To medical reform offer the alternative diagnosisRSPP and TPP at joint meeting declared aversion of the project of reform of public health services which from giving of Ministry of Health the State Duma will start to discuss on July, 7th. Business considers that reform of system of obligatory medical insurance will deduce branch from - under actions of insurance principles. Hardly it will stop the government and Ministry of Health, considering target model in reform of public health services already defined and not needing any substantial changes.
the bill “ About obligatory medical insurance “ (OMS) which first reading is planned for July, 7th, yesterday has caused the sharp criticism at joint session RSPP and TPP the Russian Federation. Since May, 25th when the document has been published, Ministry of Health collects expert opinions and offers on the site, remarks to the document also are accepted by State Duma Committee on Healthcare till July, 2nd. In RSPP have come to a conclusion that bill consideration prematurely, and demand its conceptual processing.
according to head RSPP Alexander Shokhin, bills of Ministry of Health appear “ as if lines from a snuffbox “ and “ not clearly, how to consider the given bill taking into account that there is a political decision on bill acceptance in the first reading “. In association of employers show to the document serious claims. First of all, there consider that a choice in advantage budgetary - distributive model of system OMS “ it is erroneous “. The main claim of businessmen - leaving from insurance medicine in advantage “ budgetary - distributive bases “ rendering of medical services. Insurance payments in RSPP name “ the tax to health “ which becomes “ substitute replacement of budgetary financing “. Businessmen have not found in the document aktuarnyh calculations of the size of the rate such “ The tax “.
One of the basic claims RSPP - the excessive size “ solidary “ participations of workers in financing OMS. By calculations RSPP, the payment of the worker makes two thirds “ the tax to health “. Businessmen have counted up that from 12 thousand rbl. a year, raised in the form of payments for OMS from average earnings of the worker, only 33 % go on payment actually medical aid to the worker, and 40 % of payment are investments into medical institutions and expenses on development of a network of medical institutions, 27 more % are dotirovaniem medical services for idle, payments for which (they are paid from regional budgets) one quarter - 3 thousand rbl. the Question that will change entering into the size of guarantees “ an investment component “ (without it granting of any services within the limits of guarantees is impossible theoretically), in RSPP do not discuss. The union anyway suggests to reconsider rates of payments of idle and working citizens: They should be “ are more balanced and weighed “.
Besides, in RSPP mark: in spite of the fact that the bill is on a joint of norms of the legislation on insurance business and the social legislation, the insurance organisations in it are eliminated from system OMS. In system OMS, according to RSPP, the institute of an independent expert appraisal of quality of medical services is liquidated. As a whole in RSPP suggest to build “ insurance medicine with state support “. The chairman of committee TPP concerning social policy, the deputy of the State Duma Oksana Dmitriev has declared that the position of committee TPP of the Russian Federation under this bill will be also negative.
basically criticism RSPP of the project of Ministry of Health concerns all target model of reform of system OMS, instead of “ constructional “ details. Obviously, Ministry of Health counts that in decisions of such scale (comparable reform on scales is, for example, reform of budgetary establishments in 2011) already made political decision neotmenimo at moderate scale of resistance to reform in a society. Despite criticism RSPP while there are no signs of that this resistance will be considerable.
earlier critical remarks to the document were stated also by representatives of the Ministry of Finance and FAS, but their criticism just concerned constructional elements of the project of Ministry of Health. The Ministry of Finance had questions under the status of insurer OMS and the status of federal fund OMS. There marked also contradictions: in particular, the bill provides transformation FFOMS into the insurance organisation without the licence, not accountable Rosstrahnadzoru, and insurers OMS are described in the document as service, instead of actually insurance companies. At FAS caused claims an order of an attachment insured to the insurance medical organisations: “ Taciturn persons “ from OMS are distributed among three largest insurance companies OMS in region. Such order, consider en face, can lead to monopolisation of the market of services in system OMS. Also discontent FAS has caused inclusion since 2012 in system OMS “ fast “ is will mean deprivation of the right to rendering of the first help of the citizens who have not shown policies OMS, - and also inclusion since January, 1st, 2015 in system of hi-tech medical aid.