Authors
Farkhutdinov L. I.
PhD, Specialist, Interregional Clinical Diagnostic Center, Kazan, 12à Karbysheva Str.
Corresponding author
Farkhutdinov Linar; e-mail: farhetdin@yandex.ru
Funding
Publication had no sponsorship.
Conflict of intertest
None declared.
Abstract
The article summarizes the critique of Russian healthcare system considering other countries healthcare experience as well. It’s being stressed that healthcare reforms in post-communist Russia are guided by the World Bank’s consultants, together with the fact that Russia is a member of WTO. It’s being argumented, that healthcare reforms in Russia are performed according to the policies of the aforecited organizations who are the real actors, upon which the reforms should be judged, but not the national government. From the perspective of that really sovereign actor Russian health care reforms lose their evidently inconsistent character, their means and methods become concordant with the aim, which is maximal privatization of healthcare. Conclusion confirms the opinion of Russian community of healthcare professionals that the country needs to reestablish its previous budget model of healthcare organization.
Key words
types of healthcare organizations, WTO, World bank, insurance companies, DRG, copayments, GDP
DOI
References
1. Beskaravajnaja T. V Rossii prodolzhaetsja rost kreditorskoj zadolzhennosti meduchrezhdenij [Accounts payable of Russian medical institutions keeps growing]. [Internet]. [Cited 05.04.2018]. Available from: https://medrussia.org/1301-zadolzhennosti-meduchrezhdenijj/ (In Russ.)
2. Gavrilov Je.L. Bezdificitnost' sistemy OMS – eto mif [Zero-deficit of OMS is a myth]. [Internet]. [Cited 05.04.2018]. Available from: http://fondzdorovie.ru/analitika2/detail_analitics.php?ID=1304&sphrase_id=2376 (In Russ.)
3. Gavrilov Je.L. i soavt. Oplata truda medicinskih rabotnikov kak metod upravlenija personalom v sisteme zdravoohranenija [Wages of medical workers as a method of personnel management within the system of healthcare]. [Internet]. [Cited 05.04.2018]. Available from: http://fondzdorovie.ru/analitika2/detail_analitics.php?ID=2966&sphrase_id=2381#ixzz5BE5A8vJ5 (In Russ.)
4. Grishina T., Manujlova A. V polis OMS vpisyvajut doplatu [Extra charges are added to OMS]. [Internet]. [Cited 05.04.2018]. Available from: https://www.kommersant.ru/doc/3429231 (In Russ.)
5. Demidova A. Chastnoj medicine predskazali rost iz-za nizkogo kachestva gosuslug [Low quality of state services predicts growth to private medicine]. [Internet]. [Cited 05.04.2018]. Available from: https://www.rbc.ru/business/14/09/2017/59ba38689a794752ba5ded41 (In Russ.)
6. Dobrovol'skij T., Sidorova M. Zachem gosudarstvennye bol'nicy vzjalis' okazyvat' platnye uslugi [Why did state hospitals start to provide paid services]. [Internet]. [Cited 05.04.2018]. Available from: https://vademec.ru/article/zachem_gosudarstvennye_bolnitsy_vzyalis_okazyvat_platnye_uslugi_/ (In Russ.)
7. Doklad o problemah gosudarstvennogo kontrolja kachestva i bezopasnosti medicinskoj dejatel'nosti [Report on problems of government control of quality and safety of medical activity]. [Internet]. [Cited 05.04.2018]. Available from: http://fas.gov.ru/documents/574898 (In Russ.)
8. Zhdanovskaja A. VTO. Vsemirnyj jekonomicheskij nasil'nik i dushegub. [WTO. Worldwide economic rapist and murderer]. [Internet]. [Cited 05.04.2018]. Available from: http://saint-juste.narod.ru/WTO.html (In Russ.)
9. Komarov Ju.M. X (XXVI) Chrezvychajnyj Pirogovskij s’ezd vrachej. Reshenie. [Extraordinary Pirogov congress of physicians. Decision]. [Internet]. [Cited 05.04.2018]. Available from: http://viperson.ru/articles/x-xxvi-chrezvychaynyy-pirogovskiy-s-ezd-vrachey-reshenie (In Russ.)
