Availability of health care: objectives and reality

The article considers the role of the state and market in provision of medical services against the background of crisis developments in population health. It analyses causes of the success of West European countries in preventing premature deaths and reducing non-communicable diseases (NCDs). It is established that the main difference in the approaches to reforming health care among countries is concerns assessment of the role of the state, funding and management of health care. A special emphasis is laid on the state funding of health care programmes as a reliable means of ensuring universal availability of medical services for population. Our country is characterized by introduction of liberal market relations into the health care system. Contrary to the global trend of reducing cash payment for medical services by people, in 2013 Russian people funded health care on equal footing with the state. Commercialization of health care is leading to deterioration of the population health that is inconsistent with the stated objectives of the demographic policy of the Russian Federation and necessitates adoption of a conceptual framework for development of health care in Russia on the basis of equality and fairness.