Molchanov I.N., Molchanova N.P. DEVELOPMENT OF COMPULSORY MEDICAL INSURANCE IN CONDITIONS OF ECONOMIC UNCERTAINTY

DOI: https://doi.org/10.15688/jvolsu3.2018.4.10

Igor N. Molchanov

Doctor of Economic Sciences, Professor of the Department of Political Economy of Lomonosov Moscow State University, Leninskie gory, 1, 119991 Moscow, Russian Federation;
Professor of the Department of Public Finance of the Financial University under the Government of the Russian Federation, Leningradsky Prosp., 49, 101000 Moscow, Russian Federation, This email address is being protected from spambots. You need JavaScript enabled to view it. , https://orcid.org/0000-0003-4252-2387

Natalya P. Molchanova

Doctor of Economic Sciences, Associate Professor, Professor of the Department of Public Finance of the Financial University under the Government of the Russian Federation, Leningradsky Prosp., 49, 101000 Moscow, Russian Federation, This email address is being protected from spambots. You need JavaScript enabled to view it. , https://orcid.org/0000-0002-3019-0672


Abstract. The problem of protecting health and increasing the life expectancy of the population is
multifaceted and difficult to solve with the existing volumes and dynamics of financial resources allocated by the state for health care and currently accepted budgetary restrictions. In the light of the decision of the priority national goals for the preservation of health, the increase in the life expectancy of the population, the development of human potential, the characteristic features of the Russian system of compulsory medical insurance, the features of its functioning in the current economic conditions require thorough consideration and further development in the prospective period.
The objectives of the work are: to study problems that hamper the implementation of a balanced social policy in the field of compulsory health insurance; substantiation of the need for state regulation of the process of its practical implementation; identification of innovations, the use of which at the present stage of health care reform can have a positive impact on the economic activities of medical organizations; justification of the innovations recommended for use with a view to further development of the organizational and economic mechanism in the field under study.
The work is based on dialectics as a scientific and philosophical method of cognition, laws and categories of economic theory, system approach, analytical and expert economic methods.
The text presents a general vision of the system of compulsory medical insurance: the strategic issues of its development are considered in the post-reform period (1990-2000-ies); the features of its current state (2010th years) are analyzed; the evolution of tactical changes as concrete actions contributing to the attainment of the goals has been studied; some key questions were formulated, which should be focused on the attention of interested parties (subjects of economic relations) in order to develop coordinated management decisions.
Based on the results of the study, conclusions were drawn on the need to improve the organizational and economic foundations of the work of medical and preventive institutions. It is modernization that creates real opportunities for improving the functioning of the mandatory health insurance system. Budgeting for short- and medium-term periods can not take into account the long-term goals of development of medical organizations, this is the contradiction, the uncertainty of their economic activity. In the conditions of overcoming the consequences of the economic recession, it is necessary to intensify actions to strengthen state regulation in the healthcare field,
in conjunction with more intensive use of market instruments.

Key words: social policy, compulsory medical insurance, financial security, compulsory medical insurance fund, health, medical organization.

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