10. Komarov Ju.M. Medicinskoe strahovanie: dlja Gollandii ili dlja Rossii [Komarov Ju.M. Medical Insurance for Netherlands and for Russia] Medicine 2014; (1): 42-57. (In Russ.).
11. Komarov Ju.M. Medicinskoe strahovanie: opyt zarubezhnogo zdravoohranenija [Medical insuarance: foreign experience]. Vestnik gosudarstvennogo social'nogo strahovanija [Bulletin of state social insurance] 2005; (1): 65-75. (In Russ.).
12. Maksimova T. G., Antohin Ju. N. Sostojanie i perspektivy finansovogo obespechenija rossijskogo zdravoohranenija: kratkij statisticheskij obzor [Current state and perspectives of financial provision of Russian healthcare: short statistical overview]. Izvestija SPbGU. [Internet]. 2017 [Cited 05.04.2018]; (1-2). Available from: https://cyberleninka.ru/article/n/sostoyanie-i-perspektivy-finansovogo-obespecheniya-rossiyskogo-zdravoohraneniya-kratkiy-statisticheskiy-obzor (In Russ.)
13. Malysheva E., Rejter S., Zabavina Ju. Rassledovanie RBK: kuda zavela Rossiju reforma zdravoohranenija. [RBK investigation: where did the Russian healthcare reform lead to.] [Internet]. [Cited 05.04.2018]. Available from: https://www.rbc.ru/investigation/business/26/10/2014/544cfa0acbb20f3b7672b59d
14. Marx K., Engels F. Sochinenija. Izdanie 2. Tom 3 [Works. 2-nd edition. Vol.3]. Moscow. Politizdat, 1955. P.197]. (In Russ.)
15. Marx K., Engels F. Sochinenija. Izdanie 2. Tom 16. [Works. 2-nd edition. Vol.16]. Moscow. Politizdat, 1960. P.264. (In Russ.)
16. Mehanik A. Piramida Semashko [Semashko’s pyramid] Jekspert [Expert] [Internet]. 2011 [Cited 05.04.2018]; (30-31). Available from: http://expert.ru/expert/2011/30/piramida-semashko/ (In Russ.)
17. Modeli sistem zdravoohranenija [Models of healthcare systems]. [Internet]. [Cited 05.04.2018]. Available from: //old.duma.tomsk.ru/page/2956/ (In Russ.)
18. Nehlebova N. OMS v zapushhennoj forme. [OMS in a neglected stage]. [Internet]. [Cited 05.04.2018]. Available from: https://www.kommersant.ru/doc/3396430 Accessed: 05.04.2018. (In Russ.)
19. Panova M. Mediki v dolgovoj jame [Doctors in a debt hole]. [Internet]. [Cited 05.04.2018]. Available from: http://gazeta-pravda.ru/issue/109-30606-3-4-oktyabrya-2017-goda/mediki-v-dolgovoy-yame/ (In Russ.)
20. Pahomov A., Gricenko P. Finansirovanie zakupok lekarstv i oborudovanija dlja onkobol'nyh uvelichat [Financing of purchase of drugs and equipment for oncological patients will be increased]. [Internet]. [Cited 05.04.2018]. Available from: https://vademec.ru/news/2017/12/14/finansirovanie-zakupok-lekarstv-i-oborudovaniya-dlya-onkobolnykh-uvelichat/ (In Russ.)
21. Pahomov A. Putin vystupil za vvedenie sofinansirovanija grazhdanami OMS. [Putin favored the introduction of copayments to OMS by citizens.] [Internet]. [Cited 05.04.2018]. Available from: https://vademec.ru/news/2017/10/17/putin-vystupil-za-vvedenie-sofinansirovaniya-grazhdanami-oms/ (In Russ.).
