Brief description of the compulsory health insurance fund. Characteristics of the compulsory health insurance fund

19.01.2024

The purpose of health insurance is to guarantee citizens, in the event of an insured event, receiving medical care from accumulated funds and financing preventive measures.

Medical insurance is provided in two types: compulsory and voluntary.

Compulsory health insurance is an integral part of state social insurance and provides all citizens of the Russian Federation with equal opportunities to receive medical and pharmaceutical care provided at the expense of compulsory health insurance in the amount and on conditions corresponding to compulsory health insurance programs. (question 30)

Voluntary health insurance is carried out on the basis of voluntary health insurance programs and provides citizens with additional medical and other services in addition to those established by compulsory health insurance programs. Voluntary health insurance can be collective or individual. (Question 31)

The subjects of health insurance are: citizen, policyholder, medical insurance organization, medical institution.

Insured for compulsory health insurance are: for the non-working population - the governments of the republics within the Russian Federation, government bodies of the autonomous region, autonomous districts, territories, regions, cities of Moscow and St. Petersburg, local administration; for the working population - enterprises, institutions, organizations, persons engaged in self-employment, and persons of liberal professions.

Insured for voluntary health insurance are individual citizens with civil legal capacity and/or enterprises representing the interests of citizens.

Medical insurance organizations are legal entities that provide medical insurance and have a state permit (license) to engage in medical insurance.

Medical institutions in the health insurance system are licensed treatment and preventive institutions, research and medical institutes, other institutions providing medical care, as well as persons engaged in medical activities, both individually and collectively.

The object of voluntary medical insurance is the insurance risk associated with the costs of providing medical care in the event of an insured event.

Health insurance is carried out in the form of an agreement concluded between the subjects of health insurance. Subjects of health insurance fulfill their obligations under the concluded contract in accordance with the legislation of the Russian Federation.

Every citizen in respect of whom a health insurance contract has been concluded or who has concluded such an agreement independently receives a medical insurance policy. The medical insurance policy is in the hands of the insured.

Medical insurance organizations are legal entities that are independent economic entities, with any forms of ownership provided for by the legislation of the Russian Federation, possessing the authorized capital necessary for the implementation of medical insurance and organizing their activities in accordance with the legislation in force on the territory of the Russian Federation.

Health insurance activities in Russia are subject to licensing. A state license for the right to engage in medical insurance is issued by the authorities supervising insurance activities in accordance with the legislation in force on the territory of the Russian Federation.

Insurance premiums are established as payment rates for compulsory health insurance in amounts that ensure the implementation of health insurance programs and the activities of an insurance medical organization, and are established by the legislation of the Russian Federation and the constituent entities of the Federation.

Voluntary health insurance is carried out at the expense of the profits (income) of enterprises and personal funds of citizens through the conclusion of an agreement. The amounts of insurance premiums for voluntary health insurance are established by agreement of the parties.

Public organizations of disabled people and enterprises, associations and institutions owned by these organizations created to carry out their statutory goals are exempt from paying contributions for compulsory health insurance.

To implement state policy in the field of compulsory health insurance, the Federal and territorial compulsory health insurance funds were created as independent non-profit financial and credit institutions.

The Federal Compulsory Medical Insurance Fund (hereinafter referred to as the Federal Fund) implements state policy in the field of compulsory medical insurance of citizens as an integral part of state social insurance. The Fund is a legal entity, has an independent balance sheet, separate property, accounts in institutions of the Central Bank of the Russian Federation and other credit organizations, a seal with its name, stamps and forms of the established form.

The main objectives of the Federal Fund are:

· financial support of the rights of citizens to medical care established by the legislation of the Russian Federation at the expense of compulsory medical insurance for the purposes provided for by the Law of the Russian Federation “On medical insurance of citizens in the Russian Federation”;
· ensuring the financial sustainability of the compulsory health insurance system and creating conditions for equalizing the volume and quality of medical care provided to citizens throughout the Russian Federation within the framework of the basic compulsory health insurance program;
· accumulation of financial resources of the Federal Fund to ensure the financial stability of the compulsory health insurance system.

