Correlation between models of pooling finance for public health care and indicators of demographic and transport development of territories

Ragozin Andrey V., Grishin Vladimir V., Glazunova Svetlana A.

For pooling (consolidation) of financing resources for public (free at the place of delivery) medical care, developed countries use two main approaches: a single-channel single payer model and a multi-channel model with the participation of competing insurers and several channels of budget financing for different groups of the population. The Russian Federation inherited a multichannel model from the USSR, supplementing the channels of departmental and industrial (corporate) medicine with a compulsory medical insurance system with competing commercial health insurance organizations (HMOs). The multichannel nature of financing is associated with additional costs, and its public utility in the main territory of Russia is questionable. In order to develop practical recommendations for the development of a system for financing medical guarantees to the population of the Russian Federation, a comparison was made of the development indicators of territories (their size, population density and road network) of three groups of countries: developed countries with a single-channel market model of a single payer; developed countries with a multi-channel market model of competing insurers; two countries that continue to use the uncompetitive Soviet model of Semashko - Cuba and Belarus. Taking into account the demographic and transport development of the main part of the territory of the Russian Federation, based on the results of the analysis, it seems important to abandon the multi-channel pooling model in favor of the single-channel model of a single payer represented by the Federal Mandatory Health Insurance Fund (hereinafter - FFOMS).

Keywords:healthcare financing, single payer model, multichannel model, demographic and transport development of territories.