Introduction
The market of medical services is a segment of the services market. Services market supports economic growth and development through the creation of a competitive economy, new jobs, enhancing universal access to essential services and stimulating trade. Services sectors form the backbone of an integrated and efficient economy at the national, regional and global levels.
Health care is a component of the structure of social life of the community, the primary aim of which is health saving and promotion. However, the fact that the current Russian health care system does not provide sufficient public health care guarantees, its accessibility and high quality, and the backlog of health development level from the level of the developed countries is much stronger than in many other key sectors of the economy is officially recognized by the Concept of Long-Term Socio-Economic Development of the Russian Federation for the period up to 2020 (Plavunov, Boyko and Gal, 2014).
The particular relevance of the study of modern Russian health care system is due to the ongoing processes of modernization of the industry, legislative update on health care, as well as the need to improve health management sphere. The concept of health development in the Russian Federation until 2020, developed by the Ministry of Health and Social Development, suggests a significant increase in health care costs in Russia (Togunov, 2012).
Thus, the emergence of new opportunities in the provision of health services has its advantages, but also creates additional complexity. Commercial medical services at the international level leads, on the one hand, to higher competition and thus improve access to services and the quality of services, and, on the other hand, there are problems of leakage of skilled personnel. However, the internal policy of the countries has a significant impact and can both contribute to the development of globalization in the field of medical services, and to restrain this process. But the undeniable fact is that in the context of international competition the improvement of the delivery of health services through the retention of skilled staff and support of a balanced existence of private and public medicine will be in the public interest.
Literature Review
In recent decades, due to the fact of opening of borders between the countries of the European Union, the expansion of WTO, accession to various international economic organizations, international trade, including trade in services, which provides great opportunities for the creation of overseas offices and clinics firms working in the medical field, become more transparent and accessible. This also contributes to the adoption of international standards in the field of health care and the regulation of drugs and medical devices, which include standards for GxP, ISO 9000-9004 standards, recommendations of international organizations such as WHO. The activities of international accreditation organizations, inspecting medical facilities to meet the high quality standards set by this organization (JCI), develop (Lovett-Scott and Prather, 2012).
In accordance with the Basics of Russian Federation legislation on health protection of July 22, 1993, 5487-I (hereinafter – the Basics), health care is a set of political, economic, legal, social, cultural, scientific, medical, sanitary, hygienic and anti-epidemic measures aimed at preserving and strengthening the physical and mental health of every person, maintaining its long and active life, providing medical assistance in case of loss of health. Government reforms have led to radical changes in society, obviously, could not affect such an important sphere as the protection of public health (Gaĭdar, 2012).
Over the past few years, the health care made the transition from existed for decades the public system to more advanced, flexible, meeting the requirements of today’s social insurance system. Given that the reform of the Russian health care has been largely due to the need for effective measures to combat the decline in life expectancy, a marked deterioration of public health and the environment.
The system of social (compulsory medical) insurance is intended to ensure the inclusion of the patient in the health care system of relations, its active participation in the preservation and promotion of health and the protection of individual’s rights, when receiving medical care. Important elements of the reforms are to create the optimum ratio of hospital and community-acquired, specialized and general types of medical care; the decentralization of the health care system and the establishment of health care models that meet the needs and level of development of the specific territories (Cook, 2015).
The basic principles of health care in the Russian Federation include the following (Plavunov, Boyko and Gal, 2014):
1. The responsibility of society and the state for the protection and promotion of public health.
2. Creating a public health system that integrates the activities of institutions and organizations of all forms of ownership, of all shapes and structures (state, municipal, private, insurance, etc.), which guarantee the protection and promotion of public health.
3. Provision by the state and society of all citizens with public, qualified medical care, free in its basic forms.
4. Preservation and development of social and preventive health care areas based on sanitary, epidemiological, social and individual measures aimed at protecting and promoting public health; personal responsibility for their health and the health of others.
5. Integration of science and public health practice, the use of science in public health practice.
6. The active participation of the general public in the implementation of health programs.
7. Preparation of the medical staff, complying with the norms and rules of medical ethics and medical deontology.
The Russian Federation belongs to the group of countries with predominantly public system of health care organizations, because, in spite of the reforms of the introduction of compulsory social health insurance and the creation of a public health model, which is based on the budget and insurance medicine, most of the funds for health care comes from the state budget and resources of the subjects of the Federation. The main advantages of the public health system are warranty of free medical aid to citizens, administrative control over the quality of its provision, high efficiency when exposed to the incidence of especially dangerous infectious diseases and others. Private health care system is based on voluntary medical insurance and medical assistance payment of its direct consumers. It should be noted that in such form it is not present in any national health care system and serves as an addition to the above two major types (Shishkin and Vlassov, 2009).
The strategic goal of the Russian health care is to improve the main indicators of public health, namely decline in overall mortality, maternal and child mortality; reduction in the incidence of socially significant diseases; reduction of disability from the major diseases and the increase of life expectancy. It should be understood that in order to implement this program, consolidated efforts of the whole society are required, namely performance of health management team and taking difficult decisions to increase funding for public spending on health, and, of course, the responsibility of citizens themselves to maintain and strengthen their health. The priorities and objectives, which should be reflected in the health program, follow of these areas, as well as the analysis of unresolved problems and challenges facing the industry. Priorities include saving and improving the health of working-age citizens; women of reproductive age and children, promotion of the birth rate; formation of a healthy way of life among the citizens of the Russian Federation; formation of affordable and quality health and social services for the citizens of older age groups and people with disabilities; and increase in the efficiency of spending public resources (Cook, 2015).
