ttttt ttt tttttt tt tttt tttt Phương pháp nghiên cứu đề tài tttttttt tttttttt tttttttt tttttttt tttttttt tttttttt tttttttt 5.1 Phương pháp thu thập thông tin, số liệu t ttttt t tttt tttt t ttttt t ttt ttttt 1tttttt tt ttttt ttt 1tttttt tt 1ttttt ttt 5.1.1 Phương pháp thu thập số liệu thứ cấp tttt tttt 1ttttt ttt ttt ttttt tttt tttt 1tttttt tt 1ttttt ttt t tttt tt 1ttttt ttt Các số liệu thứ cấp đƣợc sử dụng luận văn bao gồm số liệu thống “ tttttttt tttt tttt tttttttt tttt tttt tttttttt tttttt tt ttt ttttt tttttt tt tttt tttt tttttt tt ttt tttt t tttttttt tttttt tt tttttttt tttttttt kê điều kiện tự nhiên, điều kiện kinh tế - xã hội tỉnh Hà Tĩnh; số liệu tttttttt ttttt ttt ttttttt t tttttttt ttttt ttt tttttttt tttttt tt tttttttt ttttt ttt tttt tttt tttttttt ttttt ttt tttttttt tttttt tt 1ttttttt t ttt tttt t tttttt tt ttttt ttt 1ttttt ttt 1tttttttt báo cáo kết thực công tác BHYTcủa BHXH tỉnh Hà Tĩnh tttttttt ttttttt t ttttt ttt tttt tttt ttt ttttt ttt ttttt tttt tttt tttttt tt tttt tttt ttt ttttt ttt tttt t ttt tttt t ttt ttttt tttt tttt năm từ 2013- 2015 Tham khảo thêm số thông tin liên quan công ttttt ttt tttt tttt tttttt tt tttt tttt 1ttttt ttt t tttt tt ttt tttt t t ttttt t ttttt ttt t ttttt t ttttt ttt tttt tttt t ttttt t ttt ttttt ttttttt t trình nghiên cứu thực sách BHYT đƣợc công bố để làm rõ ttt tttt t tttt tttt ttttt ttt tttttt tt t ttttt t tttttt tt 1tttttt tt ttttt ttt t ttttt t ttt ttttt 1ttttt ttt tttttt tt ttt tttt t tttt tttt tttttt tt 1ttt ttttt 1ttt ttttt 1tt ttttt t thêm kết nghiên cứu luận văn ttt ttttt tttt tttt ttttt ttt ttttt ttt ttt ttttt tttt tttt ” 1tttttt tt Ngồi sử dụng thơng tin đƣợc thu thập khai thác từ báo cáo tttttttt ttttt ttt ttt ttttt ttt ttttt ttt ttttt ttttt ttt t ttttt t tttt tttt ttt tttt t tttt tttt ttttttt t ttttt ttt tttt tttt tttttttt tttttttt khoa học, sách, báo, tạp chí, Website có liên quan đến đề tài nghiên cứu tttttt tt t ttttt t tttt tttt ttttt ttt tttt tttt ttttt ttt tttt tttt tttttttt tttt tttt tttt tttt 1tttttt tt t tttt tt ttt tttt t tttttttt tttttt tt 1ttttt ttt tttt tttt phạm vi nƣớc tttt tttt t ttttt t tttttt tt ttttt ttt 5.1.2 Phương pháp thu thập.số liệu sơ cấp tttt tttt 1ttttt ttt ttt ttttt tttt tttt ttttt ttt 1tttttt tt t tttt tt Đối tƣợng thực sách BHYT theo quy định Luật BHYT gồm tttttttt ttttt ttt t ttttt t ttt ttttt t ttttt t ttt tttt t t tttt tt tttt tttt t ttttt t ttttt ttt ttttt ttt t ttttt t ttttt ttt t ttttt t có 25 đối tƣợng đƣợc