{"id":3090,"date":"2013-11-29T20:51:27","date_gmt":"2013-11-29T18:51:27","guid":{"rendered":"http:\/\/www.ced.org.tr\/?p=3090"},"modified":"2013-11-29T20:51:27","modified_gmt":"2013-11-29T18:51:27","slug":"yeni-bir-pazar-genel-saglik-sigortasi","status":"publish","type":"post","link":"http:\/\/www.ced.org.tr\/?p=3090","title":{"rendered":"Yeni bir “pazar”: genel sa\u011fl\u0131k sigortas\u0131"},"content":{"rendered":"

Tamamlay\u0131c\u0131 sa\u011fl\u0131k sigortas\u0131<\/span><\/strong><\/span><\/span><\/h2>\n

Yeni b\u00fct\u00e7ede sgk\u2019yla ilgili olarak kurumun kar\u015f\u0131lad\u0131\u011f\u0131 sa\u011fl\u0131k hizmetlerinin daralt\u0131lmas\u0131 ve kapsanmayan hizmetler i\u00e7in <\/span><\/span><\/span>\u201ctamamlay\u0131c\u0131 sigorta\u201d<\/span><\/span><\/span><\/strong> uygulamas\u0131na ge\u00e7ilece\u011fi s\u00f6yleniyor.<\/p>\n

<\/span><\/span><\/span><\/h2>\n

http:\/\/www.bianet.org\/bianet\/saglik\/151666-sgk-nin-gelecegine-dair<\/span><\/span><\/span><\/a><\/p>\n

sgk\u2019n\u0131n gelece\u011fine dair…<\/span><\/span><\/span><\/h2>\n

2014 b\u00fct\u00e7esine dair ilk i\u015faretler sgk a\u00e7\u0131s\u0131ndan beklenenle \u00f6rt\u00fc\u015f\u00fcyor: \u201c<\/span><\/span><\/span>tamamlay\u0131c\u0131 sa\u011fl\u0131k sigortas\u0131\u201d.<\/span><\/span><\/span><\/span><\/strong><\/p>\n

mustafa s\u00fctla\u015f<\/span><\/span><\/span><\/a><\/p>\n

musutlas@gmail.com<\/span><\/span><\/span><\/a><\/p>\n

\u00a0<\/p>\n

\u0130stanbul – B\u0130A Haber Merkezi<\/span><\/span><\/span><\/p>\n

28 Kas\u0131m 2013, Per\u015fembe 15:30<\/span><\/span><\/span><\/p>\n

<\/span><\/p>\n

hegel<\/span><\/span><\/span><\/span><\/strong>\u2019in \u201ctarih tekerr\u00fcrden ibarettir\u201d s\u00f6z\u00fcn\u00fc <\/span><\/span><\/span>marks<\/span><\/span><\/span><\/span><\/strong> \u201cevet tarih tekerr\u00fcrden ibarettir; ama ilkinde trajedi, ikincisinde komedi ya\u015fan\u0131r\u201d diyerek yan\u0131tlar. dolay\u0131s\u0131yla insanl\u0131k tarihinin b\u00fcy\u00fck b\u00f6l\u00fcm\u00fc bir \u201ckomedi\u201dden ibarettir. ama ne yaz\u0131k ki bu s\u0131kl\u0131kla \u201cac\u0131 bir komedi\u201ddir…<\/span><\/span><\/span><\/p>\n

genel sa\u011fl\u0131k sigortas\u0131<\/span><\/span><\/span><\/span><\/strong> konusu da bu \u201cac\u0131l\u0131 tekrar\u201d\u0131n s\u0131k\u00e7a ya\u015fand\u0131\u011f\u0131 konulardan birisidir.<\/span><\/span><\/span><\/p>\n

