Job title: Regulation of the provision of sanatorium and resort treatment under the legislation of the Russian Federation
Introduction 3
1. General characteristics of sanatorium-resort treatment -
as one of the forms social security
5
1.1. Social security - as a special social institution of the state
5
1.2. General characteristics of providing sanatorium-resort treatment
7
1.3. Some problems associated with providing
spa treatment
11
2. Regulation of the provision of sanatorium and resort treatment according to the legislation of the Russian Federation 13
2.1. General provisions regulating spa treatment
15
2.2. Special provisions on sanatorium-resort treatment 18
Conclusion 38
References 39
Introduction: At the very end of 2004, the Chairman of the Government of the Russian Federation (hereinafter referred to as the Russian Federation) Mikhail Fradkov approved a set of measures carried out by the Ministry of Health and social development of the Russian Federation and the Social Insurance Fund of the Russian Federation (hereinafter referred to as the Social Insurance Fund of the Russian Federation), with the participation of interested executive authorities and organizations, on the implementation of the Federal Law of August 22, 122-FZ regarding the provision of sanatorium and resort treatment to privileged categories of citizens. Within preparatory work on the implementation of the Federal Law of August 22, 2004. 122-FZ "On amendments to legislative acts of the Russian Federation, in connection with the adoption of federal laws "On amendments and additions to the Federal Law "On general principles organizations of legislative (representative) and executive bodies of state power of the constituent entities of the Russian Federation" and "On the general principles of organization local government in the Russian Federation", the FSS of the Russian Federation is working on a set of issues to provide sanatorium and resort treatment to citizens entitled to receive state social assistance in the form of a set of social services.
Millions of Russians have witnessed and participated in the process of radical changes in the mechanism for providing a number of benefits. Reform social sphere and health care has caused ambiguous understanding and interpretation of its goals and objectives. These transformations in the field of social security have revealed a number of serious problems and a wave of social protests among citizens of our state. The debate that is currently going on in society and media mass media regarding preferential benefits (and in particular, provision of preferential sanatorium and resort treatment), concerns issues that affect literally every person, every family.
All of the above once again confirms the relevance of the chosen topic of this course work"Sanatorium-resort treatment as a form of social security."
Purpose of the work: to determine the importance of sanatorium-resort treatment within the framework of social security. In writing this work, I will try to accomplish the following tasks: give general characteristics social security - as a special social institution of the state, consider how the provision of sanatorium and resort treatment to various categories of beneficiaries is regulated by law, identify and characterize the most basic problems associated with the provision of this type of social security, as well as ways to overcome them.
When writing the course work, materials were used judicial practice, published in official sources.
References: 1. Constitution (Basic Law) of the Russian Federation. - M.: AST Publishing House LLC, 2000. - 64 p.
2. “Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens” dated July 22, 1993 N 5487-1 (Vedomosti Congress people's deputies Russian Federation and the Supreme Council of the Russian Federation, 1993, N 33, art. 1318; Collection of Legislation of the Russian Federation, 1998, No. 10, Art. 1143; 1999, N 51, art. 6289; 2000, N 49, art. 4740; 2003, N 2, art. 167; N 9, art. 805; N 27, art. 2700; 2004, N 27, art. 2711).
3. Federal Law of the Russian Federation “On State Social Assistance” dated July 17, 1999 178-FZ (as amended by paragraph 9 of Article 125 of the Federal Law of August 22, 2004 122-FZ) // GARANT-reference legal system//Section "Legislation".
4. Law of the Russian Federation "On social protection citizens exposed to radiation as a result of the Chernobyl nuclear power plant disaster" (as amended on December 24, 1993, November 24, 1995, December 11, 1996, November 16, 1997, April 17, July 5, 1999, August 7 , December 27, 2000, February 12, August 6, December 29, 30, 2001, July 25, December 11, 24, 2002, October 23, December 23, 2003, April 26, August 22, 2004) // GARANT - reference legal system // Section "Legislation".
5. Law of the Russian Federation of June 18, 1992 N 3061-I “On amendments and additions to the Law of the RSFSR “On the social protection of citizens exposed to radiation as a result of the disaster at the Chernobyl nuclear power plant” (as amended on December 24, 1993, November 24 1995, December 11, 1996, November 16, 1997, April 17, July 5, 1999, August 7, December 27, 2000, February 12, August 6, December 29, 30, 2001, July 25 , December 11, 24, 2002, October 23, December 23, 2003, April 26, August 22, 2004) // GARANT - reference legal system // Section "Legislation".
