Privatization in health care

Privatization of state or municipal property in the field of health care means the transfer of rights and obligations of property from state and local government bodies or from state (municipal) enterprises and organizations to physical and legal entities (or their associations).

The successors of these rights and acquire rights to the property assigned to the privatized health care institutions under the conditions and in the manner prescribed by relevant laws. The object of privatization in health care may become not only property, but also organizations and institutions engaged in medical activity.

At present, privatization in Russia has become a common phenomenon covering a wide variety of types of property: land plots, buildings, premises and equipment.

The issue of privatization of some part of medical production (medical and pharmaceutical) complex, which includes not only medical and preventive and pharmacy institutions, but also enterprises producing medicines, medical equipment and medical products, is becoming more and more urgent.

Meanwhile, the privatization of health care facilities should be carried out with great care, taking into account the public expediency of the privatization of social consequences. Mechanical transfer of general norms of privatization legislation to the sphere of health care is unacceptable, it can cause irreparable damage not only to its economy, but also to the health of society.

It should be borne in mind that many Russians associate the idea of state medical institutions with free aid, and of private medical institutions with paid services. In fact, as noted above, this perception is not entirely correct, since the state is able to pay for private healthcare services from extra-budgetary funds, while at the same time public medical institutions provide paid services.

However, there is no doubt that privatization of property and health care organizations leads to the growth of paid services, which are difficult for a significant part of the Russian population to access.

On the other hand, privatization of property and organizations in the sphere of health care helps to expand the volume and diversity of services provided and facilitates access to paid services for those citizens who are able to pay for them.

Obviously, there is a rational ratio between the share of public and private property in healthcare, although it is rather difficult to establish an optimum.

The main objective of the ongoing privatization in healthcare is to demonopolize the industry, create conditions for the competitiveness of treatment facilities in order to expand the choice of types and forms of medical care by the population, improve the efficiency of services (subdivisions) and the quality of services, and increase state budget revenues.

At the same time, tasks are being set to raise the level of social protection for workers in the sector, to ensure the development of infrastructure for a single medical and pharmaceutical complex at the expense of privatization funds and to attract investment in this socially important area.

Privatization is designed to balance the interests of all subjects of medical services: their consumers (patients), health workers and the State. The main results of this process should be an increase in the efficiency of the industry and the quality of medical and preventive care, the provision of real opportunities for citizens to choose their own health care institutions and specialists, the types of payment for services, and an increase in staff salaries.

Privatisation and commercialisation (provision of services on a commercial basis) of individual institutions and organisations in the sector will also make it possible to save budgetary funds spent on privatised organisations and to direct them towards the development of a single medical and production complex.

Privatization in health care should be based on the following basic principles:

Ensuring the multisectoral (multi-sector) nature of health care, a rational combination and division of the public and private sectors, and the allocation of a common, mixed sector;

  • establishment of interaction of the privatized sector with the insurance medicine sector, provision of an opportunity to pay for services of private organizations at the expense of compulsory medical insurance funds;
  • organization of state control over activity of privatized sector in medicine;
  • preservation of existing structures of federal and regional networks of health care institutions;
  • Assistance to the non-governmental health sector from the State by simplifying registration, rental of premises and equipment, public contracts for works and services.

The formation of a multi-layered health care system is achieved through the creation of a federal public service that combines its activities with the control of insurance and private business institutions, with increasing organizational and economic responsibility of the regions for the state of health protection.