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 socioeconomic 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
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

* ThS, Bdo hem xa hoi Vtet Nam

54 I Tap chi Khoa hpc N6i vu

Ngdy duyet ddng: 15/11/201S

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 dl 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


V X KINH NGHliM-THUC TliN I
Thfle te hiln nay, viee thflc hien ehinh sdch

dflpc tam quan trpng eua ehinh sach nay nin


ASXH ddi vdi NCT d nfldc ta dang ed mdt sd

da tham gia BHXH vdi hinh thfle tfl nguyen.

ban che, vfldng mac nhfl sau:

Tuy nhien, mdt sd ngfldi lao ddng vd chu sfl

- Quy dinh vl doi tfldng

dung lao ddng van ehfla nhan thfle dung dan

Theo quy dinh eua Ludt NCT nam 2009,

dfldc chinh sach, edn nhilu doanh nghilp xay

nhflng edng dan Viet Nam tfl du 60 tudi trd

ra tinh trang trdn ddng, nd ddng BHXH ddn

len thi dfldc coi la NCT. Tuy nhien, dilu nay

tdi viee giai quylt ehe dp hflu tri eho ngfldi lao

cung dang gay ra sfl mau thuan ve vile xdc

ddng den tudi nghi hflu edn nhieu khd khan.

dinh ddi tfldng eho nhdm ehinh sdch nay.


Bin canh dd, sd Iflpng ngfldi lao dpng hfldng

Theo quy dinh cua Luat BHXH (2014), ddi

BHXH mpt Ian ed xu hfldng gia tang eung la

tfldng duac xae dinh du dilu kiln hfldng ehe

nguyen nhan dan tdi nhilu NCT trong tfldng

dp hflu tri la doi tfldng cd thdi gian tham gia

lai se khdng du dieu kiln hfldng ehl dp hflu

ddng BHXH tfl du 20 nam va den tudi nghi

tri.

hflu, ddi vdi nam Id 60 tudi, doi vdi nfl Id 55
tudi. Nhfl vay, nfl ngoai dd tudi 55 da dflpc

- Sfl phdi hpp thflc hiln chinh sdch cua cdc
edquan

tinh la ngoai dp tudi lao ddng, nhflng ddi

Theo bdo cdo tong kit hit nam 2017 cua

ehilu vdi Luat NCT (2009) thi van chfla du


Uy ban Qudc gia vl NCT Viet Nam, tai mdt

dilu kiln de dfldc tinh la NCT. Vi vay, cdc nha

so ndi, cap fly dang, chinh quyln dia phfldng,

hoach dinh ehinh sdch ASXH danh cho NCT

ed sd ehfla nhdn thfle day du trach nhiem cua

d nflde ta eung can lflu y den bat cap nay de

minh trong thfle hien chinh sach phap luat

tranh xdy ra thilu sdt, bd quin ddi tfldng.

ddi vdi NCT, thilu quan tdm, chi dao, chfla

- Thu nhap cua NCT

xdy dflng dfldc k l hoach boat ddng cu the, coi

Viet Nam la dat nfldc cd nhilu truyin

edng tac NCT chi Id nhflng boat ddng phong

thdng tdt dep ve gia dinh, trong dd ed r^t

trao. Bin canh dd, ngudn Ifle danh eho cdng


nhilu NCT hien dang tfl lao dpng kilm sdng

tdc NCT cdn ban chi. Vi vay, viec cae dia

hoac sdng dfla vdo eon ehau. Tinh den thdng

phfldng khdng xay dflng ke ho^ch cu the se

6/2018, ed khoang 1,7 trilu NCT, xap xi 16%

rat khd de huy ddng nhflng ngudn Ifle khdc

tong so NCT tai nfldc ta, nhilu ngfldi trong

ngoai xa hdi, md sfl hd trp eua Nha nfldc lai

sd dd dang dfldc hfldng che dO hflu tri - la

cd han.

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

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

tham gia ddng BHXH tfl du 20 nam trd lln.


nui, dieu kien kinh te - xa hdi edn khd khan.