ne yaz\u0131k ki ne olaca\u011f\u0131 bilinmesine, \u00f6ng\u00f6r\u00fclmesi, hatta s\u0131k\u00e7a s\u00f6ylenmesine kar\u015f\u0131n yine de o \u201cac\u0131 tekrar\u201d defalarca ya\u015fanmaktad\u0131r ve ya\u015fanmaya devam edilecektir.<\/span><\/span><\/span><\/p>\n

hi\u00e7 istemedi\u011fim \u201cben demi\u015ftim\u201d s\u00f6z\u00fcn\u00fc bir kez daha yinelememe neden olsa da, bir kez daha \u201cmedyumluk\u201d yapmadan, gelece\u011fi s\u00f6ylemek ve<\/span><\/span><\/span>gss ve sgk<\/span><\/span><\/span><\/span><\/strong> konusunda olacaklar\u0131 bir kez daha anlatmak istiyorum:<\/span><\/span><\/span><\/p>\n

yeni bir \u201cpazar\u201d: genel sa\u011fl\u0131k sigortas\u0131<\/span><\/span><\/span><\/span><\/strong><\/h2>\n

yeni b\u00fct\u00e7ede sgk\u2019yla ilgili olarak kurumun kar\u015f\u0131lad\u0131\u011f\u0131 sa\u011fl\u0131k hizmetlerinin daralt\u0131lmas\u0131 ve kapsanmayan hizmetler i\u00e7in <\/span><\/span><\/span>\u201ctamamlay\u0131c\u0131 sigorta\u201d<\/span><\/span><\/span><\/span><\/strong>uygulamas\u0131na ge\u00e7ilece\u011fi s\u00f6yleniyor.<\/span><\/span><\/span><\/p>\n

sgk\u2019n\u0131n bu kadar \u201ch\u0131zla ve a\u015f\u0131r\u0131\u201d b\u00fcy\u00fcyen bir sa\u011fl\u0131k hizmet faturas\u0131n\u0131 \u00f6deyemeyece\u011fi \u00e7ok a\u00e7\u0131kt\u0131. <\/span><\/span><\/span>\u201csgk\u2019n\u0131n sa\u011fl\u0131k hizmetini piyasala\u015ft\u0131raca\u011f\u0131n\u0131 ve dolay\u0131s\u0131yla pahaland\u0131raca\u011f\u0131n\u0131, skg\u2019n\u0131n alt\u0131ndan kalkamayaca\u011f\u0131n\u0131\u201d<\/span><\/span><\/span><\/span><\/em> defalarca yinelemi\u015ftik.<\/span><\/span><\/span><\/p>\n

\u00e7ok s\u00fcrmedi on y\u0131lda beklenen oldu, oluyor.<\/span><\/span><\/span><\/p>\n

\u015fimdi ne olaca\u011f\u0131n\u0131 yine ba\u015fka \u00fclkelerde ya\u015fanan \u00f6rneklerden \u201ckopya \u00e7ekerek\u201d anlatal\u0131m:<\/span><\/span><\/span><\/p>\n

sgk\u2019n\u0131n kar\u015f\u0131lad\u0131\u011f\u0131 sa\u011fl\u0131kla ilgili hizmetlerin kapsam\u0131 g\u00fcnden g\u00fcne daral\u0131rken, onun kar\u015f\u0131lamad\u0131\u011f\u0131 hizmetler i\u00e7in gerekli olan ve uygulamaya konulan \u201ctamamlay\u0131c\u0131 sigorta\u201d her ge\u00e7en g\u00fcn primleri y\u00fckselerek yayg\u0131nla\u015facak; prim \u00f6deyen insan say\u0131s\u0131 \u00e7o\u011falacak, dahas\u0131 t\u00fcr olarak da \u00e7e\u015fitlenecek.<\/span><\/span><\/span><\/p>\n

kapsanan hizmet t\u00fcr\u00fcne g\u00f6re <\/span><\/span><\/span>\u201cfarkl\u0131\u201d<\/span><\/span><\/span><\/span><\/strong> tamamlay\u0131c\u0131 sigorta tipleri g\u00fcndeme getirilecek.<\/span><\/span><\/span><\/p>\n

