Types of Prices
There is a great variety of price types, differing in a number of features and application areas.
Wholesale prices are used for the sale of goods and services in large batches in trade and sales transactions between organizations, as well as for the sale of products through specialized stores and sales offices of wholesale, commodity exchanges and any other trade organizations selling goods in bulk, in significant quantities.
Most often, the need for wholesale occurs when the production of products, goods, services, localized in a limited number of points, and the sphere of consumption has a wide radius, extending to many customers.
In health care, wholesale prices are used for the purchase of goods by medical organizations in large batches, as well as a fairly mass sale by medical and pharmaceutical organizations of drugs and paid services provided to large teams, groups of customers.
Retail prices are used for the sale of goods, works and services in the so-called retail trade network, i.e. in conditions of sale to individual buyers, with a relatively small volume of each sale. The goods are sold at retail prices to households (end consumers) and, to a lesser extent, to organizations and entrepreneurs.
The retail price is usually higher than the wholesale price by the trade margin, which compensates for additional costs associated with individual sales and generates profits for organizations and institutions engaged in retailing.
In healthcare, the sale of goods at retail prices is most typical when selling medicines and various treatments to citizens and the public. Paid dental services are sold at retail prices.
As fee-based health care services become more widely available to the general public, with separate types of procedures being identified as the object of payment, retail prices for health care services, known as tariffs, are becoming more common.
Characteristically, in foreign practice, tariffs (tariff) are usually understood as customs duty rates. Tariffs, as mentioned above, are also referred to as established levels of pay for different categories of medical workers, which are, in their meaning, the price of work. In many cases, tariffs are associated with price-listing prices or rates.
In health care economy, in connection with the transition to a system of payment for the services of medical organizations from the compulsory medical insurance system, tariffs have come to be understood as tariffs for medical services provided in the compulsory medical insurance system.
The nature of the tariff is determined by the chosen method of payment by the insurance medical organization (fund) for medical assistance provided by the medical treatment and prevention institution.
The following types of tariffs for medical assistance services are applied:
- the per capita rate;
- the tariff for the full cost of a polyclinic visit;
- the tariff for medical service;
- fare for complete case of polyclinic service;
- fare for the full cost of a bed-day;
- The tariff for the cost of a bed-day in the profile department;
- fare for local medical service;
- fare for completed case of inpatient service.
It is considered that the tariffs should be the same for the same type of treatment and preventive care institutions, regulated and controlled by the interested authorities.
They are elaborated, approved and used in accordance with the chosen method of payment. The object of the tariff setting is understood as medical services? in the broad meaning of the word, e.g. a patient treated in an inpatient department, consultations, etc.
Tariff calculation rules provide for the exclusion from the tariff of items and groups of expenses financed from other sources, for example, from budgets of different levels, as well as financing from the compulsory health insurance fund for targeted programmes and activities.
The tariff includes the costs of a medical institution for the implementation, which reimburse current expenses and finance the activities of the medical institution without allocating any cost or profit.
The tariff, as a form of income from non-commercial activities credited to the current account “Amounts by order” of medical institutions, includes
Preparation, review, agreement and approval of tariffs provides for participation of parties representing the interests of mandatory health insurance subjects. Tariffs are controlled prices that are subject to state regulation through a tariff agreement concluded by the members of the tariff coordination commission.
Tariffs are also a specific type of prices – prices for special types of goods set for a certain period of time. The most common are wage rates paid to employees for their work in a certain position and interest rates in the form of interest paid by the bank to depositors or charged for granting a loan.
The rates also include the established amount of rental payment to be paid by lessees of land, buildings, premises and property on a monthly (annual) basis for the objects provided to them for temporary use. Tax rates which, with a certain degree of conditionality, can be referred to the prices set by the state for taxpayers shall represent the tax payment per unit of the taxable amount. The rates are inherently close to the rates.
It should be noted that even the fines can be considered the price of the misdemeanor, and the penalties paid in case of late payment – the price of late payment.
In the Soviet economy, it was common practice to set state prices for paid medical services in the form of price lists. These prices usually include typical actual costs of medical work, taking into account labour and material norms and standards, as well as profit in the amount of a sectorial or territorial coefficient (percentage of the service cost).
Development and approval of state prices for paid services is carried out according to unified strict rules. Requirements for the methods of calculation of prices for paid services are similar for all territories of Russia.
These methods imply formation of state prices on the basis of budget norms and Norms (sectoral or institutional) for practically all cost items and use of the percentage of the cost price as profit by a higher financial or health care management body (for different territories this coefficient varies from 15 to 30%).
Since these price lists are still used in health facilities, there is a problem of reliability and conformity of these prices with the costs of health facilities in the provision of medical care.
Traditionally, price lists contain a classifier and a final price for each of them. One of the complex issues is the possibility and expediency of using unified (single) prices for similar services for different performers in a certain territory. If the price calculation is carried out according to the scheme, it can be assumed that the actual prices of different performers for similar or even similar works will be different.