In order to fulfill its main tasks, the Federal Fund:

1) equalizes the financial conditions for the activities of territorial compulsory health insurance funds within the framework of the basic compulsory health insurance program;
2) develops and, in accordance with the established procedure, makes proposals on the amount of contributions for compulsory health insurance;
3) carries out, in accordance with the established procedure, the accumulation of financial resources of the Federal Fund;
4) allocates funds in the prescribed manner to territorial compulsory health insurance funds, including on a non-refundable and repayable basis, for the implementation of territorial compulsory health insurance programs;
5) carries out, jointly with territorial compulsory medical insurance funds and bodies of the State Tax Service of the Russian Federation, control over the timely and complete transfer of insurance contributions (deductions) to compulsory medical insurance funds;
6) exercises, together with territorial compulsory health insurance funds, control over the rational use of financial resources in the compulsory health insurance system, including by conducting relevant audits and targeted inspections;
7) carries out, within its competence, organizational and methodological activities to ensure the functioning of the compulsory health insurance system;
8) makes, in the prescribed manner, proposals for improving legislative and other regulatory legal acts on issues of compulsory health insurance;
9) participates in the development of a basic program of compulsory health insurance for citizens;
10) collects and analyzes information, including on the financial resources of the compulsory health insurance system, and submits relevant materials to the Government of the Russian Federation;
11) organizes, in the manner established by the Government of the Russian Federation, the training of specialists for the compulsory health insurance system;
12) studies and generalizes the practice of applying regulatory legal acts on issues of compulsory health insurance;
13) ensures, in the manner established by the Government of the Russian Federation, the organization of research work in the field of compulsory health insurance;
14) participates in the manner established by the Government of the Russian Federation in international cooperation on issues of compulsory health insurance;
15) annually, in accordance with the established procedure, submits to the Government of the Russian Federation draft federal laws on approval of the budget of the Federal Fund for the corresponding year and on its implementation.

Territorial compulsory health insurance funds in the field of financial and credit activities and control over the rational use of financial resources in the compulsory health insurance system perform the following main functions:

· accumulate financial resources of territorial funds;
· finance compulsory medical care provided by insurance medical institutions;
· carry out financial and credit activities to ensure the compulsory health insurance system;
· equalize the financial resources of cities and districts allocated for compulsory health insurance;
· together with the state tax service of the Russian Federation, exercise control over the timely and complete receipt of insurance contributions to the territorial fund, as well as the rational use of received financial resources;
· coordinate, together with executive authorities, professional medical associations, the pricing of the cost of medical care, the territorial program of compulsory health insurance for the population, make proposals on the financial resources necessary for its implementation, on tariffs for medical and other services under compulsory health insurance.

Financial resources of the Federal Fund are federal property, are not included in budgets or other funds and are not subject to withdrawal.

Financial resources of the Federal Fund are generated through:

1) parts of insurance premiums (deductions) of business entities and other organizations for compulsory health insurance in the amounts established by federal law;
2) allocations from the federal budget for the implementation of federal target programs within the framework of compulsory health insurance;
3) voluntary contributions from legal entities and individuals;
4) income from the use of temporarily available financial resources;
5) normalized safety stock of the Federal Fund;
6) receipts from other sources not prohibited by the legislation of the Russian Federation.

Insurance contributions (deductions) to the Federal Fund are transferred by business entities and other organizations in accordance with the established procedure.

In order to protect them from inflation, temporarily free financial resources of the Federal Fund are placed in bank deposits and can be used to purchase highly liquid government securities.

Income from the use of temporarily free financial resources and the normalized safety stock of the Federal Fund can be used to finance only those activities that are carried out in accordance with the tasks of the Federal Fund provided for in this charter.

Costs for the maintenance of the Federal Fund, the creation and maintenance of its material and technical base are carried out within the limits of the funds provided for these purposes by the budget of the Federal Fund. Financial resources not spent in the past year are not subject to withdrawal and are not taken into account when appropriating allocations from the federal budget for the next year. The Federal Fund has the right to carry out income-generating activities. Income received from such activities, as well as income from the use of property under operational management, and property acquired from these incomes are used to implement the statutory objectives of the Federal Fund. The Federal Fund annually develops a budget and a report on its implementation, which, upon the proposal of the Government of the Russian Federation, are approved by federal law.

