Financing of Public Health Care for the Population of the Russian Federation: To Maintain Multichannel or Switch to a Single Payer System?

Abstract

The subject of the research is the models of collection and consolidation (pooling) of resources for payment of public (free at the place of delivery) medical care to the population in developed countries and in the Russian Federation. The purpose of the study is to develop practical recommendations on the development of a system for financing medical guarantees for the population of the Russian Federation. The relevance of the study is due to the lack of resources to pay for public health care for the entire population in our country. The scientific novelty lies in the comparison of single-channel and multichannel pooling models used by developed countries in terms of their financial-economic and medico-social efficiency with the conclusion about a higher level of costs of the multichannel model with a comparable level of coverage with medical services of the population and indicators of its health compared to the model single payer. The research methodology is based on the use of complex, statistical, comparative and retrospective analyzes. It was concluded that the use of a multichannel pooling model in the financing of healthcare in the Russian Federation with the participation of competing insurers and the use of different channels of budgetary financing for different groups of the population is an important reason for the low efficiency of the Russian healthcare system. The prospect of further research is in the formation of a scientific and methodological justification for replacing the multichannel pooling model, which has historically developed in healthcare in Russia, with a single-channel model of a single payer represented by the Federal Compulsory Medical Insurance Fund (hereinafter- CMIF).