Vdi tudi thp ngdy eang tang eao nhfl hien nay,

Mdt sd bd nganh, dia phfldng ddi vdi viee

ehinh sdch BHXH Id sfl quan tdm cua Nha

trien khai ehinh sdch NCT edn cb^im, ehfla

nflde ddi vdi thu nhap ciia NCT. Mdt sd ngfldi

chu ddng long ghep eae hoat ddng eua nganh

trong dd tudi lao ddng hien nay da nhan thflc

vdi cdng tdc NCT, trien khai cua nhieu ddn vi

55 I Tap chi Khoa hpc Npi vu


KINH NGHIEM-THUC TliN

///

khdng ddng bd, kip thdi,...
2. Mpt so giai phap hoan thien chinh
sach ASXH doi vdi NCT

khde, trfldc hit, can ndng eao chat Iflpng hi


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:

tinh eho NCT. Day la dieu kien tien quyet

- 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.

thdng y te, chdm sdc sfle khde, phdng benh,
kham, chfla benh va quan ly cac benh man
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

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.

Xay dflng va phat trien hinh thflc cham soc

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.

benh eho ngfldi dan ndi ehung cung nhU

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 tru,...
D l dam bao quyln Idi dflde kham, ehfla
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
- Tdng cUdng dau tU ve linh vUc y te, cham binh khi dm dau. Nhflng ddi tfldng NCT
sdc site khde

dflde hfldng trp cap hflu tri ddng thdi se dflpc
Hiln nay, ddi song vat chat va tinh thdn cap the BHYT. Tuy nhien, van cdn mdt bo
eua NCT d nhieu ndi van con nhilu khd phan khdng nhd nhflng NCT cd hoan canh
khan, thilu thdn, nhat Id d ndng thdn, vflng khd khdn, khdng ndi nfldng tfla, thudc dien
sau, vflng xa. Vi vdy, can thilt phai cd nhieu ngheo, khdng ed Ifldng hflu, khdng ed trp cap
giai phap nhdm nang eao sflc khde ca vl the va cung khong cd BHYT.
chat va tinh than eua NCT, de hp sdng vui,
Gid hda dan sd tao ra thdeh thfle Idn, doi
sdng khde, phat huy dflpc vai trd cua minh
hdi phai xay dflng ehinh sach cham sdc sflc
trong gia dinh va xa hdi.
khde NCT dfla tren edng ddng, thay the d£n
De NCT dat dflpc mue tieu sdng lau, sdng yeu td gia dinh. Hien nay, nflde ta cung da

56 I Tap chi Khoa hpc Npi vu


VCfc. KINH NGHliM-THUC TliN (
bat dau xay dflng h i thdng cham sdc NCT

II NCT cd hpc van vd ehuyen mdn ngdy cdng

vdi mdt so nha dfldng lao cua nhd nfldc, tuy

tang la cd hdi de khuyen khich nhflng ngfldi

nhien theo bao cdo gan day cua Uy ban Qudc

eao tuoi ed ki nang, kinh nghiem nghe nghilp


gia NCT, cac nha dfldng lao nay phu thudc

cung tham gia lao ddng, dao tao the he tre se

vdo kinh phi ciia nha nflde eho nen ed sd vat

tao dfldc hilu flng tich cflc ea va mat kinh te,

chat edn thieu thdn, trinh dd chuyen mdn,

xa hdi, dac biet trong eae nganh ma hpc qua

nghilp vu, ky nang eham sdc NCT eiia can

thflc hanh la ehu ylu thi vile nay vfla tao dilu

bp cdn thieu va yeu. Do vay, de giai quylt khd

kien eho NCT tham gia lao dpng, vfla la hinh
khan nay, can td chflc \%i mang Ifldi eung cap thfle dao tao tiet kiem cd hieu qua. Ngoai ddi
dich vu y te cung nhfl ed chi tdi chinh y te, tfldng NCT cd hpc van, doi vdi ngfldi gia cd
dae bilt la BHYT, nang cao khd nang tiep can

khd nang vd ed mong muon lao ddng, can co

cua toan dan, ddng thdi cd phflpng an dilu

chinh sach tao dilu kiln va giai quyet viee

chinh tudi hflu.


lam.

