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The problematic development of private health insurance in Russia

Society, Culture and Politics of Eastern Europe Conference, 12 and 13 December 2008. The problematic development of private health insurance in Russia. Benoit Mathivet – CEELBAS SSEES/UCL. A snapshot of the current healthcare situation in Russia. Russians are ill.

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The problematic development of private health insurance in Russia

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  1. Society, Culture and Politics of Eastern Europe Conference, 12 and 13 December 2008 The problematic development of private health insurance in Russia Benoit Mathivet – CEELBAS SSEES/UCL

  2. A snapshot of the current healthcare situation in Russia. • Russians are ill. • Life expectancy at birth slightly over 60 years in 2006 for men, 73 for women. • Public funding for healthcare is low. • Public spending on health as share of GDP: 3.2% of GDP in 2005 (WHO-HFA) • Russians massively pay for healthcare. • Russian citizens contribute to nearly 40% of total health spending according to official data. • This is mainly out-of-pocket, often informal. • Coverage by voluntary health insurance (VHI) is growing.

  3. 2000 2005 2006 Russian Federation 6927511 35287478 39752093 City of Moscow 4510897 25560636 29028919 The recent development of VHI Evolutions of sums reimbursed by voluntary health insurance companies, (1000 Rubbles). Source: Healthcare in Russia 2007 – Statistical Agency of the Russian Federation. between 2005 and 2006. 13.5% growth in Moscow City. 10.2% growth in other Russian Territories.

  4. A very localised development,mainly in Moscow and large cities. Source: Healthcare in Russia 2007 – Statistical Agency of the Russian Federation.

  5. Aims of the study • Explain how VHI was integrated in the Mandatory Health Insurance (MHI) reform of the early 1990s. • Analyse how it developed (in parallel or as a result of MHI failure). • Provide a clear picture of the current state of development of VHI in Russia and assess potential threats for the Russian Healthcare system as a whole.

  6. The MHI system launched in 1991-1993.

  7. The failure of the MHI system • Lack of resources due to low level of payroll contributions: at best, a quarter of total public resources for healthcare. • Insurance companies did not compete with each other and did not improve quality and cost-efficiency of care. • The formerly « closed » system remained developed and accessible for a fee.

  8. A case study: the company Sovita The present picture. • Wages the MHI coverage of 5.5 million citizens in 12 different territories, including 800000 citizens in Moscow. • Proposes VHI with a wide coverage including GP visits, emergency care, hospital treatment. • Options are available for child and mother care. • Premiums vary with the « prestige » of the contracting healthcare institution. • Premiums decline when bought in numbers, hence targeting corporations providing benefit packages to their employees.

  9. A potential threat for the development of the Russian healthcare system. • Increased inequality of access to healthcare. • Concentration of ressources in the « closed » healthcare system. • Surprisingly: lack of guaranties for VHI patients. • A dangerous option for future healthcare reforms.

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