On November 19, 2010, the State Duma of the Russian Federation adopted the basic law “On compulsory health insurance in the Russian Federation.” This law is aimed at strengthening the guarantees of insured citizens to receive free medical care within the framework of the basic and territorial compulsory medical insurance programs.

Insured persons (working and non-working citizens, foreigners and stateless persons, refugees) are entitled to receive free assistance in medical institutions upon the occurrence of an insured event (throughout the entire territory of the Russian Federation - within the scope of the basic compulsory medical insurance program, in the territory of the region in which the compulsory medical insurance policy was issued, within the scope of the territorial compulsory medical insurance program).

Citizens also have the right to annually choose and replace an insurance organization or doctor with a uniform policy that does not require replacement when changing insurers and is valid throughout the entire territory of the Russian Federation.

It is planned to transition to predominantly single-channel financing of healthcare organizations through the compulsory medical insurance system and payment for care at the full tariff, while the tariff should include all items of expenditure, except for the cost of purchasing equipment costing over 100 thousand rubles. An application procedure for participation in the compulsory medical insurance system and equal conditions for medical organizations of any organizational and legal form, as well as private practicing doctors, are being introduced.

In 2011-2012, as part of the healthcare modernization program, regional programs and programs for the modernization of federal government healthcare institutions are being implemented. Regional programs are financed from income received by the Federal Fund from insurance premiums for compulsory medical insurance in the amount of 2%, the budgets of the constituent entities of the Russian Federation and the budgets of territorial funds.

It is envisaged to establish a social payment for the provision of medical care to non-working pensioners - at the expense of the Federal Fund in the amount of one thousand rubles per year. From May 1, 2011, until the introduction of a universal electronic citizen card on the territory of the constituent entities of the Russian Federation, a health insurance policy will be issued to the insured in the manner established by the compulsory medical insurance rules. Emergency medical care will be included in the basic compulsory medical insurance program from 2013, and high-tech medical care - from 2015.

The second bill amends the legislation in connection with changes in the organization of management of the compulsory medical insurance system and clarification of the powers to financially support medical care in state and municipal clinics at the expense of health insurance funds.

Interbudgetary transfers from the FFOMS budget are provided in the form of subventions to the budgets of territorial compulsory medical insurance funds. In 2011 and 2012, financial support from budgetary allocations in federal budgetary institutions is carried out in the form of subsidies, while regional government institutions and municipal institutions participating in the implementation of territorial compulsory health insurance programs cannot be created in the form of government institutions. The minimum authorized capital of an insurer providing exclusively medical insurance must be 60 million rubles.

In accordance with the Law of the Russian Federation “On Medical Insurance of Citizens in the Russian Federation”, federal and territorial compulsory medical insurance funds have been created, legal framework the functioning of which are the corresponding Regulations approved by the Resolutions of the Supreme Council of the Russian Federation of February 24, 1993 (as amended on August 5, 2000).

The activities of these funds are aimed at implementing state policy in the field of compulsory health insurance for citizens as an integral part of state social insurance. The Federal Fund is created by the Government of the Russian Federation, and territorial funds are formed, respectively, by the representative executive bodies of the republics within the Russian Federation and other subjects of the Federation.

Main sources of education Federal and territorial funds are insurance contributions from business entities for compulsory health insurance, budget allocations and other revenues. The funds received are used to finance compulsory health insurance and other related activities. The budget of the Federal Compulsory Medical Insurance Fund and the report on its implementation are reviewed annually by the State Duma.

Health insurance is carried out in the form of an agreement concluded between the subjects of health insurance. Health insurance contract is an agreement between the insured and a medical insurance organization, according to which the latter undertakes to organize and finance the provision of medical care to the insured contingent of a certain volume and quality or other services under the program of compulsory medical insurance and voluntary medical insurance (Article 4 of the Law of the Russian Federation “On Medical Insurance of Citizens” in the Russian Federation").

