The economic analysis of the provision of medical services through medical insurance in Russia

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Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. Sep 2021; 29 (5): 1060-1065. doi: 10.32687 / 0869-866X-2021-29-5-1060-1065.

ABSTRACT

The article shows that the restrictions introduced during the coronavirus pandemic affected the dynamics of mutual settlements between the territorial compulsory health insurance funds (MMI, TFMMI). According to the results of the first nine months of 2020, the medical institutions of a number of subjects have not been able to earn even half of the amount of the sum that was presented for payment in 2019 on care support. medical care for patients from other regions. It was established that in addition to the relevant features of the Russian health system such as the large territory, the fragmentation of the population, the need to maintain a number of state medical institutions, there are also a number of factors which during the pandemic were most aggravated by the “weak” places in the long stagnant MMI system. Among these, an insufficient list of medical services covered by the MMI, the inability to provide medical services to all who need them due to lack of equipment, work areas, skilled care, etc. It is noted that among the general trends of the MMI, the Russian health insurance system (not only that it is not classic), especially during the pandemic, is broken down into social insurance: two funds, structures, computerization costs , etc. However, in Russia, even under such conditions, health care is funded by the MMI system up to 50%. The pandemic has demonstrated that no private sector, no paid service, no commercial insurance company can cover the full spectrum of health care complicity during the pandemic crisis. Namely, the MMI system has borne the brunt of the survival of medicine during the pandemic. It is concluded that, in particular, the need in medical facilities with an adequate reserve of funds for beds with MMI services can contribute to the development of a stable base necessary for survival in the difficult conditions of pandemic crisis. The proposal of the Accounts Chamber of the Russian Federation to continue reforming the compulsory health insurance system is considered reasonable and logical, especially in the difficult situation of combating COVID-19. The article also presents data regarding the state of MMI in 2020, at the height of the pandemic crisis in regions of the Russian Federation.

PMID:34665537 | DO I:10.32687 / 0869-866X-2021-29-5-1060-1065

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