The "vertical" of control over the health institutions include ministerial (federal), regional (major centers and cities) and local (municipal) levels. Governmental (federal, regional, municipal) public health authorities have the right to control the work of private medical institutions and private practitioners. In turn, the administrative enforcement authorities, responsible for the public healthcare system is under the jurisdiction of the legislature (the State Duma, the Federation Council). The supervision of the execution of the laws of health, in turn, is carried out by bodies and institutions of the judiciary.
A special role is given to the Russian presidential power structures. Under the constitution, the President of Russia is the head of the government policy in the field of public health. Structurally and organizationally, the public health system integrates different types of enterprises and institutions:
- the federal and regional authorities and health institutions (the governmental, fiscal health system);
- the organs and institutions of the State of the MLA;
- the private medical institutions and private practitioners (LCA bodies and agencies and the private health insurance);
- the social, religious, professional organizations, foundations, organizations and institutions of the charity and philanthropy.
To provide the diverse activities and functions of the medical release, there are such profiles of health:
1. Therapeutic and prophylactic.
2. The maternal and child health.
3. The sanitary-epidemiological service.
5. Mortem, forensic, forensic psychiatric examination.
7. Enterprises of the medical industry: medical products and pharmaceuticals.
8. Education and research.
The key issues of the Russian Ministry of Health:
- the health, including the organization of the preventive medicine and the healthcare, pharmacy services;
- the quality, effectiveness and safety of medicines;
- the spa industry;
- the sanitary-epidemiological well-being;
- the living standards and income levels;
- the payment;
- the pension;
- the social insurance;
- the conditions and safety;
- the social partnership and labor relations;
- the employment and unemployment;
- the labor migration;
- the alternative civilian service;
- the social protection;
- the population policy;
- the physical culture and sports;
- the tourism;
- the consumer protection.
The investments in healthcare have two economic functions:
- the achieving one of the main objectives of any nation - the "maximum achievable" standard of health;
- increasing efficiency of the economy.
According to WHO, at the beginning of the 21st century, the annual world expenses on the healthcare were about 1700 billion US dollars. These expenses cannot be regulated by natural way market mechanisms, as the healthcare is included into the public sector of the economy, so they are more coordinated by the state.
It should be noted that Russia is one of the few countries that spends much less on the healthcare than it is possible. In addition, the negative load performs the well-known imbalance of costs for the certain types of care that would include the following in the funding structure:
1. The ambulance - 9%
2. The outpatient care - 27%
3. The patient care - 64%.
The state health policy includes the consistent implementation of management decisions aimed at improving the health of the population. Among the leading areas, there are: the protection of environment, the occupational health, the infectious disease control, the injury prevention, the maintenance of the mental health, and the social justice in the distribution of the health services.
The strategic goal is to improve the main indicators of the public health:
- the total mortality, the maternal and child mortality,
- the declining incidence of socially significant diseases,
- the reducing of disability from major diseases,
- increasing of the life expectancy.
The current health situation in the country formed the basis for the development of a number of federal programs based on program-oriented regulations defining the certain priorities: "Diabetes", "The fight against AIDS," "Children of Russia", "Health", "Vaccine" etc.
Another important area is the creation of health facility and the effective system of continuous monitoring and analysis of the compliance process in the treatment of patients. There is a clear connection between the high levels of service process and a good treatment outcome.
There is a process of reorganization, which is carried out under the influence of the three most important factors in recent years in the healthcare system of the Russian Federation.
Firstly, the intensive implementation of the Federal law from 06.10.03. No. 131-FL “About the general principles of the organization of the local government in the Russian Federation” regarding the redistribution of powers of various levels in providing a medical care among the population, in particular, the transfer of the specialized types of help from the municipal management on the regional level.
Secondly, the implementation of the national priority health project, which has framed a resource basis for the realization of the basic principle of the structural reorganization: the rising of a primary role of healthcare.
The third major factor of the state policy, which has influenced the rising of structural efficiency of healthcare, is the improvement of a quality and availability of the medicine provision to the population, during which the list of vital medicines for the additional ensuring separate categories of citizens was approved.
Since January 1, 2006 the delivery of “The patrimonial certificate” started what allowed pregnant women in the pregnancy period and labors to realize the option of female consultation and a maternity home fully and also to create the healthy competition among the establishments of healthcare assisting women during pregnancy and labors.