Health insurance contract considered concluded from the moment of payment of the first insurance premium, unless otherwise provided by the terms of the contract (ibid.).

Insurance premiums are established as payment rates for compulsory health insurance in amounts that ensure the implementation of health insurance programs and the activities of the medical insurance organization.

Insurance medical organizations are legal entities that provide health insurance and have permission from a government agency (that is, a license) to engage in such activities.

Medical insurance organizations are endowed with a set of rights and obligations. Medical insurance organization has the right:

Freely choose medical institutions to provide medical care and services under health insurance contracts;

Establish the amount of insurance premiums for voluntary health insurance;

Take part in determining tariffs for medical services;

Bring a claim in court to a medical institution or medical worker for material compensation for physical and moral damage caused to the insured through their fault.

Medical insurance organization obliged:

Conclude agreements with medical institutions for the provision of medical care to those insured under compulsory health insurance;

Medicine is a field of science and medical practice aimed at preserving and strengthening people’s health, preventing and treating diseases. The concept of medicine is related to the concept of healthcare.

Healthcare is a system of state and public measures to protect health, prevent and treat diseases and prolong human life.

Medical science developed rapidly in the country. To train medical specialists, medical higher educational institutions were created in the capital and in a number of Russian cities.

Political and economic destructive reforms in Russia also affected healthcare and its material and technical base. Free medical care was reduced, and paid medical care began to increase.

The average life expectancy of women in 2013-2014 in Russia was 75 years

The morbidity rate of the population has increased, previously unknown diseases for the Russian population have appeared (AIDS, neoplasms, blood diseases, radiation). The birth rate has decreased, and mortality from cardiovascular diseases has increased.

Health insurance is one of the forms of social protection of the population in case of loss of health from any reason.

Health insurance aims to guarantee that citizens, in the event of an insured event (i.e., illness), receive medical care from accumulated public funds and finance preventive measures.

Compulsory health insurance is universal for the population of the Russian Federation.

The object of health insurance is the insurance risk associated with the costs of providing medical care in the event of an insured event.

The condition for providing medical services to the population covered by health insurance is a special Health Insurance Fund.

Federal Compulsory Medical Insurance Fund;

territorial compulsory health insurance funds.

The Federal Compulsory Health Insurance Fund is a legal entity. He is accountable to the Government of the Russian Federation. The Fund's funds are state property. The Foundation operates on the basis of the Charter.

Management of the activities of the Federal Fund is carried out by the board and executive directorate, headed by the executive director (appointed by the Government in agreement with the board).

The activities of the Fund are monitored by the Audit Commission.

Reports on income and expenses of the Federal Fund are submitted first to the Government of the Russian Federation, and then to the State Duma.

The activities of the Federal Compulsory Medical Insurance Fund are aimed at performing the following functions:

1) financial support for the rights of citizens to medical care established by the Law of the Russian Federation at the expense of compulsory health insurance;
2) ensuring the implementation of the Law “On Medical Insurance of Citizens of the Russian Federation”; achieving social justice and equality of all citizens in the compulsory health insurance system;
3) ensuring the financial sustainability of the health insurance system;
4) accumulation of financial resources of the Federal Health Insurance Fund;
5) financing of targeted programs.

The main function of the Federal Fund is to equalize the conditions for the activities of territorial funds in financing compulsory health insurance programs.

Financial resources of the Federal Fund are generated through:

1) parts of insurance premiums (deductions) of business entities and other organizations for compulsory health insurance in the amounts established by federal law;
2) allocations from the federal budget for the implementation of federal target programs within the framework of compulsory health insurance;
3) voluntary contributions from legal entities and individuals;
4) income from the use of temporarily available financial resources;
5) receipts from other sources not prohibited by the legislation of the Russian Federation.

The territorial fund is created to finance territorial compulsory health insurance programs.

Management of the Fund's activities is carried out by the board and its executive director. Control is carried out by the audit commission. The composition of the board is approved by the legislative (representative) authority of the constituent entity of the Russian Federation.

