Russian Health Budget Alarm: Draft Reform

The Russian parliamentary health care committee says the draft 1997 health care budget of 9.37 billion roubles ($1.72 billion), or 0.31% of Gross Domestic Product, is "woefully inadequate." This is a 12% rise over 1996, and for health care (in the sense understood in the west) a rise of 12.2%, but the committee claims that actual allocations on "medical outlays" have been cut to the bone.

The committee is pressing for improved financing of federal health institutions, saying that project financing in first-half 1996 represented only 56.7% of the targeted figure. This, it adds, is resulting in fewer hospital beds, and clinics and hospitals being forced to scrape along without finance to pay rapidly accumulating heat and repair bills. In addition, it calls for more attention and funding for programs to counter tuberculosis and upgrade provision of psychiatric medicine.

Meantime, a draft health service reform plan is emerging via the media, after years of work by health care specialists within the framework of ZdravReforma, a joint Russo-US project. This calls for a halt to "excessive decentralization of management and funds" and for uniformity of care in all Russian regions, and has announced the principle of a "new federalism" which would subject local health budget and health insurance management to federal control and regulation.