Michael Delyagin: "Expenses for Public Health Services Will Be Cutting at a Quick Pace”

“The main directions of the budgetary policy for 2013 and planned period of 2014 and 2015” are published on a website of the Ministry of Finance. Expenses under the article "Health care" will be reduced at frightening paces. In 2013 it’s planned to spend on 8,7% less, than this year and in 2015 expenses for health care will be decreased at once by 17,8%. As a whole in three years public health service loses in real expression 21,9%. Thus, as economist Michael Delyagin notes, expenses for safety and right protection increase in 2012 almost in one and a half times (at the expense of growth of financing of the police in 2,2 times and of internal troops – in 1,6 times).

Prices for oil grow, expenses for health care in a share from the gross domestic product decrease: in 2009 – by 3,5%, in 2010 – by 3,2%, in 2011 – by 2,9%. However, according to the official figures, costs of medicine grow every year. In 2008 the program of state guarantees cost 1,18 trillion rubles, in 2009 – 1,37 trillion rubles, in 2010 – 1,45 trillion rubles, in 2011 – 1,62 trillion rubles. Figures of expenses of the state grow, but percent of people who are not satisfied with medical care practically doesn't change. All these years about two thirds of the population are dissatisfied with health care. In other words, it’s apples and oranges. In 72 Russian regions, that is in the majority of them, deficiency of financing of the state program of all types of free medical care is fixed.

Quantity of medical institutions rendering free services becomes ever less. There were 11.5 thousand of such institutions in 2009 within obligatory medical insurance, 11,3 thousand – in 2010, 11 thousand – in 2011. However it’s a tendency. According to the Russian Federal Service of State Statistics, for one decade – from 2000 to 2010 – the number of hospitals decreased by 40%, policlinics – by 20%. Explanation that population has got reduced and therefore there’s no need in such quantity of medical institutions aren't required is insolvent: population of Russia for this period, alas, really decreased, but not so – only by 2%.

As ex-Minister of Health and Social Development Tatyana Golikova noted, the number of doctors and nurses is also not sufficient. On the other hand, according to WHO, Russia occupies the fourth place in the world on a total number of persons with the graduate medical education, conceding only to China, India and the USA. According to the data of WHO, Russia occupies the fifth place in the world on a number of doctors per capita – 42 physicians with graduate medical education accrue to 10 thousand Russians. Where are all these people with medical diplomas? It partly helps to understand other figures.

The American magazine Forbes made the list of the most highly paid professions. In the USA doctors earn more than other. Monthly income of the ordinary American surgeon working in hospital – 17 thousand dollars. Anesthesiologists receive 16,4 thousand a month (about 500 thousand Russian rubles), gynecologists and dentists get approximately the same sum. The first nine places of the American rating are occupied by doctors of various profiles. The manager general is only on the tenth place.

Now – what we have in Russia. It’s possible to find indicator of a salary of the Russian doctors in different cities on the site “Yandex-Rabota”. It’s possible to find there both average figure in hospitals and in private medical centers, small cities thus aren't considered. According to these data, average salary of the doctor across Russia – 25 thousand rubles, in cities with population less than 50 thousand people – less than 10 thousand rubles (together with attendances). A person studies for this purpose for eight years. He will wander about and think: it’s better to become either cosmetician, or manager general. Position of manager general in our country is far not on the tenth place on profitability. If someone would have a desire to remain in humiliating position of the state employee.

Here you are the result. Also in figures. In a rating on the state of health of the population of 145 countries with population more than 1 million people, Russia occupies the 97th place. It doesn't surprise that the first ten include the European Union countries. But many former republics of the USSR are ahead of Russia on index of state of health: Estonia (57th place), Georgia (71st), Armenia and Latvia (79th), Lithuania (81st), Tajikistan (84th), Uzbekistan (85th), Azerbaijan (87th), Belarus (91st). Ukraine (99th place), Kyrgyzstan (101st), Turkmenistan (104th) and Kazakhstan (111th) appeared below Russia in the rating of Bloomberg. However, we also left Congo, Mozambique and Chad behind. That, probably, should console.

It is considered that in conditions of crisis it is necessary to increase investments into the social sphere. Though it’s been considered not in our counrty. We have priorities. In WHO rating on expenses for health care Russia occupies the 115th place. Well, it’s ok. Just in case it’s always possible to make other rating, better one.

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