chia thành nhóm cụ thể theo trách nhiệm đóng nhƣ ttt ttttt sau: t tttt tt tttttt tt t tttt tt 1tttttt tt tttttt tt tttt tttt 1tttttt tt ttt ttttt t tttt tt 1tttttt tt t tttt tt ttttt ttt ttt ttttt ttttt ttt ttttttt t Nhóm 1: Nhóm ngƣời lao động ngƣời sử dụng lao động đóng; ttttt ttt “ tttt tttt ttttt ttt tttt tttt 1tttttt tt tttttt tt tttt tttt tttt tttt 1ttttt ttt t ttttt t ttttt ttt Nhóm 2: Nhóm đối tƣợng NSNN đóng BHYT ; ttttt ttt tttt tttt “ tttt tttt ttttt ttt ttttt ttt t ttttt t t ttttt t t ttttt t Nhóm 3: Nhóm tổ chức BHXH đóng; ttttt ttt tttt tttt “ tttt tttt tttt tttt ttt ttttt ttt ttttt ” tttt tttt ” ttttt ttt ttttt ttt ” ttt t ttt ttt tttt t tttt tttt Nhóm 4: Nhóm ngân sách nhà nƣớc hỗ trợ phần kinh phí; ttttt ttt tttt tttt “ tttt tttt tttt tttt t ttttt t tttt tttt ttttt ttt 1ttttt ttt ttttt ttt ttttt ttt t tttt tt tttt tttt t tttt tt ” tttttttt t ttttt t 1ttt tttt t Nhóm 5: Ngƣời tham gia BHYT hộ gia đình ttttt ttt “ tttt tttt ttt tttt t 1ttttt ttt tttttt tt 1tttttt tt 1ttttt ttt ” tttttt tt Do Nhóm 2,3,4 nhóm đƣợc tổ chức Nhà nƣớc đóng t ttttt t ttttt ttt ttt ttttt ttt ttttt tttttttt ttt tttt t ttt ttttt 1ttttt ttt ttt tttt t ttt ttttt 1ttttt ttt ttt tttt t 1tttttt tt t tttt tt 1tttttt tt hỗ trợ phần kinh phí nên số ngƣời tham gia cao, đạt tỷ lệ 90% t tttt tt tttt tttt t ttttt t t tttt tt 1tttttt tt ttt ttttt t tttt tt ttt tttt t t tttt tt t tttt tt tttt tttt 1ttttt ttt tttt tttt t ttttt t ttt ttttt tttt tttt t ttttt t 1tt ttttt t Cịn lại khó khăn việc mở rộng diện bao phủ tham gia BHYT toàn 1tttttt tt tttt tttt tttt tttt ttt ttttt tttt tttt t ttttt t ttttttt t 1ttttt ttt 1tttttt tt 1tttttt tt ttttt ttt tttt tttt ttt ttttt tttttt tt tttt tttt 1tttt tttt dân thuộc nhóm nhóm Đây nhóm đối tƣợng phải trực tiếp tttt tttt ttttt ttt t ttttt t ttttt ttt t ttttt t tttt tttt tttttt tt tttt tttt t tttt tt “ tttttttt tttttttt t tttt tt tttt tttt tttttttt tttt tttt ttttt ttt t ttttt t 1ttttttt t bỏ tiền túi muốn có thẻ BHYT, khả nhận thức, mức thu tttttt tt ttttt ttt t ttttt t ttt ttttt 1tttttt tt t ttttt t tttt tttt t ttttt t tttt tttt ttt tttt t tttt tttt 1tttttt tt tttt tttt tttt tttt ttt ttttt 1ttttt ttt t ttttt t 1ttttt ttt nhập, trình độ học vấn ảnh hƣởng nhiều đến việc tham gia sách tttt tttt t ttttt t ttt tttt t tttt tttt ttt ttttt tttt tttt ttt tttt t ttt tttt t t tttt tt ttt ttttt ttttt ttt ttttt ttt ttttt ttt ttttt ttt 1tt ttttt t BHYT toàn dân Vì lý trên, tác giả thực điều tra nhóm