Health care is a branch of state activity, the purpose of which is the organization and provision of affordable medical care for the population. Health care is a key element of the state’s national security.

Stages of health care development

  • Prescriptive medicine
  • Zemsky medicine
  • City medicine

The Department of Health Protection of the Regional State Administration is a regional body of executive power that ensures the implementation of state policy in the field of health care, and is also responsible for the state and development of the sector.

The main tasks of management are:

Development of well-founded proposals for the implementation of state policy in the field of health care; Coordination and control over the implementation of state health care programs, in particular disease prevention, provision of medical and sanitary assistance; Organization of provision of guaranteed free medical care to the population by state and communal health care institutions; Organization of medical assistance in urgent and extreme situations; Development of measures to prevent and reduce morbidity, disability and mortality of the population; The organization within its powers of training, retraining and advanced training of medical and pharmaceutical workers, improvement of their knowledge and practical skills. The Department of Health, in accordance with the tasks assigned to it:

Participates in the implementation of state policy in the field of health care; Ensures observance of the rights and freedoms of citizens in the field of health care by health care institutions and institutions, other enterprises, institutions, and organizations belonging to the sphere of its management; Implements targeted and prospective health care programs, prepares proposals for determining priority areas of health care development, develops measures aimed at reforming the industry; Organizes and conducts accreditation of health care institutions in the sphere of its management; Coordinates the activities of health care institutions, institutions and institutions of the state sanitary and epidemiological service, which belong to the sphere of its management, on issues of diagnosis, treatment and prevention of diseases, formation of a healthy lifestyle, protection of the territory of the region from the introduction and spread of quarantine and other infectious diseases diseases, ensuring sanitary and epidemic well-being of the population; Organizes the study of the impact of the environment on human health, develops measures aimed at preventing the harmful effects of environmental factors on human health, participates in determining directions and carrying out together with the central and local bodies of executive power, local self-government bodies work on the prevention of diseases, as well as reduction of morbidity, disability and mortality of the population; Studies, evaluates and forecasts indicators of the state of health of the population; Performs organizational and methodical management and coordination of the work of the state disaster medicine service; Provides medical and social examination and provision of rehabilitation assistance to the population; Implements state policy on guaranteed medical supply of the population; Coordinates the provision of medicinal products to the population, determines their need, creates a database of necessary data to resolve the issues of informing employees of health care institutions and the population about medicinal products and immunobiological preparations approved for use; Ensures compliance with the established procedure for providing benefits regarding the release of medicines and immunobiological drugs to citizens free of charge or on preferential terms.

Forms of organization of the health care system

Beveridge concept
Funds from the state and local budgets (50–90%) have priority in health care financing. It is used in Great Britain, Ireland, Denmark, Portugal, Italy, Spain, Greece.

Budget and insurance (Bismarckian) concept

Financing of health care takes place mainly at the expense of insurance funds created by the state according to the principles of social insurance (compulsory and solidarity).

Private system (private insurance, market, paid, American model)

It is based on the financing of medical services at the expense of citizens and business entities directly or through the system of private insurance funds.

Improvement of the budgetary POP

Characteristic
Financing: 1. budgetary; 2. participation of citizens (directly, at the expense of voluntary health insurance, hospital funds, etc.). All financial resources are concentrated at the regional level; Payer (customer): health care management bodies. Organization of medical care: priority of primary health care on the basis of family medicine.

1. General access to free medical care; 2. Preventive orientation of POPs; 3. High efficiency in case of particularly dangerous infectious diseases, occupational diseases, as well as in emergency situations; 4. With appropriate management, lower administrative costs; 5. Structural optimization of medical services and increasing the efficiency of resource use due to the principle: finances “follow the patient”; 6. Motivational and administrative mechanisms for improving the quality of medical services.

1. Absence of a targeted principle of financing POPs. 2. Insufficient budget funding, a high percentage of personal expenses of the population for health care services; 3. Inequality in access to quality medical services; 4. The possibility of duplicating medical services (at the expense of departmental medicine); 5. More opportunities for abuse; 6. The cost of pharmaceuticals is covered by patients; 7. Bureaucratized administrative unit of the SOC.

Introduction of the budgetary and insurance health care system

Funding: 1. budgetary (a list of health care services clearly defined at the legislative level); 2. insurance contributions of employers and workers for employees; 3. participation of the population (directly or through the DMS); Payer (customer): Medical Insurance Fund; Organization of medical care: priority of primary health care on the basis of family medicine

1. Strengthening the financial base at the expense of OSMS, targeted nature of contributions; 2. Achieving a fairly high degree of solidarity, regardless of a person’s financial ability; 3. General accessibility to a limited list of medical care. Limited by health insurance conditions; 4. Increasing the transparency of POP financing; 5. Coverage of the established list of pharmaceuticals at the expense of OSMS; 6. Motivational and administrative mechanisms for improving the quality of medical services; 7. Mandatory use of medical care standards.

1. Introduction of a new targeted contribution – increase in accruals to the wage fund; 2. Additional costs associated with the formation of the OSMS structure; 3. Large expenses for infrastructure maintenance and administration; 4. Lack of proven mechanisms of state regulation of medical insurance; 5. Insufficient number of specialists in the field of insurance management; 6. Increasing volumes of not always justified medical services and increasing their cost; 7. A complex system of settlements with medical and preventive institutions.