The Territorial Compulsory Health Insurance Fund performs the following functions:

accumulates financial resources of the territorial fund for compulsory health insurance;

finances the territorial compulsory health insurance program;

carries out financial and credit activities to ensure the compulsory health insurance system;

equalizes the financial resources of cities and districts allocated for compulsory health insurance;

together with the tax authorities, monitors the timely and complete receipt of insurance contributions to the territorial fund;

interacts with the Federal Fund and other territorial funds.

To perform its functions, the territorial fund can create its branches in cities and districts.

Financial resources of territorial compulsory health insurance funds are formed from:

parts of the unified social tax at rates established by the legislation of the Russian Federation;

insurance premiums of enterprises and organizations;

budget allocations;

loans from banks and other creditors;

insurance premiums for compulsory medical insurance of the non-working population, paid by executive authorities of the constituent entities of the Russian Federation, local governments, taking into account compulsory medical insurance programs within the limits of funds provided for in health care budgets;

other income (fines, penalties, from deposits).

The amount of insurance premiums is determined by federal law upon the proposal of the Government of the Russian Federation.

Insurance premiums for compulsory medical insurance of the non-working population are paid to the Fund by the governments of the constituent entities of the Russian Federation and local administrations at the expense of funds provided in the budgets.

Public organizations of disabled people and enterprises owned by these organizations created to implement their statutory goals are exempt from paying for compulsory health insurance.

Insurance contributions to the Compulsory Medical Insurance Fund are transferred to the collection accounts of the Federal and territorial funds opened in cash settlement centers (RCCs) or bank institutions serving the tax inspectorate of a given territory.

The expenditure of funds from the Federal and territorial compulsory health insurance funds is carried out in accordance with their budgets, approved respectively by federal law and the law of the constituent entities of the Federation.

Control over the timely and complete receipt of insurance contributions to the funds is entrusted to the State Tax Service of the Russian Federation.

In the structure of revenues, the predominant share is made up of insurance premiums (more than 9/10).

The expenditure part of the federal budget includes: expenses for equalizing the financial conditions of the activities of territorial funds, for the implementation of targeted programs for the provision of medical care under compulsory health insurance.

The Law “On Compulsory Health Insurance” provides for the formation of medical insurance companies, the founders of which are the local administration. Such companies can operate only if they have licenses for compulsory health insurance. Their task is to select capable medical institutions and to act as an intermediary between the territorial fund and the medical institution.

The funds of the territorial fund are sent to insurance companies, the founders of which are the local administration.

The company issues an insurance policy to all Russian citizens at their place of residence or place of work. This policy means that a person receives a “guaranteed volume of medical services” free of charge. This scope will include, at a minimum, emergency care, treatment of acute diseases, maternity and childbirth services, assistance to children, pensioners, and the disabled.

However, the population does not approve of the introduction of a new medical care system in a number of regions. According to the Ministry of Health of the Russian Federation, medical insurance companies are not needed in the compulsory health insurance system; their role can be performed by the funds themselves, without intermediaries.

Voluntary health insurance is carried out at the expense of the profits (income) of enterprises and personal funds of citizens through the conclusion of contracts. It allows citizens to receive additional medical services beyond those established by compulsory medical care; it can be collective and individual. The amount of insurance premiums is established by agreement of the parties.

2.2.1 Characteristics of compulsory health insurance funds, their legal status

Healthcare is a system of state and public measures to protect health, prevent and treat diseases and prolong human life. Healthcare in the USSR was organized at a high level, on the principles of free and accessible medical care and preventive medicine. During the years of Soviet power in Russia (1918-1990), a material and technical base for healthcare was created, a network of hospitals and outpatient clinics (polyclinics, dispensaries, dispensaries) was developed, a sanitary-epidemiological service was created, a network of institutions for the provision of specialized medical care (maternity hospitals etc.). Particularly dangerous infections (smallpox, tuberculosis, etc.) have been eliminated in Russia and other republics of the USSR. The incidence of infectious diseases has decreased significantly, overall infant and maternal mortality rates have decreased, and people's life expectancy has increased. Healthcare was a state-regulated activity primarily in the field of anti-epidemiological work. At industrial enterprises, on state farms, and in rural settlements, health centers (medical, paramedic) were created to provide first medical aid for sudden illnesses.

