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The Federation Council proposed to abolish the HIF

The Federation Council is preparing a proposal on the Elimination of Mandatory Health Insurance Fund (HIF), and returning to direct budget financing of medical care. A number of senators are convinced that in times of crisis is a necessary condition for the realization of citizens’ constitutional right to health protection.

In recent years, experts say, there is a number of complaints to the sharp rise in that people either denied free medical care or forced to wait for several months.

On Wednesday a meeting of the commission for monitoring the economic situation of the Federation Council, which examined the structure of the report on the economic situation in the country and offers to modernize the economy and overcome the crisis.

In this document, which is supposed to consider about a month at a plenary session of the upper chamber, there is an economic and social unit.

In the latter, which deals with the provision of social protection in the crisis, said the need to abandon the current health care financing system.

Commission Chairman Sergey Kalashnikov told “Izvestia”, that it is necessary to adopt a law “On the financing of health care in the Russian Federation”, which will eliminate HIF, lay these on the budget costs and provide for transfer of funding from the federal and regional levels.

- The government does not go out to fundamentally change the system. It is afraid of any changes, hoping that everything will resolve itself. The criticality of the situation forced to take this decision. Another thing is that to live in this time, a great many people do not have to - says the senator. - Insurance companies, logically, should be engaged in preventive medicine, because it is easier to prevent a disease than to cure. And we have a prevention system is completely lost, even though it was the main feature of the model semashkovskoy medicine taken over half of the world.

Now in the regions at the same time there are two medical aid program: general federal minimum program, which provides the HIF. And in addition, each region receives in addition to his program. At the same time the worst of all those regions who have decided that they can not reduce the level of medical guarantees and have the same social obligations which were in 2014-2015. But the economic situation has deteriorated dramatically. In regions of the duty to pay for the non-working population - pensioners, the unemployed, etc. These citizens do not pay into the fund, which pays for the subject, which often do not have money.

- Regions are mostly bankrupt. In 2005, when the federal government has transferred a number of powers, that is, its social obligations to the regions, there were 46. And today its 105. And many of them are underfunded, - cites Sergey Kalashnikov.

A vicious circle: the more in the region of pensioners, the unemployed, people working in the informal economy, the greater the regional budget should allocate money. And at the same time for the same reason - a relatively small proportion of working citizens and paying taxes, that is, the region has less capacity to pay.

- We have a dummy OMS system, - said Kalashnikov. - It can not be called insurance, as the President said back in 2012. It was useful in 1993, when the guaranteed target revenue: then it was not on the medicine budget, and it was purely money on health care, no one could not withdraw. And then, in the first half of 1990, she saved the situation. But now play this simulation model can not be insured, especially in our country. In accordance with Article 41. Constitution, free medical care in Russia. This means that care must be taken on the budget - and no options! And we came up with another intermediary, who do not understand what the money is aspirated.

Professor, Department of Labour and Social Policy RANHiGS Love Hrapylina told “Izvestia” that, according to recent monitoring, 98% of Russians are dissatisfied with the system of providing medical care. And most importantly, what to complain - institutions often do not have a quality and timely assistance, saying that “there is no money.” Often it is a pretext to send the patient to the registry of paid services. And it’s weird - people paid taxes to the budget, in which there is an article about health care, paid the CHI fund, and in the clinic they can offer to pay again.

- Paid services have become the norm, - Hrapylina said. - They are literally flooded all that is related to health care. But we had already paid! And for some reason, in the hospitals and clinics believe that it is nothing.

protection of patients League President Alexander Saversky told “Izvestia” that one of the problems of both the current budget and insurance system, as well as simply the insurance system - understandable criteria for the evaluation of health care, which is paid by the insurance company if pay for treatment, the institution will be infinitely treat if you pay for the result, hospitals will burn healthy people sick, and then declare healthy.

- The only best way of financing - on the contents of the health care system, - said Saversky. - Just as the army is contained. If we think about it, it is absolutely correct. Health - the same function as the protection of borders, security, the rule of law. There should be no commodity-money relations in the system! As an army we have found? People get paid work. The same is true here: the doctor is part time at work, and for this he should receive a decent wage. For budget. The health system - it is the same army that fights the disease each day, an army in action, rather than waiting for that war. Financing of such a system - design economy, which should be easy to plan.

He noted that the Soviet primary care in 1970 was recognized as the best in the world, and in general in 1978, the Soviet Union was the recognition by the WHO on 22-th place - for comparison, the US is now on the 37th.

- Because there are areas of the state that should not be regulated by the market, and planning. They calculated the distribution of the patients - have created a system of care, and it remains only to support, to introduce new technologies. This is the real management. I objected: expensive. And I say - let’s prepay expensive drugs. In the Kirov region did so, and the result showed that if they do, then they load on the patient and of rescue unit is reduced by 20-25%. Trust in the market is very stupid - pay all the money, just to live, - concluded the expert.

19 May 2016

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