According to the All-Russian Union of Insurers, insurance organizations in the system of compulsory medical insurance in the result of 2017 found violations in 20% of cases of treatment of citizens and saved about 2% of its expenses for the budget of the Federal Compulsory Medical Insurance Fund (FOMS). According to the organization, shortly, the government will begin discussing what is more important for the system - expanding the powers of insurers or criticism, which was previously sounded in their address.
However, a full-scale reform of the role of insurance organizations in the MHI system can start only in the autumn, after the report of the Accounting Chamber on their work - while the White House is more important than increasing the retirement age.
In 2017, insurance organizations in the MHI system conducted about 30 million examinations of medical assistance cases. They found violations in almost 20% or 6.3 million cases of treatment. The majority (3.2 million) make up the weak or inadequate services provided by medical organizations.
Another 2.4 million cases are poor quality medical care, which includes copious amounts of assistance to patients with oncological, cardiovascular and neurological diseases, which are the most frequent causes of death.
In 1 million cases, insurers stated that failure to perform the necessary diagnostic and treatment procedures led to a deterioration in the patient's condition.
For this work, according to the results of the year, insurers received about 1% of the amount of compulsory health insurance funds transferred to pay for medical care (at the expense of the MHIF in 2017, 1.65 trillion rubles is 16 billion rubles). At the same time, based on the results of medical and economic control, insurance companies prevented the misuse of about 1.8% of budget funds to pay for medical care, and, based on the results of the examinations, another 0.7%.
As the vice-president of the ARIA Dmitry Kuznetsov said during the International Conference of the ARIA in St. Petersburg, the growth of critical statements regarding the role of insurance organizations in the healthcare system contradicts the vector indicated by the country's leadership for the development of insurance medicine. "We sent a letter to the First Deputy Prime Minister and Finance Minister Anton Siluanov with a request to form an interdepartmental working group to discuss issues related to the phased implementation of insurance principles in the MLA," he recalled.
"The work of such a group in the government in the future will be very in demand, because disagreements about the role of insurers have existed for many years, and with the arrival of the vice-premier for social issues Tatyana Golikova, they can become acuter," a source in the government said.