đối t tttt tt ” tttt tttt tƣợng t ttttt t 1ttttt ttt ttttt ttt ttt tttt t ttt ttttt 1tttttt tt ttttt ttt 1tttttt tt ttt ttttt tttt tttt ttttt ttt 1tttttt tt 1tttttt tt tttt tttt 1ttttt ttt 1ttttt ttt tttt tttt tttt tttt ttt ttttt Số liệu sơ cấp đƣợc thu thập thông qua điều tra khảo sát phiếu điều tttttttt 1ttttt ttt tttttttt t ttttt t ttttttt t t tttt tt 1tttttt tt t ttttt t ttttt ttt ttttt ttt 1tttttt tt ttttt ttt t tttt tt ttttt ttt tttttt tt tttt tttt 1ttttt ttt tra trực tiếp đến nhóm đối tƣợng tham gia BHYT khác nhau: ttttt ttt tttt tttt ttttt ttt 1tttttt tt t tttt tt 1ttttt ttt tttttt tt ttt ttttt 1tttttt tt tttttt tt 1tttttt tt tttt tttt - Nhóm ngƣời lao.động doanh nghiệp, có trách nhiệm tham gia “ tttttttt ttt ttttt tttttt tt BHYT (nhóm 1) ” t ttttt t t ttttt t t ttttt t tttttttt tttt tttt tttt tttt tttttttt t tttt tt ttttt ttt ttt ttttt ttt tttt t tttttttt ttt ttttt - Nhóm hộ gia đình tham gia BHYT (nhóm 5) “ t tttt tt 1tttttt tt tttttt tt ttt ttttt 1tttttt tt ” ttt ttttt tttttt tt ttt ttttt ttt tttt t * Phƣơng pháp thu thập số liệu chọn mẫu điều tra: tttt tttt ttt ttttt 1ttttt ttt 1tttttt tt ttt ttttt t ttttt t tttt tttt 1tttttt tt ttt ttttt ttttt ttt Việc chọn đơn vị điều tra vào mục tiêu nghiên cứu đề tài, tttttttt ttttt ttt ttttt ttt 1tttttt tt ttt ttttt ttttttt t ttttt ttt ttttt ttt 1tttttt tt tttt tttt ttttt ttt ttt tttt t tttt tttt ttttt ttt tttt tttt tttt tttt ttt ttttt tttttttt sở phân loại chọn địa điểm có tính chất điển hình cho tổng thể 1tttttt tt t tttt tt 1tttttt tt tttttttt tttt tttt ttt ttttt ttt ttttt t tttt tt ttt ttttt t ttttt t ttt ttttt 1tttttt tt tttt tttt t ttttt tttt tttt 1tttttt tt ttttt ttt nghiên cứu để đƣa đƣợc số liệu mang tính chất tổng quan nhất, tttt tttt 1tttttt tt tttt tttt 1tttttt tt ttt ttttt ttt tttt t ttt ttttt tttttt tt tttttt tt ttt ttttt ttt ttttt tttt tttt 1ttttt ttt t tttt tt 1ttt ttttt không bị sai lệch thống kê nhiều ttttt ttt tttt tttt tttt tttt tttt tttt t ttttt t t tttt tt Do chọn nhóm đối tƣợng điều tra, nhóm điều tra theo đơn vị 1tttttt tt ttttt ttt tttt tttt t ttttt t 1tttttt tt tttttt tt tttt tttt 1tttttt tt t tttt tt ttt ttttt t ttttt t 1tttttt tt ttt ttttt ttt ttttt tttt tttt tttt tttt 1tttttt tt khác Nhóm thực điều tra doanh nghiệp có số lƣợng lao tttttttt tttt tttt ttttt ttt ttttt ttt ttttt ttt tttttt tt tttttttt tttttttt tttttttt tttttttt tttttt tt ttttttt t tttttttt ttttttt t tttttttt tttttt tt tttttttt động lớn địa bàn Thành phố