\u00f6rne\u011fin kalp hastal\u0131\u011f\u0131, enfeksiyon hastal\u0131klar\u0131, kanser gibi \u201chastal\u0131\u011fa\/duruma y\u00f6nelik\u201d ayr\u0131 sigortalar yap\u0131lmak zorunda kal\u0131nacak. her bir sigorta, ayr\u0131 bir \u201cprim\u201d anlam\u0131na gelecek ku\u015fkusuz.<\/span><\/span><\/span><\/p>\n

ikinci evre: sgk\u2019n\u0131n \u00f6zelle\u015ftirilmesi<\/span><\/span><\/span><\/span><\/strong><\/h2>\n

art\u0131k i\u00e7inde olunmas\u0131 zorunlu olan sgk \u00fcyeleri, \u00f6dedikleri prim oranlar\u0131na g\u00f6re sgk taraf\u0131ndan grupland\u0131r\u0131lacak. \u201cy\u00fcksek ve d\u00fczenli\u201d prim \u00f6deyenlerden ba\u015flayarak mevcut sgk\u2019y\u0131, farkl\u0131 ve yeni sgk\u2019lara b\u00f6lecek. b\u00f6ylelikle ortalama olarak \u201c<\/span><\/span><\/span>4 ya da 5\u201d farkl\u0131 sgk\u2019m\u0131z olacak.<\/span><\/span><\/span><\/span><\/strong><\/p>\n

bu oldu\u011funda \u201csgk\u2019na bakay\u0131m senin kim oldu\u011funu s\u00f6yleyeyim\u201d ya da \u201cye sgk\u2019am ye\u201d s\u00f6zleri s\u00f6zl\u00fcklere girecek ve giderek al\u0131\u015faca\u011f\u0131z bu uygulamaya. tabii ki e\u011fer sgk primimizi \u00f6deyebiliyorsak!<\/span><\/span><\/span><\/p>\n

bu durumun yerle\u015fti\u011fi andan itibaren de yine y\u00fcksek ve d\u00fczenli prim \u00f6deyenlerin sgk\u2019lar\u0131 \u00f6ncelikli olmak \u00fczere zaman i\u00e7inde a\u015fa\u011f\u0131ya do\u011fru inerek bu yeni ve farkl\u0131 \u201csgk\u201dlar, dolay\u0131s\u0131yla sgk\u2019n\u0131n b\u00fct\u00fcn\u00fc dilim dilim \u00f6zelle\u015fecek.<\/span><\/span><\/span><\/p>\n

asl\u0131nda vatanda\u015f bunu \u201cpiyasa kurallar\u0131 y\u00fcz\u00fcnden\u201d \u00e7ok k\u00fc\u00e7\u00fck bir prim farklar\u0131 nedeniyle \u201cye\u011fler hale gelecek\u201d.<\/span><\/span><\/span><\/p>\n

sonunda devletin \u201c\u00fczerinde ya da elinde\u201d kalan sgk yaln\u0131z \u201c4. ve 5. gruplar\u0131 kapsayanlar\u0131\u201d yani hi\u00e7 prim \u00f6deyemeyen ve e\u011fer h\u00e2l\u00e2 devlet memuru kalm\u0131\u015fsa onlar\u0131n en alt d\u00fczeyde \u00fccretlendirilenlerin sa\u011fl\u0131k sigortas\u0131 haline gelecek.<\/span><\/span><\/span><\/p>\n

k\u00fcresel sigorta \u015firketleri ve batan \u015firketler<\/span><\/span><\/span><\/span><\/strong><\/h2>\n

y\u00fcksek prim \u00f6deyenlerin kat\u0131ld\u0131\u011f\u0131 \u201cdurumu s\u00fcrd\u00fcrebilen\u201d sigorta \u015firketleri ise h\u0131zla k\u00fcresel \u015firketlerin eline ge\u00e7ecek.<\/span><\/span><\/span><\/p>\n

