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Public Councils under the Ministry of Health approved the healthcare development Strategy until 2030

27.01.2015

The strategy for healthcare development in the Russian Federation for the period from 2015 to 2030 was presented to the Public Council under the Ministry of Health by the Minister Veronika Skvortsova.

 "The aim of the Strategy is to develop the national healthcare system that would include all medical services and organizations regardless of their form of ownership and affiliation, would operate under a single regulatory and legal framework, as well as a unified governmental, experts and public control," Skvortsova said.
 The draft Strategy identifies priorities and main directions of development of healthcare, as well as the tasks aimed at preserving and improving the health of citizens, increasing the availability and quality of care, increasing longevity and fertility and reducing mortality. According to the minister, first of all we have to maintain the state guarantees for free medical care to the population.
Comment from Nikolay Dronov
 Member of the Public Council under the Russian Ministry of Health, Chairman of the Executive Committee of IPM "Movement Against Cancer", Deputy Executive Director for Legal Affairs at NP "Equal Right to Life" Nikolay Dronov praised the prepared draft Strategy and gave his comment: "We welcome the conceptual approach to the social relations in the field of health, which is incorporated in the draft "Strategy for healthcare development in the Russian Federation for the period from 2015 to 2030" presented by V.I. Skvortsova at a meeting of the Public Council under the Russian Ministry of Health. Many of the proposals, which IPM "Movement Against Cancer" and NP "Equal Right to Life" systematically and consistently brought to the attention of the national political leadership for more than 5 years, were finally reflected in the Strategy - 2030. In particular we welcome measures aimed at fulfilling the orders of the Russian President Vladimir Putin regarding radical improvement of the health insurance system. Implementation of the conceptual provisions of Strategy-2030 related to the modernization of the health insurance system and the introduction of public-private partnership will make qualified and up-to-date medical care and medicines more accessible for people; it will block the loopholes for some unscrupulous healthcare organizers and heads of public healthcare institutions to make profit from the so-called "free medical care", make impossible using of all sorts of illegal schemes for payment for medical care, put an end to corruption in the healthcare sector. And most importantly - this approach will develop in our citizens a deep sense of responsibility for the most precious thing a man can have – his or her own health! ".
Development of mandatory health insurance (MHI)
 The Strategy states that further development of mandatory health insurance shall be based on the principles of solidarity and social equality. Generation of income of mandatory health insurance shall be entirely on the principle of consolidation; the expenses shall be planned on the basis of capitation standard rates. This will eliminate disparities in the financing of different regions of Russia.
Additional health insurance (MHI+)
 The strategy has also provisions for the development of voluntary health insurance additional to MHI (MHI+). For the insured persons it offers healthcare and services which are not included in the basic MHI program (or under conditions not covered by the basic program). Step by step it will lead to a complete separation of paid and free medical services in healthcare.
 Health services under programs of voluntary health insurance will be provided at medical institutions that work within MHI. For these medical institutions provision of paid medical services to patients included in the programs of voluntary and mandatory health insurance will be prohibition, per types and conditions of care.
 In order to make voluntary health insurance programs in addition to MHI more attractive for citizens, we should amend the tax deduction procedure for working citizens by allowing the person's employer to reduce the tax base provided that this person purchased such insurance products.
 Control of the volume, timing, quality and conditions of the provision of medical care to the insured persons will be entrusted to the medical insurance institutions operating in the MHI sphere. Thereby, insurance medical institutions will ensure the fulfillment of medical institutions' obligations to provide medical care; they will act as guarantors of the rights of insured persons under the contract of voluntary health insurance (additional to the mandatory insurance) when insured persons receive additional medical services or other services.
 The cost of insurance products for citizens will be differentiated according to their level of responsibility for own health (timely preventive medical examinations, participation in recreational activities, avoiding harmful habits, etc.). The development of these mechanisms would legalize "shadow" co-payments by population for medical care and eliminate the "exemptions" from the governmental system to control quality and accessibility of healthcare, to create conditions for the consolidation of financial flows from different sources and for direction of uncontrolled flows of personal finances through the health insurance system.
 The programs of voluntary (additional to MHI) health insurance are focused at the transition to a civilized way of interactions between participants in the compulsory and voluntary health insurance. They not only allow attracting of additional funding to healthcare, but also offer the opportunity for people to choose additional medical services not included in the program of state guarantees, as well as the level of service.
 Stepwise growth of additional insurance products in the long run will make it possible to refuse from provision of paid medical services by medical institutions which participate in the basic MHI program.
Development of public-private partnership
 The document has provisions for the development of public-private partnership. The key areas of development and conditions for the implementation of mechanisms of public-private partnership (PPP) in healthcare include:
adoption of the Federal Law on the basics of public-private partnership in the Russian Federation, which was prepared by the Russian Ministry of Economic Development in order to create uniform approaches, effective implementation and development of PPP in the sphere of healthcare;
development of mechanisms to ensure payback of PPP projects, including the use of government support, while maintaining state obligations in the provision of medical care to citizens;
financial support for PPP projects, facilitating investors' access to long-term borrowings to finance PPP projects;
organizational support for PPP projects from public authorities and local government (from an idea to a turnkey project (product));
training (upgrade of qualifications) of officials of state and local governments, responsible for support of PPP projects;
more efficient use of state property, including the improvement of legislation in the field of property management in healthcare.
 The main objectives of the development of PPP mechanisms in healthcare at the federal level are as follows:
launch of pilot investment projects for the development of federally owned public health infrastructure, involving extra-budgetary sources of financing based on the principles of PPP;
preparation of guidelines for the development of public-private partnership in healthcare in the regions of Russia;
preparation of proposals to amend the legal and regulatory framework, allowing to create necessary legal conditions for intensification of the use of PPP mechanisms, as well as to improve the measures of state support of investment projects to improve healthcare infrastructure with attracting extra-budgetary funding based on the PPP principles.
 
Veronika Skvortsova urged the Public Council to be more active and initiate discussions on priority issues of healthcare development: "Russian Ministry of Health is always open for dialogue - only together we can solve the problems of our sector." The Public Council will present its proposals to improve the strategy until January 20.
PHOTO - from the website of the Russian Ministry of Health