Hà Tĩnh, Nhóm thực điều tra ttttt ttt tttt tttt ttt tttt t ttttt ttt tttt tttt 1tttttt tt ttttt ttt ttt tttt t tttt tttt 1tttttt tt t tttt tt ttt ttttt 1ttttt ttt ttttttt t t ttttt t tttt tttt ttt ttttt tttt tttt phƣờng có số dân đơng, phần lớn lao động tự do, phi thức Đối với tttt tttt ttttt ttt ttttt ttt ttt tttt t ttt tttt t t tttt tt tttt tttt tttttttt tttttttt tttt tttt t ttttt t tttt tttt ttttt ttt ttt tttt t tttt tttt ttttttt t tttttttt doanh nghiệp phát ngẫu nhiên cho 100 phiếu cho ngƣời lao động ttttt ttt tttttttt tttttttt ttttt ttt tttt tttt tttt tttt tttt tttt t ttttt t 1tttttt tt tttttt tt tttt tttt ttttttt t tttttttt ttttt ttt tttttttt 1ttt ttttt 1tttttttt doanh nghiệp, hộ dân thuộc phƣờng chọn mẫu điều tra ngƣời ttt tttt t ttttttt t ttttttt t ttttttt t 1ttttt ttt 1ttttt ttt ttt ttttt 1tttttt tt tttt tttt 1ttttt ttt t tttt tt t ttttt tttttttt tttttttt tttttttt lao động, không lấy phiếu trẻ em dƣới độ tuổi lao động, ngƣời già tttttttt tttt tttt tttt tttt tttttttt tttt tttt tttttttt tttttt tt t ttttt t ttt tttt t tttttttt tttt tttt tttttttt tttttttt ttttt ttt ttttttt t tttttttt 80 tuổi Phiếu điều tra với đơn vị khác nên việc thiết kế mẫu phiếu 1ttttt ttt ttttttt t t tttt tt tttt tttt ttt ttttt tttt tttt ttttt ttt t tttt tt ttttt ttt ttt ttttt 1tttttt tt t ttttt t tttttttt ttttttt t 1tttttt tt ttt ttttt điều tra khác nhau, phù hợp với nhóm đối tƣợng đối tƣợng cụ thể cần tttt tttt t ttttt t ttt tttt t tttt tttt ttt ttttt ttt tttt t tttttt tt ttt ttttt ttttttt t t ttttt t tttt tttt ttttttt t ttttt ttt t ttttt t 1ttttt ttt ttttttt t tttt tttt thiết Sau phiếu điều tra thiết kế xong, tiến hành điều tra thử, nhằm điều ttttttt t tttt tttt tttttt tt ttttt ttt ttt tttt t ttt ttttt tttttttt tttttt tt tttttt tt ttttttt t 1tttttt tt tttt tttt ttttttt t t ttttt t 1tttttt tt chỉnh, bổ sung câu hỏi phiếu điều tra cho phù hợp, sau hồn thiện t ttttt t ttttt ttt t tttt tt ttttt ttt ttttt ttt tttttttt ttttt ttt ttt tttt t ttt ttttt tttttt tt 1ttttt ttt 1ttttt ttt 1tttttt tt tttt tttt t tttt tt ttt tttt t 1tttt tttt 1ttttt ttt 1tt ttttt t 1ttt ttttt 1tttt tttt 1tttt tttt mẫu phiếu điều tra, tiến hành điều tra toàn theo lƣợng mẫu chọn ttt tttt t 1tttttt tt ttt ttttt ttt ttttt tttt tttt t ttttt t tttt tttt tttt tttt 1ttttt ttt ttttt ttt t ttttt t tttt tttt 1tttttt t ttttt ttt * Nội dung thông tin thu thập từ phiếu điều tra tttt tttt ttttt ttt ttt tttt t t tttt tt 1tttttt tt t ttttt t tttt tttt 1ttttt ttt 