Medical science developed rapidly in the country. To train medical specialists, medical higher educational institutions were created in the capital and in a number of Russian cities.

Political and economic destructive reforms in Russia also affected healthcare and its material and technical base. Free medical care was reduced, and paid medical care began to increase.

Reforms in Russia are accompanied by increasing problems in the social sphere. The life expectancy of people in Russia has decreased. Thus, the average life expectancy of men in Russia in 1990 was 63.9 years, in 2000 it decreased to 58.9, which is 3 years less than in India and 13 years less than in Finland, 5 years less than it was in Russia in 1990.

The average life expectancy of women in Russia in 1990 was 74.2 years, in 2000 it was already 72.4 years. According to the State Statistics Committee of Russia, the number of unemployed in 1992 was 3.8 million people, in 1999 - 9.1 million people, which is 15% of the economically active population.

Health insurance is one of the forms of social protection of the population in case of loss of health from any reason.

Health insurance aims to guarantee that citizens, in the event of an insured event (i.e., illness), receive medical care from accumulated public funds and finance preventive measures.

Medical insurance in the Russian Federation was introduced in accordance with the Law of the Russian Federation of June 28, 1991 “On Medical Insurance of Citizens of the RSFSR” (as amended by the Law of the Russian Federation of April 2, 1993). The law defines the legal, economic and organizational basis for the interest and responsibility of both the insured person and the state, enterprise, and institution in protecting the health of citizens, therefore the parties to a health insurance contract are similar to a regular insurance contract.

Compulsory health insurance is universal for the population of the Russian Federation.

The object of health insurance is the insurance risk associated with the costs of providing medical care in the event of an insured event.

The condition for providing medical services to the population covered by health insurance is a special Health Insurance Fund.

In accordance with the Law of the Russian Federation “On Medical Insurance of Citizens in the RSFSR”, which came into force on January 1, 1993, compulsory medical insurance funds are being created in Russia:

· Federal Compulsory Medical Insurance Fund;

· territorial compulsory health insurance funds.

The legal basis for these funds is: Regulations approved by Resolution of the Supreme Council of the Russian Federation dated February 24, 1993 No. 4543-1.

The Charter of the Federal Compulsory Medical Insurance Fund was approved by Decree of the Government of the Russian Federation on June 29, 1998 No. 857 “On approval of the Charter of the Federal Compulsory Medical Insurance Fund.”

Management of the activities of the Federal Fund is carried out by the board and executive directorate, headed by the executive director (appointed by the Government in agreement with the board).

The activities of the Fund are monitored by the Audit Commission.

Reports on income and expenses of the Federal Fund are submitted first to the Government of the Russian Federation, and then to the State Duma.

The activities of the Federal Compulsory Medical Insurance Fund are aimed at performing the following functions:

1) financial support for the rights of citizens to medical care established by the Law of the Russian Federation at the expense of compulsory health insurance;

2) ensuring the implementation of the Law “On Medical Insurance of Citizens of the Russian Federation”; achieving social justice and equality of all citizens in the compulsory health insurance system;

3) ensuring the financial sustainability of the health insurance system;

4) accumulation of financial resources of the Federal Health Insurance Fund;

5) financing of targeted programs.

The main function of the Federal Fund is to equalize the conditions for the activities of territorial funds in financing compulsory health insurance programs.

Financial resources of the Federal Fund are generated through:

1) parts of insurance premiums (deductions) of business entities and other organizations for compulsory health insurance in the amounts established by federal law;

2) allocations from the federal budget for the implementation of federal target programs within the framework of compulsory health insurance;

3) voluntary contributions from legal entities and individuals;

4) income from the use of temporarily available financial resources;

5) receipts from other sources not prohibited by the legislation of the Russian Federation.

Territorial compulsory health insurance funds are created by decision of the state authorities of the constituent entity of the Russian Federation. The regulations on territorial compulsory health insurance funds were approved by a decree of the Government of the Russian Federation of February 24, 1993. Branches can be created in regions (regions, territories, republics).

The territorial fund is created to finance territorial compulsory health insurance programs.