22. Pichugina E. Rossijskoe zdravoohranenie postavjat na gran' vyzhivanija [Russian health care will be put to the edge of survival]. [Internet]. [Cited 05.04.2018]. Available from: http://www.mk.ru/social/2014/10/22/rossiyskoe-zdravookhranenie-postavyat-na-gran-vyzhivaniya.html (In Russ.)
23. Ponomarenko D. Kto delaet nas bol'nymi i bednymi [Who makes us sick and poor]? [Internet]. [Cited 05.04.2018]. Available from: https://scepsis.net/library/id_3454.html (In Russ.)
24. RBK. V. Putin. Ot VTO u Rossii bol'she pljusov, chem minusov. [RBK. V. Putin. Russia gets more advantages from WTO than disadvantages]. [Internet]. [Cited 05.04.2018]. Available from: https://www.rbc.ru/economics/20/12/2012/5704014e9a7947fcbd443d61 (In Russ.)
25. Reznik I. Usrednit' dushi: chto budet v blizhajshie gody s sistemoj OMS [Averaging the souls: what will happen to OMS system in the coming years]. [Internet]. [Cited 05.04.2018]. Available from: http://medportal.ru/mednovosti/news/2015/02/02/410oms/ (In Russ.)
26. Rodionova A. Stat'ju 41 nikto ne otmenjal. [No one canceled the 41st article] [Internet]. [Cited 05.04.2018]. Available from: https://vademec.ru/article/statyu_41_konstitutsii_rf_nikto_ne_otmenyal/ (In Russ.)
27. Smit D. Illjuzija VVP. Prisvoennaja stoimost' kak dobavlennaja. [GDP illusion. Appropriated value as value added]. [Internet]. [Cited 05.04.2018]. Available from: https://scepsis.net/library/id_3795.html (In Russ.)
28. Smit D. Imperializm v XXI veke [Imperialism in XXI century]. [Internet]. [Cited 05.04.2018]. Available from: https://scepsis.net/library/id_3796.html (In Russ.)
29. Sokolov S. Malen'kie tragedii na fone bol'shih peremen. [Little tragedies against the background of big changes]. [Internet]. [Cited 05.04.2018]. Available from: https://scepsis.net/library/id_3363.html (In Russ.)
30. Ha-Chzhun, Chang. Kak ustroena jekonomika [Economics: the user’s guide]. Moscow: 2017. Also in: Greber D. Dolg: pervye 5 000 let istorii [Debt. The first 5 000 years]. Moscow: 2015. (In Russ.).
31. Huan Antonio Gomes Liebana. «Zdravoohranenie budushhego» uzhe nastupilo [Healthcare of the future is already here]. Nauchno-prosvetitel'skij zhurnal SKEPSIS [Scientific-educational journal SCEPSIS] [Internet]. [Cited 05.04.2018]. Available from: http://scepsis.net/library/id_3654.html. (In Russ.)
32. Shenin S. Ju. Dzheffri Saks i amerikanskaja pomoshh' postsovetskoj Rossii: sluchaj «Drugoj anatomii» [Jeffrey Sachs and American help to post-soviet Russia: a case of different anatomy]. Izv. Sarat. un-ta Nov. ser. Ser. Istorija. Mezhdunarodnye otnoshenija [Bulletin of Saratov university, International Relations series] [Internet]. 2010[Cited 05.04.2018]; (1). Available from: https://cyberleninka.ru/article/n/dzheffri-saks-i-amerikanskaya-pomosch-postsovetskoy-rossii-sluchay-drugoy-anatomii Accessed: 03.04.2018. (In Russ.).
33. Schumacher E. Maloe prekrasno: jekonomika, v kotoroj ljudi imejut znachenie [Small Is Beautiful: Economics as if People Mattered]. Moscow: Izdatelsky dom Vysshej shkoly ekonomiki, 2012. (In Russ.).
