The Ministry of Health and the party are united

United Russia members are ready to vote for a new law on compulsory medical insurance despite protests from the business community

The draft law on compulsory health insurance, submitted to the State Duma on June 3 by a group of deputies from the United Russia party and causing serious dissatisfaction among insurers and employers, will most likely be allowed to the first reading. The fact that, contrary to the opinion of opponents, the largest Duma faction of United Russia members will insist on this was stated yesterday by the head of the lower house committee on health protection, Olga Borzova. This is exactly how she responded to the demand to postpone consideration of the “unprepared and undermining the insurance principle” document, voiced the day before at a joint meeting of the Russian Union of Industrialists and Entrepreneurs and the Chamber of Commerce and Industry. Deputies lobbying the position of the Ministry of Health and Social Development, the main developer of the bill, were not embarrassed by the protests of either representatives of employers (insurers), or insurance companies, or the public. Only the Federal Compulsory Medical Insurance Fund (FFOMS) actively stood up for the bill, which, if the law is adopted, will receive the status of the only insurer in the country and tens of billions of additional rubles into its accounts. This was enough for the deputies.

It is worth noting that not all State Duma deputies are ready to support the departmental bill. A member of A Just Russia, Oksana Dmitrieva, announced at a meeting at the RSPP that her party is against holding the first reading and will vote against the bill. Most of all, Dmitrieva, a professional healthcare organizer, is confused by the point in which it is proposed to accept new medical institutions into the compulsory medical insurance system without any inspection - in a notification procedure. “The notification nature of the inclusion of new health care facilities (medical and preventive institutions. - Ed. ) in the compulsory medical insurance program, prescribed in the bill, not only excludes systemic control over the quality of medical services provided there, but also lays the ground for outright abuse,” Oksana is sure. Dmitrieva. In her opinion, the bill’s proposed incentives for insurance companies whose clients “show good health indicators” provide even greater scope for abuse. Thus, Ms. Dmitrieva says, insurance companies are charged with a completely alien function of prevention. “Receiving such encouragement is as easy as shelling pears,” Ms. Dmitrieva is sure. - To do this, you don’t need to engage in prevention, but you don’t even have to treat anyone. It is enough to insure only the young, healthy and rich, but not to insure the old and sick.” According to her, you can even specially organize such a supposedly medical insurance company, insure only the employees of some friendly rich company in it, and then calmly receive incentives from the state for those who have “become healthier.” “This is a real money vacuum cleaner,” summed up the deputy.

By the way, the possibility of such fraud is not ruled out by one of the experts who took part in the development of the document, Vice-Rector of the State University - Higher School of Economics Sergei Shishkin. But, according to him, some risks are contained in any such document; it is impossible to completely eliminate them. For example, the risk of the new law allowing the patient to choose a clinic at the discretion of the patient may be huge queues for hospitalization in regional hospitals, which are an order of magnitude better equipped than municipal ones in most Russian cities. “If residents of rural areas go to regional hospitals with some basic appendicitis, then the right of other similar rural residents to receive highly qualified medical care for more serious illnesses will be violated,” Mr. Shishkin noted.

Another risk, which the creators of the draft law on compulsory medical insurance consider as a forced cost, will be the actual deprivation of some citizens of medical care, and of some health care facilities - payment for the care provided. We are talking about those people who, for one reason or another, did not receive an insurance policy. Now such patients can receive at least emergency care, which is not included in the compulsory health insurance system. The new bill provides for the inclusion of ambulances in the compulsory medical insurance system by 2013, but says nothing about how to help citizens without insurance then.

United Russia deputies are sure that focusing on such “trifles” will only hinder the prospects contained in the bill. And in this, officials from the Ministry of Health and Social Development and the Federal Compulsory Medical Insurance Fund fully agree with them. “The legal framework established by the bill will be the same for all subjects of the Russian Federation. The bill erases the boundaries between subjects,” Andrey Yurin, director of the Federal Compulsory Medical Insurance Fund, pointed out the innovation of the new law. The undeniable advantage of this version of the law, in his opinion, is, for the first time, clearly stated obligations of regional authorities to pay insurance premiums for the non-working population. As well as the introduction of strict time regulations for payments. “Here the law clearly states that within 25 days payment must be made, and within another ten days the territorial fund where the person was insured must transfer money to the territorial fund at the place where assistance was provided,” Mr. Yurin recalled. This will help increase the availability of medical care for insured citizens anywhere in the country, the director of the Federal Compulsory Medical Insurance Fund is confident.

It is still unclear how the conflict between business and officials, as well as the two factions of the State Duma, will end. Apparently, the highest state power must take sides in this split. All parties understand this. RSPP President Alexander Shokhin wrote a letter to Deputy Prime Minister Alexander Zhukov with a request on behalf of all employers in Russia to influence the situation and prevent the first reading of the bill. A response is expected any day now.

Galina PAPERNAYA