Systematization of healthcare financing problems in the Russian Federation
Financial relations play an important role among the elements of the healthcare system in Russia. Their efficiency influences the performance and goals of public healthcare. The financial system has accumulated many problems that have been influencing the effectiveness of the whole system. Therefore, there is a constant search for the best option that is considered as one-channel financing. Practical introduction of new approaches, however, has solved only some problems that appeared over the last years of budgetary and insurance model. Scientific publications do not provide complex analysis but the authors tend to refer to them for the purpose of substantiating the analyzed data. This does not provide an aggregate picture and, furthermore, does not enable us to view the complete range of problems. With the above-mentioned in mind, the present study appears to be valuable contribution. The paper presents the results of a study on healthcare financing problems in Russia. The problems are grouped into 12 categories: - discrepancy between the state obligation to provide free medical care and the real amount of state financial resources; - discrepancy between the basic sources of financing, i.e. obligatory medical insurance and budget resources; - imperfection of methods of payment for medical services; - imperfection of contractual relations; - inadequacy of the system of tariffs and expenditures accounting; - inadequacy of the system of medical care planning; -insufficient correlation of methods of payment for medical care and forms of remuneration for medical personnel; - lack of competition; - absence of risk elements in the health insurance system; - imperfection of the legislative base; - uncontrolled (almost on a large-scale) growth of explicit and shadow payments for medical services; - imperfection of the system of monitoring introduction of financial measures; - lack of scientific support. The outlined number of problems reveals obvious imbalance of the financial system of the established budgetary and insurance model of healthcare in Russia.