Abstract
The current state of the Russian health care system is a consequence of the reforms carried out in the last two decades, during which the positive characteristics of the previous system of management and financing were lost. The steady decline in the assessment of the state of health of Russians after 45 years indicates the insufficient quality and availability of the medical care, which is increasingly felt with age, due primarily to the reduction in the number of doctors and medical personnel. In the context of a prolonged decline in real incomes of the population, a very eloquent assessment of the social consequences of the reform is the growth of the private sector in the health sector. Focusing public attention on the situation with COVID-19 pushes to the background not only the assessment of the activities of the authorities in this area, but also the satisfaction of the needs for medical care of other, often seriously ill patients. A typical example of this approach is insufficient attention to the medical examination of the population. The pandemic becomes the litmus test that shows the negative consequences of the reform of the health care system: a significant reduction in infrastructure, the outflow of qualified medical personnel from the public sector, a decrease in the availability of quality medical care, increasingly dependent on the solvency of the population, the loss of hope for the help of state medicine on the part of the vast majority of the population. It seems quite convincing to assume that the authors of the reform initially consider such a result as their goal.
Highlights
The current state of the Russian health care system is a consequence of the reforms carried out in the last two decades, during which the positive characteristics of the previous system of management and financing were lost
The steady decline in the assessment of the state of health of Russians after 45 years indicates the insufficient quality and availability of the medical care, which is increasingly felt with age, due primarily to the reduction in the number of doctors and medical personnel
In the context of a prolonged decline in real incomes of the population, a very eloquent assessment of the social consequences of the reform is the growth of the private sector in the health care system
Summary
В ПФО на треть (33,4%) сократилось число больничных коек, в Кировской обл. Процессы «оптимизации» в ПФО меньше затронули фельдшерско-акушерские пункты и амбулаторно-поликлинические организации, однако это явно не компенсирует значительных потерь инфраструктуры здравоохранения. По мнению главы Всероссийской лиги пациентов А. Саверского, реформа системы здравоохранения стартовала неправильно: «хотели, как на Западе, чтобы коек было мало, а главным стало амбулаторное звено. Но начали совсем не с того конца: сперва нужно было развить амбулаторный блок, а уже потом сокращать койки. Неумелые действия по оптимизации привели к тому, что у нас вырос частный сектор, и продолжает расти. Необходимо отметить, что решение назревших проблем в сфере здравоохранения нередко подменяется так называемым адресным подходом, в процессе.
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