Abstract

Introduction. Many developed countries have recognized the social sphere, including healthcare, as a full-fledged manufacturing sector of the economy, creating a significant share of value added in the sectoral structure of GDP. As part of the study, a comparison was made of the share of gross value added in the GDP of the United States, EU countries and Russia created by healthcare in 2018, as an example of the analysis of the impact of healthcare in different countries on gross value added, which is a significant indicator for assessing the correctness of the organization of healthcare financing.Material and methods. Used a comprehensive, statistical, comparative and retrospective analysis of available data.Research results. The data obtained indicate that the share of Russia's GDP created by healthcare is many times less than that of the United States and EU countries, which limits the growth of the Russian economy, causes poverty for a significant part of medical workers and hinders investment in the healthcare system and its demand for innovation.Discussion and conclusion. The authors see the root cause of the problems in the mistake of choosing the mandatory health insurance income system, the linkage of which to formal employment in a largescale shadow economy leads to the “free rider problem” (Free-Rider Problem) and a pronounced payment imbalance between providers and consumers of public health care due to its payment at deliberately unprofitable (below actual cost) tariffs. The most optimal solution is considered to be the replacement of salary-linked compulsory medical insurance contributions with a universal targeted tax for automated payment transactions.

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