vatanda\u015flar\u0131m\u0131z art\u0131k \u00f6rne\u011fin \u201camerikan sigorta\u201d \u015firketlerinde sigortal\u0131 hale gelecekler ve buna sevinecekler. ama \u00e7ok sevinmesinler, \u00e7\u00fcnk\u00fc<\/span><\/span><\/span>\u201cobama reformu\u201d <\/span><\/span><\/span><\/span><\/strong>kapsam\u0131 i\u00e7inde olmayacaklar ne yaz\u0131k ki!<\/span><\/span><\/span><\/p>\n

ama onlar kuvvetli olduklar\u0131 i\u00e7in sigortal\u0131lar\u0131n\u0131 hizmetin en ucuza sunuldu\u011fu kurumlara, yerlere ve hatta \u00fclkelere y\u00f6nelecek.<\/span><\/span><\/span><\/p>\n

b\u00f6ylelikle \u00f6nceki g\u00fcn ba\u015fbakan\u0131n \u00f6v\u00fcnd\u00fc\u011f\u00fc yurt d\u0131\u015f\u0131na \u00e7\u0131kan vatanda\u015flar\u0131m\u0131z\u0131n say\u0131s\u0131 daha da artacak ve \u201csa\u011fl\u0131k turizmi\u201d yapan vatanda\u015flar\u0131m\u0131z giderek \u00e7o\u011falacak.<\/span><\/span><\/span><\/p>\n

\u201c<\/span><\/em>\u015feamet tellall\u0131\u011f\u0131 yap\u0131yorsun\u201d <\/span><\/span><\/span><\/span><\/em>diyecek baz\u0131lar\u0131n\u0131z ama s\u00fcrd\u00fcreyim:<\/span><\/span><\/span><\/p>\n

\u00f6zelle\u015ftirilen b\u00f6l\u00fcmleri sat\u0131n alan sigorta \u015firketleri bir s\u00fcre sonra t\u0131pk\u0131 \u015fimdi sgk\u2019n\u0131n ya\u015fad\u0131klar\u0131n\u0131 ya\u015fayacaklar ve bu i\u015fi s\u00fcrd\u00fcremeyip batacaklar.<\/span><\/span><\/span><\/p>\n

tabii ki bir s\u00fcre sonra \u201cdevlet taraf\u0131ndan kurtar\u0131lacak\u201dlar…<\/span><\/span><\/span><\/p>\n

hep \u00f6yle olmad\u0131 m\u0131!… ne de olsa \u201cdevlet babad\u0131r\u201d… \u00fcstelik de \u00e7o\u011fu babalar gibi \u201cbaba\u201dd\u0131r.<\/span><\/span><\/span><\/p>\n

tam da onlar\u0131n kurtar\u0131ld\u0131\u011f\u0131 o d\u00f6nemde devlet zaten en alt grubun sa\u011fl\u0131k hizmet giderlerini bile\u00a0 kar\u015f\u0131layamad\u0131\u011f\u0131 i\u00e7in, \u201ckonkordato\u201d ilan edecek ve eklenen n\u00fcfusla birlikte <\/span><\/span><\/span>\u201cgss modeli\u201d<\/span><\/span><\/span><\/span><\/strong>nin art\u0131k \u201cs\u00fcrd\u00fcr\u00fclemez\u201d olaca\u011f\u0131na karar verip, bundan vazge\u00e7mek zorunda kalacak ve ba\u015fka bir model bulacak.<\/span><\/span><\/span><\/p>\n

genel b\u00fct\u00e7eden ve \u00fccretsiz sa\u011fl\u0131k hizmeti<\/span><\/span><\/span><\/span><\/strong><\/h2>\n