34. Alexander N., Kessler T. How GATS. 2003. [Internet]. [Cited 05.04.2018]. Available from: https://www.globalpolicy.org/component/content/article/209-bwi-wto/43726.html
35. Ayuso S. Cuba becomes first nation to eliminate mother-to-child HIV transmission. [Internet]. 2015. [Cited 05.04.2018] Available from: https://elpais.com/elpais/2015/07/01/inenglish/1435762153_583486.html
36. Bijlmakers L. The World Bank’s Private Sector Development Strategy: Key Issues and Risks. [Internet]. 2015. [Cited 05.04.2018] Available from: https://www.researchgate.net/publication/ 265003535_The_World_Bank%27s_Private_Sector_Development_Strategy_Key_Issues_and_Risks
37. Centers for Medicare and Medicaid Services. [Internet]. 2018. [Cited 05.04.2018]. Available from: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html
38. Chang H. FPIF Special Report. Kicking Away the Ladder: The Real History of Free Trade. [Internet]. 2003. [Cited 05.04.2018]. Available from: http://www.personal.ceu.hu/corliss/CDST_Course_Site/Readings_old_2012_files/Ha-Joon%20Chang%20-%20Kicking%20Away%20the%20Ladder-The%20%E2%80%9CReal%E2%80%9D%20History%20of%20Free%20Trade.pdf
39. Fitz D. Why is Cuba’s Health Care System the Best Model for Poor Countries? [Internet]. 2012. [Cited 05.04.2018]. Available from: https://mronline.org/2012/12/07/fitz071212-html/
40. Is Canada the Right Model for a Better U.S. Health Care System? [Internet]. 2017. [Cited 05.04.2018]. Available from: http://knowledge.wharton.upenn.edu/article/lessons-can-u-s-learn-canadian-health-care-system/
41. Kazi S. Dirty hospital rooms a top concern for Canadians. [Internet]. 2013. [Cited 05.04.2018]. Available from: http://www.cbc.ca/news/health/dirty-hospital-rooms-a-top-concern-for-canadians-1.1321668
42. Lipson D. The World Trade Organization’s health agenda: opening up the health services markets may worsen health equity for the poor. [Internet]. 2001. [Cited 05.04.2018]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121630/
43. Ruccio D. Unhealthy healthcare: double squeeze. [Internet]. 2016. [Cited 05.04.2018]. Available from: https://anticap.wordpress.com/2016/08/30/unhealthy-healthcare-double-squeeze/
44. Ruccio D. Unhealthy healthcare: pay more, get less. [Internet]. 2016. [Cited 05.04.2018]. Available from: https://anticap.wordpress.com/2016/08/23/unhealthy-healthcare-2/
45. Ruccio D. Unhealthy healthcare: workers pay. [Internet]. 2016. [Cited 05.04.2018]. Available from: https://anticap.wordpress.com/2016/08/24/unhealthy-healthcare-3/
46. Russian Federation. [Internet]. [Cited 05.04.2018]. Available from: https://www.wto.org/english/thewto_e/acc_e/a1_russie_e.htm
47. Scott-Samuel A. et al. The Impact of Thatcherism on Health and Well-being in Britain. International Journal of Health Services 2014; 44 (1): 53-71.
48. Singer D. The Health Care Crisis in the United States. [Internet]. 2008. [Cited 05.04.2018]. Available from: https://monthlyreview.org/2008/02/01/the-health-care-crisis-in-the-united-states/
49. The Health Insurance Experiment. [Internet]. 2006. [Cited 05.04.2018]. Available from: https://www.rand.org/pubs/research_briefs/RB9174.html
50. The World Bank Data. Mortality rate, under-5 (per 1 000 live births). [Internet]. [Cited 05.04.2018]. Available from: https://data.worldbank.org/indicator/SH.DYN.MORT?year_high_desc=false
51. Waitzkin H., Hellander I. Obamacare. [Internet]. 2016. [Cited 05.04.2018]. Available from: https://monthlyreview.org/2016/05/01/obamacare/
52. We own it: public services for people, not for profit. [Internet]. [Cited 05.04.2018]. Available from: https://weownit.org.uk/public-ownership/nhs