The system of mandatory social health insurance in the Republic Of Kazakhstan: balancing financial sustainability and social protection of the population

Abstract

The economy of Kazakhstan is characterized by a pronounced social orientation, in which the healthcare system,
including insurance-based financing mechanisms, represents one of the key components of social protection
indicators. This study analyzes the financial mechanism of the compulsory social health insurance (CSHI) system
in the Republic of Kazakhstan in the context of implementing social protection objectives. Based on data from
the Social Health Insurance Fund for 2020–2024, the structure of funding sources, the dynamics of financial
inflows, and population coverage under the CSHI system are examined. The study assesses the degree of
budgetary dependence of the insurance model using an author-developed budget dependency coefficient
and the compound annual growth rate (CAGR). Institutional contradictions between the social orientation of
the system and its financial autonomy are identified, as well as a mismatch between the growth of financing
volumes and limited social outcomes in terms of the quality and accessibility of medical care. The findings
indicate the necessity of improving the financial and managerial mechanisms of the CSHI system to enhance
its sustainability and effectiveness as a tool of social protection. The results of the study may also be used for
analytical purposes and for improving healthcare financing policies.