Public-private partnership in the system of compulsory health insurance: features and trends

Abstract

Public-private partnership projects can act as a growth driver for healthcare both at the federal and regional levels. The inclusion of investment projects based on the principles of public-private partnership in the system of compulsory health insurance has a number of features. First of all, it is declarative in nature, and the volume of medical care is distributed by the commission at the regional level. There are discrepancies in the position of the relevant departments on the participation of public-private partnership projects in the system of compulsory health insurance, which brings dissonance to the industry and explains the reluctance of investors to participate in its development. While the Ministry of Health of the Russian Federation declares the “softening” of barriers to the integration of the private sector (concessions) into the public sector, the Mandatory Health Insurance Fund declares the need to stop including private medical organizations in the system of payment for compulsory health insurance. The exclusion of the private sector from financing through the compulsory health insurance system will in fact be equated on the part of the investor with the absence of any guarantees of profitability. Payment through the system of compulsory health insurance is not a mechanism that guarantees income, but the existing monopoly of the state in healthcare on the distribution of medical care creates a situation in which the amount of financial resources directly depends on the state authorities.