Lecture number 3 Thread: Insurance Medicine. PLAN: 1,The current state of health. 2,Financing of health care in the budget and health insurance. 3,insurance regulations

At the present stage of the public health system, funded by a residual, moves to the system according to the variety of forms of ownership and economic activity, allowing the use for the health problems for new sources of funding.

The state of affairs in healthcare today is characterized as a crisis, signs of which are as follows: 1. Medical institutions are managing their byudzhetom. 2. There is an absolute shortage of qualified outpatient diagnostic and treatment especially pomoschi. 3. Underground economy flourishes in medicine. Exacerbated by social injustice in public zdravoohraneniya. 4. The population, employers and the health care system is not economically interested in improving the health of the people.

With the transition to insurance medicine is implementing such principles of the health system, such as: 1) self-supporting at all levels of health systems, and 2) the arrival of additional funds in the health of different including extra funding based on health insurance;

3 ) A guarantee to the patient free choice of doctor and hospital in the framework of the new system, with the patient to decide the matter and determine payment for actual work performed or the end result, and 4) increase of salaries of medical staff in the face of health insurance in accordance with the growth of the quality of health services;

The subject of the contract of compulsory insurance is to provide public health care and medical and health-care, spa treatment. The amount of money invested in the fund's health is determined by the insurance.

Financing of health care in the budget and health insurance Financing of health care in the budget and health insurance. Sources of financing health care is, other than the budget: 1 - Deduction of enterprises, institutions, organizations including budget, within the compulsory health insurance.

2 - Means of enterprises on direct payments for medical uslug 2 - Means of enterprises on direct payments for medical uslug. 3 - Personal tools grazhdan. 4 - Charitable contributions, donations of enterprises, organizations and individuals, including and inostrannyh. 5 - Bank loans and other loans. 6 - Income from securities bumag. 7 - other sources not prohibited by the legislation of the Republic.

By the nature of health care financing can distinguish three types of systems: - the state - social insurance - payment;

State or budget is funded from general tax revenues to the state budget and covers all categories of the population. The bulk of health facilities owned by the state.

The second and the most representative group of systems based on the principle of social insurance. They are also governed by state authorities and in this sense are public, but in contrast to the state systems are funded on a tripartite basis - through targeted contributions of employers and employees is, and grants from the state of the general or targeted revenue.

In some countries, health financing based on the concept of social insurance, but the role of the general state budget are higher than in traditional social Strahovski systems. The third type of system - mostly paid, funded by community funds.

More interesting in practice appear social. Strahovski health system More interesting in practice appear social. Strahovski health system. First of all, it should be noted that the social function of these systems is different from the budget. Both of these types of systems are funded from public consumption funds, provide the distribution of medical care, regardless of the cost of labor. They equally serve to satisfy the needs of socially acquired, and easier access to health care for all populations.

Insurance funds formed in the stock, the target-based and designed for a specific group of persons involved in the relevant insurance program. Such a system has its obvious advantages. Primarily targeted funding provides a more prominent position in the public health priorities.

Regulation of health insurance Regulation of health insurance. 1) - Citizens of the Republic shall be subject to compulsory health strahovaniyu. 2) - Medical insurance - it is a way of financing health care through: * the budget through the Soviets of People's Deputies, * costs of utilities for compulsory health insurance * Payment citizens through personal income;

3) - Insurers are buying policies of obligatory medical insurance for their employees and family members. 4) - The term of the contract, the number of customers and the sum insured per person determined by the insurers themselves. 5) - The policyholder has the right to terminate the contract with the health insurance fund, with returns 75% of the unused for medical purposes principal contribution to the fund, except for the amount of margin

6) - The period of the contract payments for medical services are maintained accounting medical facility through banks on the deposit slip. In this policy is determined by a one-time payment chek.7) - Calculated a check made out for an amount exceeding the amount of the remainder of the polls, the Fund is not paid

8) - If you can not pay for services by bank transfer, the customer has the right to exchange the fund a check for cash settlement and thus to recover their costs for medical services. You must submit to the fund linked to an insurance policy correctly executed payment check, which must be signed and medical pechat.9) - At the end of the contract the remaining amount on the policy at the request of the customer can be transferred to the new term of the contract in addition to the new amount of medical insurance or converted to cash.

These financial transactions are accounting insurer, after transferring the money to his account from the account of the health insurance fund.