- Thuc day chinh sdch viec 1dm

Cac chinh sdch ve vile lam can linh boat,

Mue tieu dau tien cua chinh sdch viec lam

phu hpp, thuc day NCT vfla duy tri dflde sfle

danh eho ddi tflpng NCT Id bdo ddm thu nhap

khde, vfla ed thu nhap, thay ddi quan niem va

tdi thilu va giam ngheo bin vflng cho nhdm

thai dp xa hdi vl gia hda, nhin nhan NCT la

ngfldi NCT khong ed Ifldng hflu hay nhflng

nhflng thanh viln ed ddng gdp tieh eflc eho

trp cap xa hdi khae.

xa hdi.

Khi dan sd gia di nghia la sd Ifldng ngfldi

- Xdy dUng he thong cd sd dU lieu ve NCT


tham gia vao Iflc Ifldng lao ddng eung ed xu

Hiln nay, Nha nflde ta dang ehu trpng din

hfldng giam theo vd cd tdc ddng khdng tdt tdi

vile day manh phdt triln he thdng thdng tin,

nin kinh tl. Vdi tdc dp gid hda ddn sd d nflde

dfl lieu chung cua ea nfldc. Vi vay vile lflu trfl

ta trong top nhanh nhat the gidi, thi tdc ddng

Cd sd dfl lieu vl NCT la biln phdp bat kip vdi

cfla nd tdi nin kinh t l edn manh me hdn. Tuy

xu tbI, dam bao dflpc vile lflu trfl, khai thac

nhien, dieu nay eung khdng ban ehi mang lai

vd sfl dung thdng tin quan ly NCT. Vile hoan

nhflng tac ddng tieu eflc. Ban chat eua sfl gid

thiln he thdng cd sd dfl lieu cua NCT mang

hda dan sd la ty sudt ngfldi trIn dd tudi lao


lai nhflng Idi ich vd cflng thilt thflc nhfl: quan

dpng Idn hdn ngfldi dfldi dp tudi 15, dilu dd

ly thdng tin cd bdn, cdc ngudn trp cap, tinh

ddng nghia vdi Iflpng dan sd cd kinh nghilm,

trang sfle khde,... Khdng cd nhflng thong tin

kien thfle Idn. Trong dieu kiln hiln nay, tuoi

chinh xae, cap nh4t ve NCT thi khdng the cd

thp trung binh cua con ngfldi tang cao ddng

nhflng danh gia xae dang vl cac van dl kinh

nghia vdi chat Ifldng sfle khde NCT cung

te, xa hpi va sflc khde cua ngfldi eao tudi. Day

dflpc cai thien ro ret. De sfl dung tdi da ngudn

se la dau vdo quan trpng eho vile dl xuat eae

nhan Ifle trong dilu kiln ty II tham gia lao

ehinh sach, ehflpng trinh thilt thfle, ed trpng


ddng giam dan, can phai ed nhflng chinh sach

tdm va hilu qud cho viec khai thdc, nghiln

hd trd viec 1dm ddi vdi NCT hieu qua. Viee ty

eflu chuyin sau vl NCT, trong do ylu cau dat

57 I Tap chi Khoa hpc Npi vu


KINH NGHIEM-THUC TliN

///

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 dl 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, dl 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

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

nhdn d^n din vile can dilu ehinh tudi nghi

- Nguyen Van Tap, Trfldng Viet Dung, Dio

hflu. Dau tien ed the ke tdi do tuoi thp binh

Van Dung, "Nhu cdu, khd ndngtiep edn vdsiidiini

qudn cua ngfldi dan dang tang. Theo sd lieu

dich vu y tecua NCT tai 28 xd ndng thdn trong 02


cua Diln dan Kinh t l the gidi thi vao nam

ndm 2000-2001", Tap chi Y hpc thflc hdnh, BQ V

2016, tuoi thp binh quan cua ngfldi Viet Nam

te. So 09 (487), 2004, Tr.15-47.

la 75,6 tuoi. Dilu nay cho thay thdnh qud eua

58 I Tap chi Khoa hpc Npi vu

- Quoe hdi, Luat Ngitdi cao tuoi (2010), Ha Ngi