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