مجلة الدراسات والبحوث القانونية
Volume 3, Numéro 3, Pages 131-149
2018-09-10

التحولات القانونية لنظام التأمين الطبي Legal Changes In The Medical Insurance System

الكاتب : عبد المجيد خطوي .

الملخص

إن المبدأ الأساسي للتأمين الصحي هو مواجهة المخاطر الطبية، لأنه كلما تطورت المجتمعات ازداد معها تطور عدد الأفراد وازدادت معه الأمراض و المسؤولية القانونية الناجمة عنها، وأيضا زادت الحاجه إلى الحماية والأمان ضد المخاطر الطبية، وذلك كون أن الأصل في الضمان الاجتماعي والطبي هو الاحتياط لوقت يحتاجه فيه الشخص لمواجهه متطلبات مستقبليه محتمله الوقوع، حيث يستمد هذا النظام قوامه المالي من اشتراكات المنخرطين وفي مقابل ذلك يطالب هؤلاء بالتعويض عند الحاجة، كما يجب التأكيد على مساهمة برامج وخدمات التأمين الصحي في حمايه المريض، وذلك من خلال توفير الحماية الاجتماعية ضد خطر المرض، والتي من شانها التأثير على كل ما يتعلق بالمريض، ويؤدي كذلك إلى زيادة الطلب على خدمات التامين الاجتماعي والطبي. وقد نتج عن هذه التطورات في المجال القانوني والاجتماعي تشكل نظام التامين من المسؤولية الطبية، إلى غايه اكتمال الصورة بظهور قواعد حديثة لتأمين المسؤولية الطبية. Abstract: The world knows a great civilization and scientific and technological development very important. Despite this, power and grace, this civilization is powerless and unable to plague considered the most dangerous, which threatens the security of all countries is medical risks that strikes all mankind by generating a large number of innocent victims. The progressive processes in the legal field and the regime of international law to protect the environment have resulted from responsibility. The relevant information system, relating to solidarity, is both a copyright transaction and the carrying out of its functions. And is removed from work in the area of medical liability, because of the inability of civil liability to perform its compensatory function.And before the effectiveness of the rules of civil and administrative and Criminal responsibility for many legislations have used new compensation schemes like the guaranteed funds and insurance which contributed effectively in the compensation for Victims medical risks. The basic principle of health insurance is to guard against medical risks, since all societies in development have more of the need for disease protection and the accompanying responsibilities, in fact, the origin of the disease. social and medical insurance is the security sought by any person for future and probable needs, this system is fed by financial resources from membership fees and in return they ask for indeminization in case of need, in addition it is necessary emphasize the importance of the contribution of health programs and services in the protection of the sick health insurance, Through the provision of social and health cover against disease risks provide social protection the risk of illness and can influence patients from many forms, so the multiplication of these risks causes the increase in demand on social security and medical services. Progress in the medical and legal fields has led to the emergence of the system of medical liability insurance up to modern rules delimiting and covering medical liability. The compensation for medical liability is the obligation of doctors and medical facilities to insure their liability under the insurance and collective compensation systems, or to be compensated by the security funds, with the possibility that the State may intervene sometimes to compensate for such damages, so that this intervention is complementary to those traditional systems of compensation, As a multifaceted and multifaceted intervention in the absence of a general rule of liability for performing its compensatory function for these risks, most regimes and legislation have resorted to the development of new methods to protect the injured, while retaining the general systems of risk compensation Or development. The establishment of a group of distinct mechanisms of compensation and insurance of a participatory nature in some European countries

الكلمات المفتاحية

التأمين الطبي. المسؤولية المدنية ،صناديق، الضمان التشاركي. Medical Insurance, Civil Insurance, Social Funds, Mutual Security.