THE FINANCING PRIMARY HEALTH CARE UNDER PANDEMIC THREATS

Abstract

The pandemic COVID-19 exposes a number of health care problems common for developed and developing countries, creates unprecedented threats and risks and cast doubt on the rightness of widespread approaches to the development of health care and especially primary health care (PHC). The pandemic has shown that even in developed countries the lack of access to first aid for vulnerable groups of the population (pensions, poor, migrants,etc.) can lead to catastrophic consequences for the society. Thus, PHC has indisputable characteristic of a public goods and services - non-excludability. This means that access to PHC must be free and equal to all persons in any region, whether such persons are temporary or permanent residents without exemptions caused by citizenship and social status. Insurance medicine, the source of financing of which is the contributions of insured persons and employers, is not able to provide such access. Thus, the social institutions combining market and non-market principles of financing and providing PHC services must support health care system workable. Budget is a main source of funding PHC service. Also, additional funding of open and equal access to PHC needed. Such funding can support: by earmarked deductions from income of insurance funds; by restrictions of tax evasion by “free-riders” entrepreneurs using unfair low wages of migrants and minorities for rising profits; by the issuing special “green bonds” for finance PHC equipment; and by expansion of activities local charity funds.