Integration of military medical services and civilian health careas a key condition for the provision of medical care to military personneland the population in the event of a large-scale military conflict.

Abstract

The escalation of the military conflict in Ukraine threatens with a shortage of resources for the military medical service. The solution may be the integration of civil and military medicine - it is provided for by the military medical doctrine of NATO, but does not have a systematic implementation in the Russian Federation, which even in peacetime limits the availability of medical care to military personnel, and in the event of an escalation of the conflict in Ukraine threatens to overload the military medical service . Attempts to integrate civilian and military medical infrastructure were unsuccessful due to the lack of a systematic approach to their interaction and the inability of the departments concerned to reach an agreement on the mechanisms and sources of funding.The authors propose to return to the principles of organizational integration between military and civilian medicine, which were first proposed in the ХIX century by N.I. Pirogov, successfully used by the health care of the USSR during the civil and second world wars and forgotten after the collapse of the Soviet Union. For financial and economic integration, it is proposed to include military personnel in the CHI system for medical care that military medical institutions cannot provide due to their overload, remoteness or lack of necessary specialists.It is proposed to solve the problem of paying compulsory medical insurance contributions for military personnel by replacing the compulsory medical insurance contributions paid by employers (for employees) and the subjects of the Federation (for the non-working population) with a universal compulsory medical insurance contribution automatically withheld at the same rate for all legal entities and individuals from all non-cash transactions - thereby financing additional medical guarantees for military personnel, leveling the “free rider effect” in the CHI system.