gss d\u0131\u015f\u0131ndaki tek ve ak\u0131lc\u0131 model de hizmetin genel b\u00fct\u00e7eden kar\u015f\u0131lanmas\u0131 ve t\u00fcm\u00fcyle \u00fccretsiz olarak sunulmas\u0131 oldu\u011fu i\u00e7in zorunlu olarak ona d\u00f6n\u00fclecek. b\u00f6ylece bu \u00fclkede \u201cgss maceras\u0131\u201d da, \u201ccan ve beden pahas\u0131na\u201d bitmi\u015f, bitirilmi\u015f olacak!<\/span><\/span><\/span><\/p>\n

bu s\u00fcrecin toplam\u0131 en \u00e7ok 20-25 y\u0131ld\u0131r.<\/span><\/span><\/span><\/p>\n

bu zaman zarf\u0131nda da en iyimser tahminlere g\u00f6re en az 1000 (yaz\u0131yla: bin) milyar dolarl\u0131k bir kaynak sa\u011fl\u0131k ve sigorta konusundaki k\u00fcresel ve \u00f6zel \u015firketlere ak\u0131t\u0131lm\u0131\u015f olacak.<\/span><\/span><\/span><\/p>\n

tabii ki bu s\u00fcrecin sonunda o d\u00f6neme yeti\u015fenler \u201csevinecekler\u201d bir kez daha.<\/span><\/span><\/span><\/p>\n

ve \u201cherkese e\u015fit \u00fccretsiz sa\u011fl\u0131k\u201d diyenler de ama\u00e7lar\u0131na ula\u015fm\u0131\u015f olacaklar!<\/span><\/span><\/span><\/p>\n

ama ba\u015flang\u0131\u00e7 noktas\u0131na d\u00f6nd\u00fc\u011f\u00fcm\u00fcz i\u00e7in hep beraber ayn\u0131 s\u00f6z\u00fc s\u00f6yleyece\u011fiz:<\/span><\/span><\/span><\/p>\n

<\/span>\u201c<\/span><\/em>biz bu halt\u0131 neden yedik!\u201d<\/span><\/span><\/span><\/span><\/em><\/p>\n

tabii beklenen kahkahalar yerini buruk g\u00fcl\u00fcmsemelere b\u0131rakm\u0131\u015f olacak.<\/span><\/span><\/span><\/p>\n

i\u015fte onun i\u00e7in bu komedinin ad\u0131 da \u201cac\u0131kl\u0131 komedi\u201ddir ve \u00f6yle bilinecek…<\/span><\/span><\/span><\/p>\n

tarih tekerr\u00fcrden ibarettir ger\u00e7ekten de…<\/span><\/span><\/span><\/p>\n

can, beden ve sa\u011fl\u0131k pahas\u0131na tekerrr\u00fcr ettirmemek ise \u201cinsan\u201dlar\u0131n elindedir.<\/span><\/span><\/span><\/p>\n

ama \u201csahiden\u201d insanlar\u0131n! (ms\/hk)<\/span><\/span><\/span><\/p>\n

\u00a0<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"

Tamamlay\u0131c\u0131 sa\u011fl\u0131k sigortas\u0131 Yeni b\u00fct\u00e7ede sgk\u2019yla ilgili olarak kurumun kar\u015f\u0131lad\u0131\u011f\u0131 sa\u011fl\u0131k hizmetlerinin daralt\u0131lmas\u0131 ve kapsanmayan hizmetler i\u00e7in \u201ctamamlay\u0131c\u0131 sigorta\u201d uygulamas\u0131na...<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[62],"tags":[],"class_list":["post-3090","post","type-post","status-publish","format-standard","hentry","category-sagliktan-haberler"],"aioseo_notices":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts\/3090","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3090"}],"version-history":[{"count":0,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=\/wp\/v2\/posts\/3090\/revisions"}],"wp:attachment":[{"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3090"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3090"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.ced.org.tr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3090"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}