Principles are of course important, but where ...

Principles of course important, but far more important than the practical realization. Today we can confidently state that claimed to implement in the early 90-ies of the Russian health care reform in the direction of the classical model of health insurance failed for various reasons. In our country we have always understood only reason we go to its uncharted way. Here, for example, already in the abbreviation of "compulsory health insurance" laid nonsense: if there are other states of "health insurance", then we can not be otherwise, as soon as "optional." In essence, this already excludes the free liberal relations between producer and consumer of medical services. Already it is in the construction of the medical insurance system initially involves the development of events in the direction of authoritarianism, state, planning is not in their best options. And these events were not long in coming as a kind of the barrier to a possible way to becoming a true system of protection in case of illness and disability. Events OMC, separating desired from the actual events of the first - to save the state structures in the emerging system of local self-government, the construction of subjects interaction system based on hidden administrative levers of control, preservation of established forms of state financial relations in health care - in essence were the peculiar forms of budget financing and kept the formation of market relations in health care. Second event - a strategic blunder to ensure tariff OMS non-working population at the state of financial insolvency, which is based on the budgets of local administrations, that even after decades of existence of the system has failed to provide the financial cover of this market sector health services. Event is the third - cost model system for calculating rates of medical services, relying on the quantitative characteristics: number of services, number of visits, number of hospital days. Fourth event - the formation of the insurance field of NMR in most regions of the country carried out the so-called administrative separation method, rather than on the principles of healthy competition, it did not create a true market for health insurance organizations in the CHI system. Event is the fifth - the legal and institutional failure of health care facilities (HCF) to become full-fledged subjects of the medical services market, in an environment where these agencies on the status of the property were and remain to date the state structures. Capacity of staff and health care facilities are governed by stringent regulations and administrative vertical management. Event sixth (out of the system) - the default of 1998 undermined the financial stability of the system of local self-government and at the same time, this situation has not been used for self-survival of the CFR and the establishment of market relations between subjects of the MLA.