1tttttt tt 1ttttt ttt tttt tttt 1tttttt tt - Hiểu biết đối tƣợng sách BHYT, BHYT tồn dân “ tttttttt ttt tttt t tttttttt tttt tttt ttttt ttt ttttt ttt t ttttt t t tttt tt 1tttttt tt ttt ttttt tttt tttt tttt tttt ” t tttt tt - Công tác tuyên truyền, nguồn tiếp cận thông tin nhƣ nào? “ tttttttt ttt tttt t ttt tttt t 1tttttt tt t tttt tt 1tttttt tt ttttttt t ttt ttttt t ttttt t t tttt tt 1ttttt ttt ” 1tttttt tt - Đánh giá nhận xét đối tƣợng sách BHYT có “ tttttttt ttttt ttt tttttttt ttttt ttt tttttt tt ttttttt t tttttttt tttttttt tttttttt t ttttt t ttttt ttt tttttt tt tttttttt tttttttt 1tttttt tt thuận lợi khó khăn, hạn chế gì? tttt tttt tttt tttt 1ttttt ttt tttt tttt ttttt ttt ” 1ttttt ttt Ý kiến đối tƣợng điều tra có ý nghĩa lớn việc đánh giá ttt ttttt tttttt tt ttt ttttt tttt tttt tttttt tt tttt tttt ttttttt t ttt ttttt ttt ttttt ttttttt t ttttttt t ttt tttt t tttt tttt tttt tttt tttttttt ttt ttttt 1tttttttt thực trạng công tác thực BHYT toàn dân địa bàn tỉnh Hà Tĩnh ttttt ttt ttt ttttt 1tttttt tt 1tttttt tt 1ttttt ttt t ttttt t ttt tttt t tttt tttt 1tttttt tt ttt tttt t ttt tttt t tttt tttt tttt tttt tttt tttt * Phƣơng pháp thu thập tttt tttt ttt ttttt 1ttttt ttt 1tttttt tt Việc thu thập số liệu đƣợc thực cách phát phiếu điều tra trực tttttttt 1ttttt ttt ttt ttttt tttt tttt tttttt tt ttt ttttt tttt tttt t ttttt t 1tttttt tt tttt tttt t ttttt t t ttttt t ttt ttttt tttt tttt tiếp, với câu hỏi đƣợc soạn thảo trƣớc bảng hỏi cho nhóm đối tttttttt t ttttt t 1tttttt tt tttt tttt tttttt tt tttt tttt ttt ttttt t ttttt t ttttt ttt 1ttttt ttt ttttt ttt ttttttt t t tttt tt ttt ttttt tttt tttt 1tttt tttt 1ttttttt t tƣợng - Nhóm 1: Mục đích tiến hành điều tra nhóm để trả lời câu hỏi tttttttt ttttt ttt 1ttttt ttt tttttt tt “ t tttt tt ttttt ttt ttt ttttt ttt tttt t 1tttttt tt ttt tttt t ttt tttt t ttt ttttt tttttt tt t ttttt t tttt tttt ttttt ttt t ttttt t tttt tttt hiểu biết sách BHYT, BHYT tồn dân; đánh giá cơng tác 1ttttt ttt tttt tttt t ttttt t tttttttt 1ttttt ttt 1ttttt ttt tttt tttt 1tttttt tt ttt ttttt 1tttttt tt tttt tttt tttt tttt tttttt tt t tttt tt 1tttttt tt 1tt ttttt t triển khai, thực BHYT toàn dân đơn vị Sẽ tiến hành điều tra 03 đơn vị ttt ttttt tttttt tt 1tttttt tt ttt ttttt tttt tttt 1tttttt tt t ttttt t ttttttt t tttt tttt tttttttt tttt tttt ttttt ttt ttt ttttt ttt tttt t ttt tttt t ttt tttt t tttt tttt 1ttt ttttt doanh nghiệp ” ttttt ttt - Nhóm 2: Mục đích tiến hành điều tra nhóm để trả lời