6. Federal Law of the Russian Federation of November 24, 1995 181-FZ “On social protection of disabled people in the Russian Federation” (as amended on July 24, 1998, January 4, July 17, 1999, May 27, 2000, June 9 , August 8, December 29, 30, 2001, May 29, 2002, January 10, October 23, 2003, August 22, 2004) // GARANT - reference legal system // Section "Legislation".
7. Federal Law of the Russian Federation of November 26, 1998 175-FZ “On the social protection of citizens exposed to radiation as a result of the accident in 1957 at the Mayak production association and the discharge of radioactive waste into the Techa River” // GARANT - reference legal system / / Section "Legislation".
8. Federal Law of the Russian Federation of January 10, 2002 N 2-FZ “On social guarantees for citizens exposed to radiation as a result of nuclear tests at the Semipalatinsk test site” (as amended on March 17, August 22, 2004) // GARANT - legal reference system//Section "Legislation".
9. Federal Law of the Russian Federation of November 7, 2000 N 136-FZ “On the social protection of citizens engaged in work with chemical weapons” // Collection of Legislation of the Russian Federation. - 2000. - N 46. - Art. 4538.
10. Federal Law of the Russian Federation dated January 2, 2000. N 40-FZ "On Veterans" // GARANT - reference legal system // Section "Legislation".
11. Federal Law of the Russian Federation of December 10, 1995 195-FZ "On the fundamentals of social services for the population in the Russian Federation" // GARANT - reference legal system // Section "Legislation".
12. Law of the Russian Federation 4301-1 of January 15, 1993 “On the status of Heroes Soviet Union, Heroes of the Russian Federation and full holders of the Order of Glory" // GARANT - reference legal system // Section "Legislation".
13. Federal Law of the Russian Federation dated January 09, 1997. 5-FZ "On the provision of social guarantees to Heroes of Socialist Labor and full holders of the Order of Labor Glory" // GARANT - reference legal system // Section "Legislation".
14. Federal Law of the Russian Federation of February 23, 1995 N 26-FZ “On Natural Healing Resources, Medical and Health Areas and Resorts” // Collection of Legislation of the Russian Federation. - 1995. - N 9. - Art. 713.
15. Federal Law of the Russian Federation of May 27, 1998 N 76-FZ “On the status of military personnel” (Collected Legislation of the Russian Federation, 1998, N 22, Art. 2331; 2000, N 1, Art. 12; N 33, Art. 3348; 2001, N 31, article 3173; 2002, N 19, article 1794; N 21, article 1919; N 26, article 2521; N 48, article 4740; 2003, N 46, article 4437; 2004, N 18, Art. 1687; N 30, Art. 3089).
16. Federal Law of the Russian Federation dated August 22, 2004 No. 122-FZ “On amendments to legislative acts of the Russian Federation and the recognition as invalid of certain legislative acts of the Russian Federation in connection with the adoption of Federal Laws “On Amendments and Additions to the Federal Law “On General principles of organization of legislative (representative) and executive bodies of state power of the Russian Federation" and "On the general principles of organization of local self-government in the Russian Federation" // GARANT - reference legal system // Section "Legislation".
17. Law of the Russian Federation of January 21, 1993 N 4328-1 “On additional guarantees and compensation for military personnel serving in the territories of the Transcaucasian states, the Baltic states and the Republic of Tajikistan, as well as performing tasks in a state of emergency and in armed conflicts” (in as amended by the Law of the Russian Federation of July 21, 1993 N 5481-1) // GARANT - reference legal system // Section "Legislation".
18. Resolution of the Supreme Council of the Russian Federation of December 23, 1992 N 4202-1 “On approval of the Regulations on service in the internal affairs bodies of the Russian Federation and the text of the Oath of an employee of the internal affairs bodies of the Russian Federation” (Gazette of the Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation , 1993, No. 2, Article 70; Collection of Legislation of the Russian Federation, 2002, No. 27, Article 2620).
