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The Ministry of Health and Social Development is reducing the list of high-tech types of medical care
The head of the Ministry of Health and Social Development, Tatyana Golikova, again alarmed Russians with severe chronic illnesses. The Ministry of Health and Social Development is speeding up the transfer to the balance of territorial compulsory medical insurance funds of high-tech medical care, which is currently financed from the federal budget. “Some of the high-tech care will become specialized and will be provided within the framework of the compulsory health insurance system,” Ms. Golikova said the other day, speaking at the Moscow State Medical University named after I.M. Sechenov. The corresponding order will be signed, according to her, by the end of November.Among those “demoted” since 2011 should be procedures of gastroenterological, hematological, dermatovenerological, neurological, rheumatological and endocrinological profiles. As the Ministry of Health and Social Development explains, when making the decision to transfer these operations to the compulsory medical insurance system, it was taken into account that such types of assistance “do not include high-tech interventional interventions, but are expensive due to the cost of drug provision during their provision.” “These types of assistance, in fact, can no longer be considered high-tech also because their implementation does not require any special rare skills from doctors and they are already widely used in medicine,” the ministry explained to Vremya Novostei.
Indeed, just a few years ago, the list of high-tech services even included hemodialysis, equipment for which is now equipped in one form or another in any district hospital. But this does not mean that the “vacated” positions in the list of high-tech assistance will be filled with new types of scientifically progressive procedures. This is not what we are talking about. “The types of assistance remaining on the list will be differentiated by groups depending on their cost and complexity,” says the Ministry of Health and Social Development.
Officials have been planning to include high-tech medicine in the basic compulsory health insurance program since 2015, and they were talking about a gradual change in funding sources. This is exactly what is written in the draft law “On Compulsory Health Insurance in the Russian Federation” developed by the Ministry of Health and Social Development and adopted in the first reading last summer. True, back at the end of 2009, Tatyana Golikova’s department started talking about the need to transfer a significant part of expensive services from the list of high-tech assistance to the list of so-called specialized assistance. But then this project had to be postponed, partly due to active opposition from communities of patients with severe chronic diseases. And Ms. Golikova’s current decision will likely again cause protest. “The list of excluded specialties now proposed by the ministry exactly repeats last year’s proposal and assumes, for example, the exclusion from the category of high-tech services that patients with hemophilia need. These are very expensive procedures, and it is impossible to fully finance them from the budget of compulsory medical insurance funds. Thus, funding is simply being reduced,” Alexander Saversky, head of the All-Russian Patients’ Union, told Vremya Novostey. It is worth noting that high-tech types of medical care are financed according to quotas established at the federal level, which ensures a fairly high interest of clinics in patients falling under this category. At the same time, specialized care is paid for under the compulsory medical insurance tariff, which cannot become a full-fledged incentive for a good medical institution.
But Tatyana Golikova’s department categorically disagrees that the proposed changes reduce the costs of unbranded “high-tech” manipulations. The Ministry of Health and Social Development emphasizes that this decision was made taking into account the ongoing work to improve the provision of medicines to citizens and to review the procedures and standards of medical care. “The necessary financial resources for the provision of high-tech care will continue to be allocated in full,” Ms. Golikova assured patients and doctors. According to her, the heads of regional health authorities have already been instructed to ensure the provision of specialized medical care to patients with diseases in the specified profiles within the framework of territorial state guarantee programs.
True, for the territorial compulsory medical insurance funds themselves, all these are still just words. “So far, no funds have been provided in our budget for 2011,” the territorial fund of one of the regions of central Russia told Vremya Novostey. “And to start financing new types of assistance, it is necessary to make changes to the state guarantee program, to the list of specialized assistance and the compulsory health insurance budget.”
Thousands of guarantees
For 2011, the state guarantee program provides funding in the amount of 7633.4 rubles. per citizen of Russia. Of these, 4102.9 rubles. - from compulsory medical insurance funds. Financing of high-tech medical care next year will be increased from 36.2 billion to 41 billion rubles. In 2010, complex medical interventions were performed on 280 thousand Russians.