Researchers distinguish some ...

Researchers have isolated some of the contradictions arising in the functioning of competition in health care. In particular, some of them may include: 1) the contradiction between the system of incentives in health care and basic laws of competition (high prices for medical services remain even when an excess supply), 2) the contradiction between the expensive medical technologies and universal accessibility in obtaining medical services 3) the contradiction between the real presence of patients and the high cost of medical services (without improving the quality of care), 4) conflict, in which lies the essence of what the current system of health promotion work encourages innovation, increases costs or increase quality without a corresponding reduction in the cost of medical services. The scope of competition is divided into certain levels. It is logical to release the next conditional levels of the competitive environment in the production of health services (Figure 1). Competition and competitiveness - the concepts are universal for any market of goods and services. However, some industry-specific management imposes restrictions on the formation of a competitive environment or the assessment of competitiveness. If a competitive product to the consumer or the expert is able to evaluate directly, the assessment services (including medical), usually made indirectly. Some features of competitiveness assessment of medical services the following areas: the object of evaluation is the activity of the organization (health care setting, medical practices, etc.), providing medical services, assessment services related to the quality assessment process and technology services; evaluation of the medical staff directly to consumers; estimate the temporal characteristics of the provision of health services, evaluation of services provided by matching service quality standards (the conditions and culture of service), evaluation and integration of the subjective views of patients who received a one-time medical services. Based on the foregoing, we must conclude that in the evolution of the health system of the Russian Federation during the first decade of XXI century in the provision of medical care is not a very competitive environment of production and consumption of medical services, and real conditions to create such an environment. The presence of the scope of competition in terms of production and consumption of medical services, increasing the competitiveness of health - care institutions and medical practices are especially important for the future development of the national health system in the context of globalization. Creating conditions for competition in the health system, the launch of the mechanisms of civilized rivalry between doctors, finally, management of competitive health care facilities and physician practices - the problem, without comprehension and solutions which can not be a qualitative change in the present state of national health care.