Social consequences of the healthcare reforms in the regions of Russia (on the example of the Volga federal district)

The current state of the Russian health care system is a consequence of the reforms carried out in the last two decades, during which the positive characteristics of the previous system of management and financing were lost. The steady decline in the assessment of the state of health of Russians after 45 years indicates the insufficient quality and availability of the medical care, which is increasingly felt with age, due primarily to the reduction in the number of doctors and medical personnel. In the context of a prolonged decline in real incomes of the population, a very eloquent assessment of the social consequences of the reform is the growth of the private sector in the health sector. Focusing public attention on the situation with COVID-19 pushes to the background not only the assessment of the activities of the authorities in this area, but also the satisfaction of the needs for medical care of other, often seriously ill patients. A typical example of this approach is insufficient attention to the medical examination of the population. The pandemic becomes the litmus test that shows the negative consequences of the reform of the health care system: a significant reduction in infrastructure, the outflow of qualified medical personnel from the public sector, a decrease in the availability of quality medical care, increasingly dependent on the solvency of the population, the loss of hope for the help of state medicine on the part of the vast majority of the population. It seems quite convincing to assume that the authors of the reform initially consider such a result as their goal.