19. Resolution of the Social Insurance Fund of the Russian Federation dated March 17, 2004 N 24 “On approval methodological instructions on the procedure for appointing, conducting documentary on-site inspections of policyholders for compulsory social insurance and taking measures based on their results"// Russian newspaper.- 82 from 04/20/2004.-P.14; 86 dated 04/23/2004.-P.11; 88 from 04/27/2004.- P.14.
20. Bulletin of the Supreme Court of the Russian Federation.-2002.-5.
21. Review of judicial practice of the Supreme Court of the Russian Federation for the third quarter of 2002//Bulletin of the Supreme Court of the Russian Federation.-2004.-7.
22. Constitution of the Russian Federation: Scientific and practical commentary/Under. ed. acad. B.N. Topornina.- M.: Yurist, 1997.-716 p.
23. Short course lectures on social security law // Composition. Korablina Yu.V. - Moscow, 2003. - 105 p.
24. Commentary on Federal Law 122-FZ of August 22, 2004 “On amendments to legislative acts of the Russian Federation and the recognition of some legislative acts of the Russian Federation as invalid in connection with the adoption of federal laws “On amendments and additions to the Federal Law “On General principles of organization of legislative (representative) and executive bodies of state power of the constituent entities of the Russian Federation" and "On the general principles of the organization of local self-government in the Russian Federation" // Bulletin of non-governmental organizations "Legislative process in the State Duma: human rights analysis." - Published by the Center for the Development of Democracy and Rights human rights, Institute of Human Rights, International Historical and Educational Human Rights and Charitable Society "Memorial" with the support of the National Endowment for Democracy.- Issue 76 (special) // Internet address: on the website of the Center for the Development of Democracy and Human Rights at www.demokratia.ru /analyst/reviewlaws/
25. Review of legislation // "ConsultantPlus" dated January 10, 2005.
26. Andrey Isaev (Chairman of the Committee on Labor and Social Policy State Duma). Law on benefits: what fate awaits benefit recipients?//Izvestia, 08/04/2004
27. Fedor Smirnov. Towards a unified social space: the first step (All-Russian seminar-meeting in Belgorod) // Medical newspaper, 56, July 23, 2004.
PROBLEMS OF PROVIDING SANATORIUM TREATMENT TO CITIZENS HAVING THE RIGHT TO STATE SOCIAL ASSISTANCE
Introduction
In accordance with Article 7 of the Constitution of the Russian Federation, our state is social, that is, its policy is aimed at creating conditions that ensure a decent life and free development of people. In this regard, one of the important functions of the state is to actively influence social relations in the interests of broad sections of the population. Citizens due to age, disability, loss of a breadwinner and other cases provided for by law are provided with social support measures in the form social benefits, additional payments to pensions, subsidies, vital goods and social services, including vouchers for sanatorium and resort treatment.
The purpose of this work is to explore the legislative and practical aspects of the problem of providing vouchers for sanatorium-resort treatment for certain categories of citizens in the presence of medical indications for the prevention of major diseases and to make some amendments to the legislation of the Russian Federation regulating these legal relations.
To achieve this goal, it is necessary to solve the following tasks:
Study the Federal Law of July 17, 1999. No. 18-FZ "On state social assistance";
Research statistical data on vouchers provided and citizens awaiting their provision in the Kaluga region;
To get acquainted with the practice of considering cases of providing sanatorium and resort treatment to preferential categories of citizens in the courts of general jurisdiction of the Kaluga region.
1) The right of citizens to receive social assistance in the form of vouchers for sanatorium and resort treatment.
In accordance with the Federal Law of July 17, 1999 No. 178 - Federal Law "(3 state social assistance" (hereinafter - Federal Law No. 178-FZ), starting from 2005, the Social Insurance Fund of the Russian Federation (hereinafter - the FSS RF) and his executive bodies provide travel packages for the prevention of major diseases sanatorium-resort treatment of citizens of preferential categories, if they have medical indications. The following people have the right to receive this type of state social assistance: disabled war veterans, participants in the Great Patriotic War, combat veterans, disabled people, disabled children, etc. (Article 6.1 of Federal Law No. 178-FZ). -
The procedure for providing vouchers for sanatorium and resort treatment is established by the Order of the Ministry of Health and Social Development of the Russian Federation dated March 27, 2012. No. 271n “On approval of the Administrative Regulations for the provision of the Social Insurance Fund of the Russian Federation to citizens entitled to receive state social assistance in the form of a set of social services, state services for the provision, in the presence of medical indications, vouchers for sanatorium treatment carried out for the purpose of prevention major diseases, and free travel on intercity transport to and from the place of treatment.”
