Russian healthcare in the context of achieving universal access to health services by 2030

The article presents the results of an analysis of data from global monitoring systems and international studies for the period 2000-2017, reflecting the trends in our country's movement towards universal health coverage (UHC) and a reduction in catastrophic medical expenses paid by patients from their own funds within the framework of the tasks for achieving the Sustainable Development Goals by 2030. It is emphasized that for our country it is of great interest to adapt the successful experience of developed and actively developing countries in using targeted integrated strategies for development of UHC programs aimed at giving priority to health in the system of public financing measures. This is confirmed by the data that for the period 2000-2017 against the background of an increase in the share of replacing the missing state funds with cash funds of citizens in the total health budget of our country from 30% to 40%, there was a parallel increase in the number of households, in the structure of the budgets of which the share of health expenditures exceeded 10% of their total financial resources. According to the analysis of monitoring data, the increase in the number of Russian families with this form of catastrophic costs of medical care reached in 2018 the number of 7,532,579 cases with a prevalence rate of 5.23%. These indicators are higher than the data levels for 1997 by more than 2.2 and 2.1 times, respectively. At the same time, the risk of financial catastrophe for families due to the need to seek surgical care in 2018 was noted in 21.3% of cases (WB, 2019). The study emphasizes the importance of scientific assessment of the consequences and prospects for the increased participation of private commercial institutions in implementation of the government program of the State guarantees of free medical assistance to citizens. The significance of such a study is due to the trends of increasing volume of the market for provision of disparate medical services and the need, therefore, to develop optimal intersectoral strategic approaches to development of both the public healthcare system and commercial medicine in the interests of ensuring health and well-being of the population.