Kurultai deputy Askhat Aimagambetov has stated that medical procedures which can lead to additional state expenditure, a burden on doctors and lost time for patients need to be reviewed.
WHERE UNNECESSARY COSTS ARISE
According to Askhat Aimagambetov, the state incurs additional costs because of procedures which, in his assessment, are not always necessary. As an example, he cited mandatory hospitalisation for the repeated confirmation of disability in cases where a person's condition is permanent and irreversible.
Under this procedure, a person has to book an appointment with a doctor, take tests, obtain a referral and join a queue through the hospitalisation portal. The patient then undergoes examinations and treatment as an inpatient, even though there may be no medical need for hospitalisation.
For the state and the compulsory social health insurance (OSMS) system, this means additional costs; for doctors, an additional burden; and for patients, lost time. The deputy also noted that such hospitalisations can increase the burden on hospital beds.
WHAT HAS CHANGED IN THE DISABILITY CONFIRMATION SYSTEM
As Askhat Aimagambetov reported, in 2025 his committee raised the issue of mandatory hospitalisation during the repeated confirmation of disability. The problem was discussed with the ministries of health and labour, after which a solution was found through amendments to subordinate legislation.
The deputy also noted the need to reform the medical and social assessment system, ruling out unjustified determinations of disability and removing unnecessary barriers for those who are entitled to assistance.
REPEATED TESTS BEFORE HOSPITALISATION
He gave a separate example involving oncology hospitals. According to him, before hospitalisation, patients may be required to undergo electrocardiography (ECG), echocardiography and a cardiologist consultation even in the absence of heart disease.
In just one oncology centre in Karaganda, as Aimagambetov noted, there are around 17,000 patient hospitalisations each year. In his estimation, this means thousands of repeated tests. At the same time, the absence of such procedures can lead to sanctions from the Social Health Insurance Fund (FSMS).
The deputy reported that doctors themselves propose establishing a validity period for test results and repeating them only when medically indicated.
WHY DIGITALISATION DOES NOT SOLVE THE PROBLEM ON ITS OWN
Askhat Aimagambetov considers digitalisation, the use of artificial intelligence (AI) and a review of the administrative processes themselves to be necessary.
According to him, before transferring a procedure to an electronic format, it is necessary to determine whether it is genuinely needed, which actions are duplicated and what information government bodies can obtain from each other without the citizen's involvement.
Thus, a digital format does not in itself eliminate the redundancy of a requirement: if an unnecessary procedure is simply moved into an electronic system, it will remain an additional step for the person and the state.
CONTEXT
The problem of financing OSMS in Kazakhstan took shape against the backdrop of identified violations in the payment for medical services and questions about the effectiveness of control over FSMS funds. In 2024, the Supreme Audit Chamber reported violations amounting to billions of tenge following an audit of the Fund's activities, and the FSMS itself later stated that there was a liquidity shortfall. In subsequent years, violations were also identified at the level of individual medical organisations.
In 2026, following an analysis of the FSMS's activities, a decision was taken to transfer the Fund to the remit of the ministry of finance, and President Kassym-Jomart Tokayev stated that the violations identified in OSMS were systemic in nature.
At the same time, law enforcement agencies continued investigations into cases linked to the possible unlawful receipt of medical insurance funds.
In the first half of 2026 alone, unjustified payments worth more than 4 billion tenge were prevented in the OSMS system. Anti-fraud mechanisms identified defects before the funds were transferred to medical organisations.
