Direct speech

Vladimir Fedotkin, State Duma deputy, member of the budget committee

Today there is no money for healthcare either in the budget or in the Compulsory Medical Insurance (CHI) fund. The government also does not have the opportunity to increase salaries for medical staff. So it turns out that doctors earn on average 27 thousand, nurses - 15-17 thousand, nannies - 14 thousand rubles. This is official data. Horror? But the real nightmare is that these figures are inflated by 2-3 times. I personally saw salary sheets in regional hospitals with salaries of 5-6 thousand rubles per month. Who would be flattered by that kind of money? Perhaps if they work at 2-3 pay rates, but after such a load, it’s time for the medical staff to become patients in their own hospitals. Which is what sometimes happens. At the committee meeting, we asked representatives of the relevant ministry if they could at least index the salaries of medical staff at the level of official inflation - 5.5 percent. They replied that if this was done, mass layoffs would have to be carried out.

Is it any wonder that Russia ranks 115th in the world in terms of healthcare financing (this is somewhere on the level of Mozambique), in terms of availability of medical services - 130th place, and in terms of life expectancy - as much as 158th. Such a reduction in funding for this area has not been observed for 15 years. Even in the darkest crisis years of 1998 or 2008, much more was spent on the health of the nation. And next year, according to the new budget, 115 billion rubles will be allocated for this area, that is, 22 percent less than this year.

The prospect is even brighter. By 2017, according to the draft new budget, 77 percent of the current amount of funds for health care will remain. And this is without taking into account inflation, and if with it, then 50 percent. The reduction in inpatient care will have a particularly painful impact on Russians: it has already been reduced, but funding will still be cut by 30 to 162 percent instead of 270 billion rubles. The number of hospitals has already been reduced by half - by 6 thousand units, clinics - by 3,200 units (15 percent), antenatal clinics - by 3 thousand, and rural obstetric centers - by as much as 7 thousand. Little by little, all treatment costs are being shifted onto the shoulders of patients. And if only they would... A voter complained to me: there used to be a paramedic-midwife station in the village, and there she gave injections to her husband, who had suffered a stroke. Now the point has been closed, and for the sake of IVs she has to take him 25 kilometers to the regional center...

Expenditures on outpatient care in the next three years will be reduced from 113 to 78 billion rubles. So now not only this woman, but also many Russians, in order to see a doctor, will sometimes have to travel not 20-30, but all 100 kilometers to the nearest clinic. Starting next year, primary health care will also be reduced by 1.5 times. And at the same time, dozens of huge ultra-modern medical centers are being built. But they often include those who could not be helped at the primary care stage - diagnosed and treated at an early stage of the disease. Is it really rational to invest millions in brand new centers when the need for them could be reduced by developing primary care and diagnostic centers? What about maternal and child health? Its funding will be reduced by almost 2 times next year alone, and by 2017 - by as much as 8 times.

The compulsory medical insurance fund, which people rely on so much, is already in acute shortage. Because half of the contributions are transferred by the regions, and they themselves are in debt, as much as 2 trillion rubles. That’s why the government decided to withdraw 140 billion rubles from the compulsory medical insurance fund in 2015 to balance regional budgets. In 2016-2017 - another 130 billion rubles. Paradox! The money was transferred for the treatment of the population, but it is withdrawn in order to somehow balance the budgets. The story is repeating itself with the funded part of the pension: people saved for the future, but for the second year the government withdraws these funds for some of its own purposes, and when the time comes to pay, the money will not be found in any daylight. The current government seems to care little about this prospect. It is much more important to buy the loyalty of officials through even greater privileges. Including in the field of medical care.

* The author is a State Duma deputy, ex-chairman of the Ryazan Regional Duma, Doctor of Economic Sciences, member of the Federation Council from 1997 to 2001

“It’s much more important to buy the loyalty of officials...”