câu hỏi cho tttttttt ttttt ttt ttt ttttt ttt ttttt “ t ttttt t tttt tttt 1tttttt tt tttt tttt t ttttt t t ttttt t 1tttttt tt 1ttttt ttt ttttttt t t ttttt t t ttttt t tttt tttt t ttttt t ttt ttttt công tác tuyên truyền, tiếp cận thông tin ngƣời dân hộ gia đình, t ttttt t tttttt tt ttttt ttt ttttt ttt tttttttt 1ttttt ttt tttt tttt ttt ttttt tttt tttt ttttt ttt 1ttttt ttt ttttt ttt ttttttt t 1tttttt tt tttttttt ngƣời khơng thuộc nhóm ngƣời lao động có.chủ sử dụng lao động, khó tttt tttt ttt ttttt ttttt ttt 1tttttt tt t tttt tt tttttt tt tttttttt ttt ttttt ttttt ttt tttt tttt ttt ttttt tttttttt t tttt tt khăn trình tiếp cận hiểu biết BHYT toàn dân Sẽ tiến hành điều tttt tttt ttt ttttt 1ttttt ttt tttt tttt tttttt tt ttt ttttt ttt ttttt t tttt tt tttttttt tttt tttt 1ttttt ttt ttt ttttt 1tttttt tt ttttttt t tttt tttt ttt ttttt tttt tttt 1ttttt ttt 1tttttt tt tra hộ gia đình 02 phƣờng ttttt ttt ttttt ttt tttt tttt tttt tttt t tttt tt tttttt tt ” 1tttttt tt 5.2 Phương pháp tổng hợp xử lý thông tin tttttttt tttttttt tttttttt tttttttt tttttttt tttttttt tttttttt tttttttt Tài liệu sau thu thập kiểm tra phát sai sót, thiếu xác tttt tttt ttt ttttt 1tttttt tt tttt tttt t ttttt t t tttt tt t ttttt t tttt tttt ttt tttt t t ttttt t 1tttttt tt tttt tttt t ttttt t t ttttt t ttt ttttt ghi chép, tổng hợp, chỉnh sửa thơng tin cịn thiếu sau sàng lọc tính tttttt tt tttttt tt ttt ttttt tttt tttt 1tttttt tt ttt ttttt tttttt tt tttt tttt ttttttt t t ttttt t tttt tttt tttt tttt tttttt tt ttt tttt t tttttttt ttttt ttt 1tttttt tt 1ttttt ttt toán cho phù hợp với mục tiêu mục đích nghiên cứu ttt tttt t ttt ttttt ttttt ttt 1tttttt tt t ttttt t tttt tttt ttttt ttt tttt tttt 1tttttt tt ttt ttttt ttt ttttt Sau đƣợc làm thông tin số liệu thu thập đƣợc đƣợc tác t ttttt t tttt tttt ttttt ttt t ttttt t ttttt ttt tttt tttt ttttt ttt 1ttttt ttt t tttt tt t tttt tt ttt ttttt ttttt ttt ttt tttt t tttt tttt tttttt tt ttt tttt t ttt ttttt giả cập nhật tính tốn tổng hợp thông qua hệ thống bảng, biểu, đồ thị ttttttt t ttttt ttt tttttt tt ttttt ttt t ttttt t 1tttttt tt 1ttttt ttt 1ttttt ttt tttt tttt 1tttttt tt tttt tttt 1tttttt tt ttt tttt t ttttt ttt ttt tttt t tttttttt ttttt ttt ttt tttt t đề tài sử dụng công cụ Microsoft Excel 2010 số chƣơng trình ứng dụng t ttttt t tttttttt 1ttttt ttt tttttt tt ttttt ttt tttt tttt 1ttttt ttt 1ttttt ttt tttt tttt ttt tttt t ttt tttt t ttt tttt t tttttt tt 1ttttt ttt ttt tttt t 1tttttt tt khác để tính tốn tttt