Lotions for the old and sick

Recently, the government announced the next measures to reform the healthcare system. There are two innovations. Firstly, the fate of the “extra” 2% became clear, by which it was decided to increase the amount of insurance payments, starting from 2011. In general, these payments, which are made by employers, will amount to 34% of each salary issued by them. As a result of a heated discussion between departments (see The New Times No. 15 of April 26, 2010), the insurance rate in the compulsory health insurance system will be not 3.1%, but 5.1%.

Characteristically, Prime Minister Vladimir Putin did not say anything about the fact that these additional 2% will join the general treasury of the compulsory medical insurance system. He explained that they will go to a special fund, which, according to preliminary calculations, will amount to more than 300 billion rubles. And it is from this fund that the material base of domestic medical institutions will be updated.

It would seem that everything is logical: the equipment of our hospitals and polyclinics is outdated and does not make it possible to carry out either prevention or treatment at the proper level. An additional 300 billion rubles will obviously not interfere with our medical institutions. But the question arises: what does all this have to do with insurance?

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Today in Russia, the minimum medical insurance costs at least 30 thousand rubles, and such a low price on the market needs to be looked for

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The principle of medical insurance is extremely clear: people pay relatively little money in order to receive more expensive treatment in the event of an insured event. Here we are talking about the creation of a virtually clean budget fund, which, however, is poured 2% of insurance premiums. And a particular employee can now count not on specific treatment for specific insurance money, but only on the indirect effect of using the fund being created: maybe he will be lucky to get to a hospital whose equipment has been updated at the expense of the above-mentioned 300 billion rubles.

The second innovation is related to the formation of an insurance program for the elderly "Health". 1000 rubles a year will be put on the account of each of our pensioners. This thousand, according to the authors, an elderly person can use to buy some medical services. If he does not spend this amount within a year, it will be added to his pension. The idea seems to be correct. But again questions arise.

What is one thousand rubles a year? Today in Russia, the minimum medical insurance without hospitalization (a simple visit to a polyclinic and the provision of outpatient services) costs at least 30 thousand rubles, and such a low price on the market needs to be looked for. And pensioners, as a rule, have a lot of diseases, often need hospitalization, their insurance costs many times more. One thousand rubles is not enough even to conduct an elementary examination. Therefore, people will tend to use the extra thousand not for medical purposes, even if they need it, but as an addition to their pension. As a result, the program's ambitious goal of improving the health of older people will certainly not be achieved.

The example of these two innovations clearly shows the global problem of our healthcare system. It seems that no one in the government still understands what it should be like in the end: budgetary (free for the population, as it is written in the Constitution), insurance (through the compulsory medical insurance system) or paid. The solution of this issue has once again been postponed, obviously, until the presidential elections to be held in 2012. In the meantime, a conceptual decision has not been made, the government is following the path of such “gadgets” that do not solve problems, but seem to demonstrate concern for people.