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GOVERNMENT HEALTH CARE FINANCING POLICIES
E.B. Duplinskaya, candidate of economic sciences, associate professor E.P. Kobeleva, candidate of pedagogical sciences, associate professor Siberian transport university (Russia, Novosibirsk)
Abstract. The article discusses the results of the evaluation of the health care effectiveness in Russia and in some developed foreign countries, based on a comparative analysis of the share of the healthcare expenditures in gross domestic product, as well as life expectancy, and the cost of medical services per capita.
Keywords: healthcare financing, effectiveness evaluation, life expectancy, budget financing, gross domestic product.
Financial management involves the creation of necessary infrastructure, the structure and composition of which are determined by a corresponding level of management (federal, regional, corporate, etc.). The main goal of the reforms in all industrialized countries is to radically improve the effectiveness of public finance management [1].
Each state pays great attention to the development of the health care system, including its financial provision. Health is one of the fundamental human rights, therefore, the problems associated with the financing health care are the most significant. In the modern world, the development of health care system can not be limited to any single country, as the level of
The United States (17.1%) occupies the first place in terms of the share of health expenditures in relation to GDP, followed by Sweden (11.9%), and Switzerland
health development of a certain country affects the entire world [2,3].
In order to solve the international health problems in 1948, the World Health Organization (WHO) was established. Currently, WHO, whose members are 194 countries, annually monitors the main indicators and characteristics of national health systems [4].
In the world experience, one of the most important indicators of the health care system is the share of gross domestic product (GDP) directed to the maintenance and development of public health protection. Comparative characteristics of countries in terms of health care financing as a percentage of GDP are presented in Figure 1.
(11.7%), with a small gap, on the third position. The lowest level of this indicator is shown by such countries as Singapore (4.9%), Kazakhstan (4.3%) and Malaysia
Figure 1. The share of health expenditure in GDP in 2016, %
(4.1%). The expenditures in the Russian Federation have reached 7.07% of GDP, but according to the Ministry of Health they do not exceed 5.7% of GDP, which is quite low level compared to other developed countries of the world.
The most informative indicator of the development of national health care systems is life expectancy index. Table 1 lists the countries with the highest and lowest life expectancy. The Russian Federation is ranked 116th in this list out of 190 possible.
Table . The level of life expectancy in the world [5]
Position Country Life expectancy, years Position Country Life expectancy, years
1 Hong Kong 84.0 9 Israel 82.4
2 Japan 83.6 10 France 82.2
3 Italy 83.1
4 Singapore 83.0 116 Russia 70.1
5 Switzerland 83.0
6 Iceland 82.6 188 Central African Republic 50.7
7 Spain 82.6 189 Lesotho 49.8
8 Australia 82.4 190 Swaziland 49.0
The analysts of the world-famous rating agency Bloomberg annually publish a rating of the effectiveness of public health care services in the world. The experts calculate an efficiency index that takes into account three indicators: average life ex-
pectancy, health expenditure relative to GDP, and health expenditure per capita. Table 2 provides a ranking of some countries on the effectiveness of health care systems in 2016.
Table 2. Effectiveness of health care systems in 2016 [5]
Position Country Rank Average life Share of health Cost of medical ser-
expectancy, years expenditures in GDP,% vices per capita, USD
1 Hong Kong 88.9 83.98 5.40 2021
2 Singapore 84.2 82.65 4.92 2752
3 Spain 72.2 82.60 9.03 2658
4 South Korea 71.5 82.16 7.37 2060
5 Japan 68.2 83.59 10.23 3703
53 Azerbaijan 30.9 70.76 6.04 471
54 Brazil 28.9 74.40 8.32 947
55 RF 24.3 70.37 7.07 893
In 2016, the first three positions were shared by Hong Kong, Singapore and Spain. It is also worth noting South Korea and Japan among the leaders. According to the results of the study, the country with the most effective health care system is Hong Kong, which has scored 88.9 points. The average life expectancy of citizens of this country is 84 years, the cost of medical services per capita is more than 2 thousand dollars, which makes up 5.4% of the share of health expenditures from GDP. Hong Kong is followed, with a small gap, by
Singapore, Spain, South Korea and Japan. The top ten leaders also include Italy, Israel, Chile, United Arab Emirates and Australia. Kazakhstan was included in this rating for the first time, which took the 45th place among 55 states. With life expectancy of 71 years, health expenditures in Kazakhstan were 4.36% of GDP or $ 539 per person.
It is worth mentioning that the US, having the best medicine in the world, took only 50th place. This country spends on health care 17% of GDP, which is almost $
9,500 per capita, the highest level in the world. The average life expectancy is about 79 years. This situation proves that excessively high public and private health care costs are not the main indicator of their effectiveness.
The Russian healthcare system occupies the 55th position in this list, the last in the rating. The share of health expenditures is 7.1% of GDP or 893 dollars per capita, the average life expectancy of Russians is 70.4 years. When compiling the rating, the experts charged the Russian health care system with 24.3 points, while the leader of the rating Hong Kong received 88.9. Among five the worst ones, besides Russia, there are also Jordan, Colombia, Azerbaijan and Brazil.
References
1. Duplinskaya E.B., Kobeleva E.P. World experience in managing public finance (by the example of Great Britain) // Science and Education: New Time. - № 3. - 2018
2. Fuchs, Victor R. Health economics. The New Palgrave: A Dictionary of Economics, v. 2 - 1987. - pp. 614-19.
3. Williams, A. Health economics: the cheerful face of a dismal science, in Williams, A., Health and Economics. - London: Macmillan. - 1987.
4. Rating of countries in the world according to the level of life expectancy. Humanitarian encyclopedia // Center for Humanitarian Technologies, 2006-2018 [Electronic resource] : URL: http://gtmarket.ru/ratings/life-expectancy-index/life-expectancy-index-info (reference date 04/16/2018).
5. Rating of the countries of the world on the effectiveness of healthcare systems in 2016. Bloomberg // Center for Humanitarian Technologies. [Electronic resource]: URL: http://gtmarket.ru/news/2016/10/08/7306 (reference date: May 10, 2018)
6. Duplinskaya E.B. Budget system and budget process, - Novosibirsk, 2014. - 144 p.
ГОСУДАРСТВЕННАЯ ПОЛИТИКА ФИНАНСИРОВАНИЯ СФЕРЫ ЗДРАВООХРАНЕНИЯ
Е.Б. Дуплинская, канд. экон. наук, доцент Е.П. Кобелева, канд. пед. наук, доцент
Сибирский государственный университет путей сообщения (Россия, г. Новосибирск)
Аннотация. В статье представлены результаты оценки эффективности сферы здравоохранения в России и развитых иностранных государствах, проведенной на основе сравнительного анализа доли расходов на здравоохранение в валовом внутреннем продукте, уровня продолжительности жизни, стоимости медицинских услуг на душу населения.
Ключевые слова: финансирование здравоохранения, оценка эффективности, продолжительность жизни, бюджетное финансирование, валовый внутренний продукт.
Thus, the financing through state orders, state programs, funds, grants and contracts, which are placed on a competitive basis for both state non-commercial and non-governmental non-profit organizations, is recently becoming a promising direction for increasing the efficiency of budget financing. But this method of budget financing of social services is not an alternative to the basic normative budgetary financing [6].
Analyzing the experience of foreign countries, it is necessary to take into account the fact that each country has its own specific features and mechanisms of health care financing.