The Territorial Compulsory Health Insurance Fund performs the following functions:

· accumulates financial resources of the territorial fund for compulsory health insurance;

· finances the territorial compulsory health insurance program;

· carries out financial and credit activities to ensure the compulsory health insurance system;

· equalizes the financial resources of cities and districts allocated for compulsory health insurance;

· together with the tax authorities, exercises control over the timely and complete receipt of insurance contributions to the territorial fund;

· interacts with the Federal Fund and other territorial funds.

To perform its functions, the territorial fund can create its branches in cities and districts.

Financial resources of territorial compulsory health insurance funds are formed from:

· parts of the unified social tax at rates established by the legislation of the Russian Federation;

· insurance premiums of enterprises and organizations;

· budgetary allocations;

· loans from banks and other creditors;

· insurance premiums for compulsory medical insurance of the non-working population, paid by executive authorities of the constituent entities of the Russian Federation, local governments, taking into account compulsory medical insurance programs within the limits of funds provided for in health care budgets;

· other income (fines, penalties, from deposits).

The amount of insurance premiums is determined by federal law upon the proposal of the Government of the Russian Federation.

Public organizations of disabled people and enterprises owned by these organizations created to implement their statutory goals are exempt from paying for compulsory health insurance.

Control over the timely and complete receipt of insurance contributions to the funds is entrusted to the State Tax Service of the Russian Federation.

In the structure of revenues, the predominant share is made up of insurance premiums (more than 9/10).

The funds of the territorial fund are sent to insurance companies, the founders of which are the local administration.

It should be noted that, along with compulsory health insurance, there is voluntary health insurance, introduced on October 1, 1992.

2.2.2 Prospects for healthcare development

In the next five years, healthcare will probably completely switch to insurance principles of financing. The head of the Federal Compulsory Insurance Fund (FOMS), Dmitry Reichart, spoke about further reform of the system. Compulsory health insurance was introduced in Russia 15 years ago as an additional source of healthcare financing. However, this did not affect the improvement of the quality of service in Russian clinics, and private medical centers are becoming increasingly popular. At a meeting in Klin, President Dmitry Medvedev expressed dissatisfaction with the current compulsory medical insurance system. “So far, claims go either to the chief physician or to local authorities, and people do not quite understand why insurance companies are needed at all,” the president was indignant. According to Medvedev, for many Russians, health insurance policies are perceived simply as pieces of paper. Therefore, he believes that it is necessary to force insurance organizations to comply with the law and work for the patient.

Participants of the Federal Compulsory Medical Insurance Fund outlined the priorities for the development of the industry for the coming years. The first thing to be done is to ensure the same quality of medical services throughout the country. As Dmitry Reichart explained, the Ministry of Health and Social Development is already preparing uniform medical and economic standards for the provision of care. The second task is to transfer healthcare exclusively to insurance financing. Now hospitals and clinics receive funds from several sources at once. According to the Ministry of Health and Social Development, in 2007, in the total volume of financing, federal funds amounted to 18.1%, the share of the consolidated budget - 45.3%, compulsory medical insurance - 36.6%.

However, starting from 2011, all cash flows will be concentrated in the Compulsory Medical Insurance Fund and then distributed among health care institutions based on the tariff. "We want to make sure the money follows the patient," Mr. Reichart said. “They provided assistance and issued an invoice to the fund.” The introduction of “per capita standards” will entail an increase in tariffs for the provision of medical care, says the head of the Compulsory Medical Insurance Fund. They must cover the real costs of medical institutions. Undoubtedly, the costs of the Compulsory Medical Insurance Fund will increase significantly, which will require an increase in revenues to the fund. Currently, the Federal Compulsory Medical Insurance Fund receives 1.1% of the unified social tax and 2% goes to territorial funds. To switch to 100% financing of clinics, it is necessary to increase the standards of deductions at least twice.

And finally, the patient’s right to choose a clinic and doctor will be realized. To achieve this, it is planned to introduce a single insurance policy, with which a citizen will be able to go to both a public hospital and a private clinic. Non-state medical institutions, “built-in” into the compulsory medical insurance system, will provide free of charge the minimum set of medical services approved by current legislation.