Conflicting (and sometimes antagonistic ...

conflicting (and sometimes antagonistic economic terms) the interests of entities in the production and consumption of medical services. payers and intermediaries do not bear ultimate legal responsibility for patient outcomes: (surrogate forms of competition moved in the relations of patients and payers, which leads to a conflict of interest - payer seeks out all sorts of ways for refusing to pay for expensive medical services, and is thus not a supporter of the patient, and his antagonist). for lack of patients, physicians and payers as- some objective indicators of quality of care. inability to establish the unique relationship between price and quality of medical services. The specific characteristics of the patient as a consumer of medical services and distinguishes it from other users (not medical) goods and services - a kind of absolute priority to the preservation of life and health, without paying attention to the potential costs. Lack of opportunities and lack of awareness is extremely patient about the prices of medical services among different doctors. Some delicacy in obtaining such information directly from the doctor. All of the above leads a research idea to the opinion that in the present state of national health care (more - in the emerging field of production and consumption of medical services) there is no underlying systemic structure and, consequently, the terms of the subjects of such a system, allowing virtually implement such a mechanism to improve the quality of medical services as competition. In the vast scientific literature since the publication of studies of Adam Smith to contemporary authors , is given a set of definitions of the essence of competition in the annex to the market economy. Much less studies of competition in medicine. In our opinion, competition in health - a state of relations between actors and the process of production and consumption of health services within a specific civilized form of competition between health care providers (doctors ) to achieve a high degree of satisfaction of targeted needs of the patient. In essence, the concept of "competition" is important not the term itself, not the degree of accuracy in this category, understanding and making sense of a certain process, the functions of the subjects of relationships, relationships - leading to some positive results, characterizing the quality of medical assistance on a sufficient set of specifically defined and accepted parameters. The competition - a kind of internal mechanism, the objective and necessary function of life and evolution of the market for medical services. competitiveness, in our opinion, can be synthesized many aspects of the factors functioning and development of health and medical practices. However, the competitive environment in itself is not ambiguous and contradictory.