tttt 1tttt tttt t tttt tt 5.3 Phương pháp phân tích số liệu tttttttt tttttttt tttttttt tttttttt tttttttt tttttttt Phƣơng pháp chủ yếu đƣợc sử dụng phân tích số liệu luận văn tttttt tt tttttttt tttt tttt tttttttt ttttt ttt tttttt tt tttt tttt tttttt tt tttt tttt tttttttt tttttttt tttttttt tttttt tt ttt tttt t 1ttt ttttt phƣơng pháp thống kê, phƣơng pháp số tƣơng đối, phƣơng pháp số tuyệt tttttttt tttttt tt t ttttt t ttttttt t ttt tttt t ttttt ttt 1tttttt tt tttttt tt ttttttt t 1tttttt tt tttttttt t ttttt t tttttt tt ttt tttt t 1ttttttt t đối… - Phƣơng pháp phân tổ thống kê: Dựa vào phƣơng pháp này, toàn số ttt ttttt ttt ttttt ttt ttttt tttt tttt 1ttttt ttt ttt ttttt ttttt ttt ttt ttttt ttttt ttt ttttt ttt tttt tttt liệu thu thập đƣợc đƣợc phân tổ theo nhóm đối tƣợng khác t tttt tt t ttttt t tttt tttt ttttt ttt tttt tttt tttt tttt t ttttt t 1tttttt tt ttt tttt t t tttt tt t ttttt t tttt tttt 1tttttt tt ttttt ttt t tttt tt 1ttt ttttt ttttt ttt - Phƣơng pháp thống kê mô tả: phƣơng pháp mô tả toàn vật ttttttt t ttttt ttt tttt tttt tttttttt tttt tttt tttttttt ttttttt t ttttttt t ttttt ttt tttttt tt ttttt ttt ttttttt t tttttt t tttttt tt ttttttt t tttttt tt tƣợng sở số liệu tính tốn Phƣơng pháp thực thơng ttttt ttt 1tttttt tt t tttt tt ttttt ttt tttt tttt ttttttt t ttttttt t 1tttttt tt 1tttttt tt ttt ttttt t tttt tt ttt ttttt qua việc sử dụng số bình quân, số tối đa số tối thiểu t tttt tt tttttttt ttttt ttt ttt ttttt t ttttt t tttt tttt ttt ttttt t ttttt t ttttttt t 1tttttt tt 1ttttt ttt ttttt ttt ttttt ttt tttttttt ttttt ttt tttttt tt tttt tttt ttt ttttt - Phƣơng pháp thống kê so sánh: Dùng để so sánh số tuyệt đối so sánh 1tttttt tt ttttt ttt 1tttttt tt t tttt tt ttt tttt t tttt tttt tttt tttt tttt tttt 1ttttt ttt t tttt tt 1ttttt ttt t tttt tt tttttt tt tttt tttt ttttttt t tttt tttt số tƣơng đối để đánh giá so sánh số đơn vị, đối tƣợng, số ngƣời tham gia ttttttt t ttt ttttt ttttttt t ttttt ttt t ttttt t tttttttt tttt tttt ttttt ttt ttttttt t ttt ttttt tttttttt tttttttt ttttttt t tttttttt tttttttt t tttt tt 1tttttttt BHYT theo thời gian Việc so sánh đƣợc tiến hành theo phƣơng pháp đồng ttt ttttt ttt ttttt ttt ttttt tttt tttt tttttttt t ttttt t ttt tttt t 1tttttt tt ttttt ttt t tttt tt t tttt tt t ttttt t ttt ttttt tttt tttt thời gian đối tƣợng so sánh sau tìm quy luật chung tttttttt tttttttt tttttttt tttttttt tƣợng nghiên cứu t ttttt t ttt tttt t tttttttt ttttttt t tttttt tt tttt tttt ttttt ttt ttttt