Russian Healthcare found ineffective

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Meeting of the Russian Government Commission on Healthcare

Patriotic health system ranked last in the ranking of the effectiveness of that amount to Bloomberg analysts. The news can be present in two ways. It includes a rating, relatively speaking, the best. But Russia has become the worst in him. Thus, the total health expenditure in the country, researchers estimate that about 7% of GDP, and the average life expectancy of Russians – 70.4 years. The Russian Ministry of Health called the data obsolete. Experts also reminded of the underfunding of domestic medicine.

Russia ranked last in the ranking of the effectiveness of health systems, which includes 55 countries. Above and Beyond the Russian Federation were countries such as Brazil, Azerbaijan, Colombia, Jordan, etc. Rating compiled annually by analysts compiled by Bloomberg based on international statistics, published by the World Health Organization (WHO), the World Bank, the International Monetary Fund, etc.

Analysts expect the index of efficiency, which takes into account three components: life expectancy, health expenditure in relation to GDP, and the same spending per capita. At the same time after the WHO, analysts take the measure of total health expenditure, taking into account both public and private expenditures on prevention and treatment of diseases, emergency care, family planning, etc. In the rating participate only those countries where the population is more than 5 million people, the average life expectancy of over 70 years, and per capita GDP is more than 5 thousand. Dollars.

According to the researchers, in the Russian health care costs account for 7.1% of GDP. In per capita terms, it is 893 dollars average life expectancy of Russians -. 70.4 years. In comparison with other countries of the ranking Russians have the lowest life expectancy.

At the same time, according to the rankings, excessively high public and private spending on health care are not good. Indicative US case. They are in the ranking is not the first, but on the 50th. In the US, healthcare costs account for 17% of GDP, or 9.4 thousand. USD. Per capita. A life expectancy of Americans closer to 79 years. According to the logic of researchers to spend and could be more effective and have, as a result, life expectancy is much higher.

The top three leaders are as follows. In the first place Hong Kong: spending on health – 5.4% of GDP, or 2 thousand dollars per capita, life expectancy – nearly 84 year… The second place – Singapore expenses – 5% of GDP, or 2.8 thousand dollars per capita, life expectancy – nearly 83 year… Third place – Spain: costs – 9% of GDP, or 2.7 thousand dollars per capita, life expectancy – about 84 years… No wonder also that among the leaders there is Japan, which is famous for longevity.

The Ministry of Health with the estimates of foreign analysts disagreed. “First of all, it should be noted that the rating of the effectiveness of health systems, published by Bloomberg, based on data for 2014, which differ significantly from today’s picture of the day”, – explained in the press service of the department Veronika Skvortsova. Thus, today the Ministry of Health, the life expectancy of Russians is 72.06 years.

Working meeting with Healthcare Minister Veronika Skvortsova

We do not agree with the Office and with estimates of health care spending. According to the Ministry of Health, “they do not exceed 5.7% of GDP.” Which refers to the costs – not specified. Public and private or only public? The costs of federal and consolidated budget?

When talking about the financing of health confusion in numbers occurs frequently. Especially when you consider that the recently passed health care in Russia to channel funding through the Mandatory Health Insurance Fund (CHI).

Earlier, the president of the National Medical Chamber Leonid Roshal has repeatedly raised the issue of extremely low public financing of health care in the Russian Federation. However, judging by the numbers, which he led, it was a question of inpatient health care costs. In 2014, the federal budget it was planned at 2.5 trillion rubles., Or 3.7% of GDP.

This indicator and caused discontent Roshal. As he had said, “The Ministry of Finance should we, doctors at the hands of wear” because doctors still agree to work in such conditions. “None of the Western systems in such financing would stand and die”, – assured Roshal. In 2016, the federal budget laid down the cost of inpatient care at the level of 2.4 trillion rubles., Or about 3% of GDP.

The Ministry of Health insists that the Russian healthcare system is effective. “Last year, a group of international researchers published the results of a large-scale project to assess life expectancy (LE) and healthy life expectancy (HALE) in 188 countries. The researchers evaluated the time interval from 1990 to 2005 and from 2005 to 2013. According to them, in our country, the growth in life expectancy in men over a specified time was 7.34 years of healthy life – 6.52 years. In the US these figures were respectively 1.29 years and 1.06 years, in Germany – 1.59 and 1.16 years, – reported in the Ministry of Health. – If you analyze the data given by the international team of experts, our country is on the increase in life expectancy and HALE for men ranked fourth and fifth place from 188. For similar figures for women of our country is also ahead of the list. ” “These results were achieved also thanks to a significant reduction in mortality from the major causes, as well as a record for our country reduce infant and maternal mortality,” – say the Ministry of Health.

However, mortality in the special relationship the government. This summer, the director of the Ministry of Public Health Department of Public Health, Oleg Salagaev reported that the rate of total mortality has ceased to be used to assess the quality of care, defined as more demographic processes, aired earlier RIA Novosti. This can be understood so that the Ministry of Health in part does not bear responsibility for the situation with mortality when she grows up – the reason is not bad medicine, and in demography, but when it is, in some cases declining – it is a merit of Ministry of Health.

Russian experts admit that not only underfunding becomes an acute problem of Russian health care, but also low efficiency of spending of allocated funds. According to columnist Medportal.ru Irina Reznik, “according to WHO, inefficient investment in Russian healthcare are from 40 to 60%.” As an example, are expensive scanners, which can handle not every doctor.

At the same time, respondents “NG” experts are quite skeptical about the Bloomberg ranking. “In my opinion, a direct correlation between the ratio of spending on health care and life expectancy there. In Russia, it combines elements of free medicine left over from the Soviet system, voluntary and compulsory health insurance, private clinics and government, providing yet paid services, which in theory can be obtained on probation for free, – explains the analyst of IFC Markets Dmitry Lukashov. – This is pure chaos, which greatly complicates the assessment of the medical services market, so it is not clear how these are taken 7.1% of GDP. “

Analyst “Solid Management” Sergei Zvenigorod sees the rankings much more political than some more sense. In his opinion, this rating is not directed so much against Russia, but against the current US President Barack Obama, whose policies in the health sector and is recognized as the time ineffective. However, this does not exclude the fact that in the Russian healthcare has problems.

Director of the Foundation of the independent monitoring of the “Health” Eduard Gavrilov said that was previously issued another rating – the British medical journal Lancet. It ranks countries in terms of public health, taking into account such factors as the level of hygiene, child mortality, alcohol use, smoking, etc. Participating in the rating 188 countries, Russia ranked 119th place near Syria and Ukraine.

“The Ministry of Health and can fend off this rating, citing the fact that those criteria are not selected, but the numbers speak for themselves,” – said Gavrilov. He recalled that “during 2013-2015 years, Russia has been reduced more than 100 thousand. Beds mainly specialized in the first place in district hospitals”. Gavrilov said: “Only in the 2014 national health care were missing 90 thousand health workers, and by the end of 2015, the volume of paid medical services exceeded 500 billion rubles, which is almost five times higher than the 2013 level…”

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