In addition, to ensure the integrity of the health care system needs a common approach to planning, regulation, standardization, licensing and certification of the field, and the basis of financing of health care in the framework of state guarantees at the same time must serve the mandatory health insurance system. Therefore, the recognition of the existence of a single Russian Federation health system is an essential factor in guaranteeing the citizens’ right to health and medical care and to ensure the effectiveness of health care organizations in Russia (Rozenfeld, n. d.).
Research Question
The purpose of the research is to analyze current health care system of the Russian Federation and determine its prospects in the international market. The main question: how the Russian health care system can be competitive in the international arena? It is important to find out competitive advantages of the Russian healthcare system, which will allow it to enter the global market and effectively operate there. The following questions should be answered:
What are the major features of the global healthcare industry?
What crucial changes have led to the development of healthcare of Russian Federation?
What are the current trends of the Russian healthcare sector?
What are the main effects of Russian healthcare sector on the global healthcare industry?
In order to achieve specified purpose, below mentioned objectives should be considered:
The primary goals of health care reform are giving the most important factor in health status and the security element of the country; de-monopolization of public health; search for and implementation of alternative sources of financing, the development of value-added services, adequate material possibilities of every citizen; the restructuring of the health system; and priority development of primary health care and social assistance on the principles of general medical practice and family. Thus, it is necessary to form science-based concepts of the Russian Federation population health in terms of socio-economic reforms, which would become the main purpose of creation of favorable trends in the health of the population. In this connection, it is necessary to form motivation among the population to a healthy lifestyle; improve the social and environmental impact; ensure the legal equality of citizens in the health sector; and reinforce the preventive orientation in the activities of all the services related to the protection of public health (OECD, 2012).
Methodological Approach
According to well-known statistical data, very alarming demographic situation in the country is currently obvious. It is about the increasing mortality, falling birth rates, thus there is a natural decline in population. Today, no one can deny that the health of citizens, as the socio-economic category, is an essential element of national wealth and is the first most important object of social protection (Gaĭdar, 2012).
Theoretical and methodological basis of the research is based on scientific papers and monographs of domestic and foreign scholars and practitioners devoted to the study of problems of efficiency of formation and use of health care resources. The work is based on a systematic approach that allows determining the health care system, on the one hand, as part of the socio-economic system of the state, and, on the other hand, as a set of individual elements that have different effects on the implementation of its functions. Generally accepted methods and techniques of scientific knowledge were used, namely generalization and formalization of information, comparative analysis, sampling methods, and grouping of data (Gaĭdar, 2010).
Method of the abstraction allows the scholar to mentally escape from the desired properties of the phenomenon. Simultaneously, interesting stuffs of the subject are exposed. Analysis allows decaying the material considered into the distinct components and inspecting the single fragments of the components. Synthesis links fragments into a whole, reforming single, new relations from the separate fragments. Deduction arranges the important transfer from the common to the specific phenomena, while the analogy causes logical summary, as a consequence of which the knowledge of one topic arise on the origin of matches with such objects (Ruane, 2005).
Bibliography
Cook, L. (2015). Constraints on Universal Health Care in the Russian Federation: Inequality, Informality and the Failures of Mandatory Health Insurance Reforms. [online]. Available from: <http://www.unrisd.org/80256B3C005BCCF9/(httpAuxPages)/3C45C5A972BF063BC1257DF1004C5420/$file/Cook.pdf> [Accessed: 5 April 2016]
Gaĭdar, E. T. (2012). Russia: A Long View. Cambridge: MIT Press.
Kumar, R. (2010). Research Methodology: A Step-by-Step Guide for Beginners. 3rd ed. Thousand Oaks: SAGE Publications Ltd.
Lovett-Scott, M. and Prather, F. (2012). Global Health Systems. Burlington: Jones & Bartlett Publishers.
OECD (2012). OECD Reviews of Health Systems OECD Reviews of Health Systems: Russian Federation 2012. OECD Publishing.
Plavunov, N. F., Boyko, Yu.P. and Gal, I.G. (2014). Healthcare system in the Russian Federation and prospects of its further development, Vestnik, 2(36).
Rozenfeld, B. A. (n. d.). The Crisis of Russian Health Care and Attempts at Reform. [online]. Available from: <http://www.rand.org/pubs/conf_proceedings/CF124/CF124.chap5.html> [Accessed: 5 April 2016]
Ruane, J. M. (2005). Essentials of Research Methods: A Guide to Social Research. Oxford: Blackwell.
Shishkin, S. and Vlassov, V. (2009). Russia’s healthcare system: in need of modernization. [online]. Available from: < doi: 10.1136/bmj.b2132> [Accessed: 5 April 2016]
Togunov, I.A. (2012). Competition in health care and medicine, Corporate Management, (5): 11-14.
