The Russian healthcare system is run by the Ministry of Health, whose responsibilities include regulation of the whole system, health insurance, medical treatment and sanitary services. Russian medicine is free, but there are also popular private hospitals and clinics as not everyone wants to rely on the underfunded public system. The current health system has many problems, with many changes expected.
During the time of the Soviet Union medical provision reached a certain level, but problems with the financial and political situation meant a lack of quality in treatment. After the collapse of the USSR, and a shift in market conditions, the required equipment began to flow into the country. Right after that, private clinics, hospitals and other “wellness” facilities began opening.
The Structure of the Health System
Healthcare in Russia is free, though all working citizens in Russia pay for medical services in advance, regularly making contributions to the healthcare budget through taxation. The Federal Compulsory Medical Insurance Fund in Russia is funded by contributions from the public, accounting for around 5% of the budget, supplemented by other tax revenues. According to Article 41 of the Russian Constitution, it is the right of every citizen to have free medical care. The system of healthcare in Russia is socially oriented, focusing on the support and promotion of good health. As a part of the health system, doctors systematically monitor the population’s health. The aim is to identify different diseases at an early stage and to refer patients to medical treatment or rehabilitation. In Russia, particular attention is paid to the education of good hygiene and information about healthy lifestyles.
Russia’s healthcare system is divided into 3 parts:
The government system of healthcare is regulated by the Ministry of Healthcare of the Russian Federation. Its responsibilities include organizing the development and implementation of government policies in the healthcare sector for all citizens of the country. All executive authorities, in particular the Russian Academy of Medical Science, pharmacies, research organizations and sanatoriums fall under the government’s control.
Pharmacies, pharmaceutical and medical institutions in this sector are regulated by local self-administration.
As with the previous systems, the private system includes research organizations, medical institutions and pharmacies but is financed by individuals and private funding.
So the healthcare system in Russia is mixed. Nowadays the coexistence of these 3 systems supports the quality of medical services. In 2018 the federal budget expenditure will amount to 460 billion rubles. It is planned that in 2019 it will be 428 billion rubles, but in 2020 it will reach 499 billion rubles.
A survey from the Russian Public Opinion Research Centre shows that Russians consider the most pressing problems to be long queues in hospitals and clinics, the absence of necessary equipment, and incompetence by doctors. More than half of those interviewed (56%) complained about the long wait for healthcare. 42% pointed to poor conditions in hospitals, the lack of seating, and bad ventilation. More than one-third of the respondents (37%) pointed to the lack of sufficient professionalism.
52% surveyed assessed the healthcare system negatively, 37% marked it as satisfactory, and just 9% thought it adequate.
Healthcare in Russia faces a number of problems. Challenges include:
● lack of specialists and equipment, resulting in long queues;
● doctors working in arduous conditions which affect the quality of their work;
● rising costs of medicine;
● poorly qualified doctors;
● old medical equipment, with some hospitals still using equipment from the Soviet era;
● Shortage of doctors because of low pay.
What changes should people expect in 2018?
The majority of innovations in medicine relate to information technology and new methods of diagnosis and treatment.
The introduction of telemedicine and electronic prescriptions. By the end of 2018 all hospitals should be connected to the internet, with the introduction of digital medical cards, electronic prescriptions, and electronically recorded sick leave. Electronic prescriptions reduce the doctor’s need to write on paper and the patient’s need to take it to a pharmacy. The new system will allow the doctor to upload the prescription directly to the pharmacist.
Tighter controls on the price of medicines
At the beginning of 2018 a new system of price control was introduced to monitor public procurement. This is meant to address forms of corruption which have plagued the system. These enhancements are designed to result in savings across the national budget.
Screenings for oncological diseases will be conducted more often, to support the early detection of cancer, leading to faster diagnosis. Starting this year a programme called “The rural doctor” is being instituted in cities and villages with populations of less than 50 thousand. As part of the programme any doctor under 50 years of age who moves to the countryside to work for at least 5 years will receive one million rubles. In addition, this programme allows the participation of feldshers to work in rural areas; they will earn salaries of 500,000 rubles.