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Mikhail Zurabov complied with the terms of the ultimatum

Minister of Health and Social Development Mikhail Zurabov met the deadline for the ultimatum put forward by State Duma deputies. As Andrei Isaev, head of the Duma Committee on Labor and Social Policy, said yesterday, the head of the Ministry of Health and Social Development presented for consideration by legislators three draft packages of measures aimed at improving the situation both in health care in general and in the additional drug provision program (DLO) in particular. “We have recognized one of them as socially acceptable,” Mr. Isaev said. Let us recall that legislators demanded that all problems of drug provision for beneficiaries be resolved by March 20, otherwise they promised to dismiss the most unpopular cabinet minister. But, contrary to all expectations, there will be no grand show with the expulsion of the minister today. “We have instructed the head of the Ministry of Health and Social Development to finalize the chosen option as soon as possible and submit it to the Duma by the end of this week,” the deputy explained. According to almost all the experts interviewed by Vremya Novostey, deputies will try to organize a loud and spectacular expulsion of the minister, who (not without connivance from above) in recent months has become a “whipping boy”, immediately before the elections to the Duma, for example in the fall.

What exactly is the novelty of the proposals of the Ministry of Health and Social Development, which forced the deputies to lag behind Mr. Zurabov for a while, and whether it is in the mentioned projects at all, Andrei Isaev refused to clarify. Perhaps the deputies simply needed special proposals from the ministry designed only for them. “The minister is a person of such a level of intelligence that you rarely meet in the State Duma, it is unlikely that he had to invent something just to meet the deadline,” this is how the chairman of the board of directors of the Pharmexpert Center of Medical Sciences, Yuri Krestinsky, commented to Vremya Novostey on yesterday’s events. In his opinion, “everything he proposed was probably very good.” According to the expert, all variants of the minister’s proposals one way or another come down to three main points, which have been widely discussed lately and do not represent any secrecy. Firstly, it is necessary to restore the insurance principle of the DLO; for this, several of the most expensive diseases to treat need to be separated into separate federal programs (the corresponding law needs to be adopted), secondly, to sort out the debts to suppliers and manufacturers for the past year, and - third, to use the administrative and financial resources of the regions in the program, which was not the case before.

The implementation of the first and second points completely depends on the political will and pace of work of the same State Duma deputies: the allocation of budget funds and the adoption of laws is their diocese. It is possible to pass the relevant laws in just a month or a month and a half, especially in the part that concerns the funds missing to pay off the debt. “After the 16 billion rubles already allocated to repay the debt are paid - the president signed the corresponding document at the end of last week - another 20 billion are needed to completely close this problem. But in fact, a significant discount is possible on the part of manufacturers and suppliers. In this case, a little more than 10 billion rubles will have to be returned,” Yuri Krestinsky told a Vremya Novostey correspondent. According to his center, manufacturers are ready to “throw off” from 5 to 7 billion rubles. debt, and distributors - 4 billion. Even with such “discounts”, none of the program participants will burn out. Logistics costs last year were little different from those in 2005, but the volume of supplies of expensive medicines (which are much more profitable to sell) increased significantly in 2006.

The situation is not so simple with the last point - attracting regions. The need to involve them in co-financing DLO was announced yesterday by the new head of the Federal Service for Surveillance in Healthcare and Social Development (Roszdravnadzor), Nikolai Yurgel, who was appointed to this position just ten days ago. The previous head of the service, Ramil Khabriev, was removed from his post on March 5 “in connection with the situation surrounding the provision of medicines to beneficiaries.” In dismissing Mr. Khabriev, Prime Minister Mikhail Fradkov asked his potential successor to organize “financing not only at the federal level, but also at the regional level.” Mr. Yurgel started with this. It is known that through joint efforts with the head of the Federal Compulsory Health Insurance Fund, Dmitry Reichart, the issue of co-financing has already been resolved in 16 regions. It is assumed that the entity will have to add from 15 to 20% of all funds that are required to provide benefits to beneficiaries in a given region.

Attracting funds from regional budgets will make the federal program much closer to local administrations. Naturally, they don’t want to spend money on beneficiaries. Governors will immediately take control over the prescription of medicines; they will also be interested in adequate preparation of applications, because they will have to pay for all the “surpluses”. “Previously, when drawing up applications, we were completely bypassed; for the first time I signed such a document in January of this year,” Igor Chkanov, head of the territorial department of Roszdravnadzor for the Kursk region, told Vremya Novostei.

Galina PAPERNAYA