| The Moscow City Duma calculates the losses of the territorial compulsory medical insurance fund In recent days, the capital's authorities have not missed a single opportunity to declare their disagreement with the Russian government's plans to take the lion's share of the Moscow Territorial Fund's funds to the Federal Compulsory Health Insurance Fund. Last week, the capital’s parliament addressed members of the government and State Duma deputies; Yuri Luzhkov promised to discuss this issue with Finance Minister Alexei Kudrin, and also addressed the president personally. However, I have not received an answer yet.
The topic of saving the capital's healthcare system was raised at yesterday's meeting of the Moscow City Duma. The occasion was the report of the head of the Moscow Compulsory Medical Insurance Fund Andrei Reshetnikov on the implementation of the fund’s budget for 2003. According to him, tax innovations from the federal authorities jeopardized budget execution last year. The introduction of a regressive UST rate, as well as a simplified taxation system for small businesses, led to a loss of fund income in the amount of 1.2 billion rubles. As a result, of the 15 billion rubles planned for 2003. the fund managed to collect only 14 billion. Only austerity allowed the fund to implement all programs providing free medical care to Muscovites, Mr. Reshetnikov said, adding that the implementation of tax reform in its current form threatens the collapse of the entire healthcare system of the capital. The head of the territorial Compulsory Medical Insurance Fund was also supported by Moscow City Duma deputy Mikhail Antontsev. “If the federal government does not respond to Moscow’s appeals, then there will be a collapse in 2005,” he said.
The essence of the amendments to the Tax Code proposed by the federal government lies not only in the long-promised reduction of the unified social tax from 35 to 26% of the wage fund, but also in the redistribution of these funds between the federal and territorial compulsory medical insurance funds. Today, out of 35% of the unified social tax, 3.6 percentage points go to medical needs, of which 3.4 goes to regional compulsory medical insurance funds, and 0.2 to the federal one. The government proposes to change this ratio. If the bill is adopted, then out of the 26 percent unified social tax, 2.8 percentage points will go to medicine, the regions of which will get only 1.8. For the Moscow Compulsory Medical Insurance Fund, such an initiative by the federal authorities will result in a loss of 9 billion rubles, or almost half of the health insurance budget for 2005, planned at 19 billion rubles. At the same time, Federation Council member Vladimir Plotnikov clarified, the central government does not undertake any additional obligations to finance medical institutions located in the city. You also cannot count on compensation from the federal budget. At one time, German Gref tried to calm down the protesting regions, saying that the total losses of territorial compulsory medical insurance funds would not exceed 16 billion rubles, which would be compensated from the federal budget. However, Moscow City Duma deputies claim that, according to conservative estimates, the regions' losses will amount to at least 60 billion rubles.
Unfortunately, during yesterday’s meeting, which resembled a military council, the deputies did not figure out how else they could help the capital’s doctors. Ready for anything, Andrei Reshetnikov doomedly thanked the legislators for their appeal to the federal authorities adopted a week ago, noting that the Moscow City Duma obviously could not do more. Alexander GUDKOV |
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