РОССИЙСКОЕ ЗДРАВООХРАНЕНИЕ: ПРОБЛЕМЫ И ПЕРСПЕКТИВЫ
There is an evidence that today health spending efficiency in Russia is low: comparing Russia to foreign countries shows that, considering current expenditures, a number of medico-social variables reflecting healthcare effectiveness, e.g. life expectancy, mortality and equity in access to healthcare, can be improved. The article examines causes that deteriorate health spending efficiency: imbalance in Program of state guarantees in health, structural disproportion in health spending sources, the lack of universal outpatient drug provision program and inadequate motivation of health professionals. The authors also examined possible measures aiming to solve stated problems.
With low take-up of both private health insurance and the existing public drug reimbursement scheme, it is thought that less than 5% of the Russian population have access to free outpatient drug treatment. This represents a major policy challenge for a country grappling with reforms of its healthcare system and experiencing low or no economic growth and significant associated reductions in spending on social services. In this paper, we draw on data from a recent Levada-Center survey to examine the attitudes and social solidarity of the Russian population towards drug policies in general and towards the introduction of a proposed voluntary drug insurance system in particular. In addition to being among the first to explore these important questions in the post-Communist setting, we make three important contributions to the emerging policy debates. First, we find that, if introduced immediately and without careful planning and preparation, Russia’s voluntary drug insurance scheme is likely to collapse financially due to the over-representation of high-risk unhealthy individuals opting in to the scheme. Second, the negative attitude of higher income groups towards the redistribution of wealth to the poor may further impede government efforts to introduce voluntary drug insurance. Finally, we argue that Russia currently lacks the breadth and depth of social solidarity necessary for implementing this form of health financing.
The article is devoted to the review of the forming systems of public health in S.Peterburg, it shows main stages of private medical insurance, relations between its participants. The article focuses on improving the models of medical care, and suggests some recommendations for raising efficiency, based on local opportunities and peculiarities. The author pays attention to the importance of choosing an adequate market conditions, type of strategy for the competitive advantages implementation, which determines the prospects of its development.
The paper examines the structure, governance, and balance sheets of state-controlled banks in Russia, which accounted for over 55 percent of the total assets in the country's banking system in early 2012. The author offers a credible estimate of the size of the country's state banking sector by including banks that are indirectly owned by public organizations. Contrary to some predictions based on the theoretical literature on economic transition, he explains the relatively high profitability and efficiency of Russian state-controlled banks by pointing to their competitive position in such functions as acquisition and disposal of assets on behalf of the government. Also suggested in the paper is a different way of looking at market concentration in Russia (by consolidating the market shares of core state-controlled banks), which produces a picture of a more concentrated market than officially reported. Lastly, one of the author's interesting conclusions is that China provides a better benchmark than the formerly centrally planned economies of Central and Eastern Europe by which to assess the viability of state ownership of banks in Russia and to evaluate the country's banking sector.
The paper examines the principles for the supervision of financial conglomerates proposed by BCBS in the consultative document published in December 2011. Moreover, the article proposes a number of suggestions worked out by the authors within the HSE research team.