voprecotestВопросы экономикиVoprosy Ekonomiki0042-8736Voprosy Ekonomiki, NP10.32609/0042-8736-2022-8-32-47voprecotest-4088Research ArticleЭКОНОМИКА ТРУДА И СОЦИАЛЬНОЙ СФЕРЫLABOR AND SOCIAL ECONOMICSЯвляется ли страховой российская система обязательного медицинского страхования?Is the Russian system of compulsory health insurance an insurance one?https://orcid.org/0000-0002-0807-3277ШишкинС. В.ShishkinS. V.

Шишкин Сергей Владимирович, д. э. н., директор Центра политики в сфере здравоохранения

Москва

Sergey V. Shishkin

Moscow

 

shishkin@hse.ruНациональный исследовательский университет «Высшая школа экономики»РоссияHSE UniversityRussian Federation2022040820220832—47Copyright © Voprosy Ekonomiki, NP, 20222022Voprosy Ekonomiki, NPVoprosy Ekonomiki, NPhttps://www.vopreco.ru/jour/about/submissions#copyrightNoticehttps://www.vopreco.ru/jour/article/view/4088

Обсуждаются основания для квалификации созданной в России системы обязательного медицинского страхования (ОМС) как страховой. Систематизированы теоретико-методологические подходы к описанию систем социального медицинского страхования. Проведен сравнительный анализ эволюции страновых систем ОМС и систем бюджетного финансирования здравоохранения с позиций институциональных изменений как усиления или ослабления трех типов регулирования (государственного, общественного, частного), которые обеспечивают выполнение функций формирования, объединения средств и покупки/оплаты медицинской помощи. Выделены общие характеристики современных моделей социального медицинского страхования, отличающие их от бюджетных систем. Сделан вывод, что российскую систему ОМС можно квалифицировать как социальную страховую в части формирования и объединения финансовых средств, но как гибридную, сочетающую элементы страховой и бюджетной систем, в части покупки/оплаты медицинской помощи.

The subject of the article is a discussion of the grounds for qualifying the system of compulsory health insurance (CHI) created in Russia as an insurance system, which is questioned by many experts. The article sys tematizes theoretical and methodological approaches to the description of social health insurance systems. A comparative analysis of the evolution of national systems of compulsory health insurance and systems of budgetary financing of health care was carried out from the standpoint of considering institutional changes as strengthening or weakening three types of regulation (state, societal, private), which ensure the performance of the functions of revenue collection, pooling of funds, purchasing of services. On this basis, general characteristics of modern models of social health insurance, which distinguish them from budgetary systems, are highlighted. The Russian CHI system can be qualified as a social insurance system in terms of the formation and pooling of financial resources, but as a hybrid, combining elements of the insurance and budgetary systems, in terms of the purchase of medical care.

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The authors declare that there are no conflicts of interest present.