ttt tttttt tt ttttt ttt tttttttt tttttttt ttttt ttt tttttt tt t tttt tt ttttt ttt 1ttttt ttt t ttttt t ttt ttttt t ttttt t tttt tttt t ttttt t 1ttttt ttt ttttt ttt t tttt tt tttttt tt t ttttt t cứu nhƣ: Chỉ tiêu phản ánh điều kiện kinh tế - xã hội tỉnh Hà Tĩnh; Chỉ tiêu ttt ttttt t ttttt t t ttttt t t tttt tt ttt ttttt ttt tttt t ttt ttttt tttt tttt ttttt ttt t ttttt t ttt ttttt 1tttttt tt ttttt ttt 1ttttt ttt ttttt ttt t ttttt t t tttt tt phản ánh thực trạng thực sách BHYT tồn dântrênđịa bàn tỉnh;Chỉ t ttttt t t ttttt t 1ttttt ttt t ttttt t 1ttttt ttt 1tttttt tt tttt tttt ttttt ttt tttt tttt 1tttttt tt ttt tttt t t ttttt t tiêu phản ánh nguyên nhân, ảnh hƣởng đến thực sách BHYT tồn tttttt tt 1ttttt ttt tttttttt t ttttt t Ngoài sử dụng thêm hệ thống tiêu giai đoạn nghiên tttt tttt 1tttt tttt ttt ttttt tttttt tt 1tttttt tt tttt tttt ttt ttttt 1ttttt ttt t ttttt t ttttt ttt 1tttttt tt ttttt ttt t ttttt t 1tttttt tt 1tt tttt tt 1ttt ttttt 1tt tttt tt dântrên địa bàntỉnh t tttt tt ttt tttt t 6.Kết cấu đề tài tttttttt tttttttt tttttttt tttttttt Chƣơng 1: Khung lý thuyết thực sách Bảo hiểm y tế tồn dân 1ttttt ttt tttt tttt tttt tttt tttttttt tttttttt t ttttt t t ttttt t tttt tttt t ttttt t tttt tttt 1tttttt tt tttt tttt tttttttt ttt ttttt ttttt ttt Chƣơng 2: Thực trạng triển khai sách Bảo hiểm y tế tồn dân địa bàn 1tttttt tt ttttt ttt 1tttttt tt ttt ttttt t ttttt t ttttt ttt ttt ttttt ttt ttttt 1tttttt tt tttt tttt ttt tttt t tttttt tt 1tttttt tt tttt tttt 1tttttt tt tttt tttt ttttt ttt tỉnh Hà Tĩnh 1tttttt tt 1tttttt tt Chƣơng 3: Giải pháp đẩy mạnh thực sách Bảo hiểm y tế toàn dân t ttttt t ttt tttt t tttttt tt 1tttttt tt tttt tttt địa bàn tỉnh Hà Tĩnh t ttttt t t ttttt t ttt ttttt tttt tttt tttt tttt ttttt ttt t tttt tt 1ttttt ttt 1tttttt tt ttttt ttt tttt tttt t ttttt t ttttttt t ttt tttt t t tttt tt 1ttttt ttt ... ttttt t HIỂM Y TẾ TOÀN DÂN TẠI TỈNH HÀ TĨNH 82 1ttttt ttt tttt tttt tttt tttt ttttt ttt ttt ttttt ttttt ttt tttt tttt ttttt ttt 3.1 Quan điểm, mục tiêu đ? ?y mạnh thực sách Bảo hiểm y tế toàn. .. tttt ttttt ttt tỉnh Hà Tĩnh 1tttttt tt 1tttttt tt Chƣơng 3: Giải pháp đ? ?y mạnh thực sách Bảo hiểm y tế tồn dân t ttttt t ttt tttt t tttttt tt 1tttttt tt tttt tttt địa bàn tỉnh Hà Tĩnh t ttttt t... 1ttt ttttt 1tt tttt tt dântrên địa bàntỉnh t tttt tt ttt tttt t 6.Kết cấu đề tài tttttttt tttttttt tttttttt tttttttt Chƣơng 1: Khung lý thuyết thực sách Bảo hiểm y tế toàn dân 1ttttt ttt tttt tttt