This Administrative Regulation lists the standards, deadlines, authorities, and sequence of actions when providing vouchers for sanatorium-resort treatment to citizens, and provides comprehensive grounds for refusing to provide vouchers: application from persons who do not belong to preferential categories of citizens, failure by the applicant to provide the necessary documents, the applicant’s refusal of the public service completely
1993 (with amendments and additions 30.32 2008) // Russian newspaper - 2009 - No. 7.
2 Federal Law of the Russian Federation No. 178-FZ: adopted by the State. Duma 06/25/1999 (as amended on 07/02/2013) // reference and legal system “Consultant Plus”
or regarding the possibility of obtaining a voucher for sanatorium treatment, the applicant’s execution of documents in violation of the requirements of Russian legislation/"
Financing of expenses associated with the provision of social services in relation to categories of citizens included in the Federal Register of Persons entitled to receive state social assistance is carried out at the expense of funds and in the amount provided for in the federal budget for the corresponding year.
In accordance with the current Russian legislation, the State institution -
- Go to section » 2012
Deputy General Director of the Federal State Budgetary Institution “SSC FMBC named after. A.I. Burnazyan FMBA of Russia", chief freelance specialist of the Russian Ministry of Health in sanatorium and resort treatment, professor Natalya Korchazhkina
Sanatorium-resort treatment is a special type medical care, based on the predominant use of natural healing resources for the purposes of prevention, treatment and rehabilitation. Special significance it acquires in connection with the formation of a new three-level model of healthcare organization in the Russian Federation, aimed at prevention, timely detection of diseases, as well as treatment using modern high-tech methods.
For example, in 2010, respiratory diseases took first place in the structure of diseases both among the entire population and among children aged 0 to 14 years. At the same time, regular preventive sanatorium-resort treatment of such diseases makes it possible to achieve stable remission of the disease, which leads to a significant reduction in morbidity, mortality and an increase in life expectancy for a significant number of citizens of the Russian Federation.
There has been an increase in the incidence of malignant neoplasms of the entire population in dynamics since 2008. However, such patients need not only treatment of complications associated with the underlying disease and the consequences of special treatment (radiotherapy, chemotherapy), but also additional restorative treatment concomitant diseases in a sanatorium setting. However, there are no specialized beds in the country to provide care to such patients.
All this requires a significant revision of the system of sanatorium and resort treatment for citizens of the Russian Federation, which was formed during the Soviet period and has exhausted itself for a number of reasons.
Firstly, the separation of large medical and recreational areas and resorts within the former Soviet republics (the main resort areas in the Baltic, the Carpathians, the Crimea, the Black Sea, Azov coasts and Transcaucasia) made the existing methodology for the distribution of patients, taking into account the profile for treatment, untenable natural factors.
Secondly, significant technological progress in the field medical technologies, based on the use of natural and preformed physical factors, made it possible to provide almost any effect necessary as part of treatment.
Thirdly, the quality of the sanatorium-resort services provided cannot but depend on the technological base of organizations of the relevant profile. Despite the fact that in recent years work has been carried out to modernize sanatorium and resort institutions, there is still an acute shortage of most sanatoriums under the jurisdiction of the Russian Ministry of Health equipped with modern balneotechnical equipment.
According to the concept further development of the domestic healthcare system until 2025, an important direction is the revival medical prevention, rehabilitation and improvement of sanatorium and resort care. A special place in solving these problems is occupied by sanatorium-resort treatment, which is a unique resource that allows for after-care and medical rehabilitation patients after specialized medical care.
Modern system sanatorium and resort treatment in the Russian Federation is represented by 1958 sanatorium and resort organizations various types, organizational and legal form and departmental subordination. The bed capacity of sanatorium and resort institutions in the Russian Federation by federal district is shown in Table 1.
Table 1
Bed capacity of sanatorium and resort institutions of the Russian Federation
|
Federal District |
Quantity health resort organizations |
Bed capacity |
Number of people receiving treatment |
||
|
Coursework (outpatient) |
By vouchers |
||||
|
1 196 141 (22,2%) |
1 096 886 (22,2%) |
||||
|
1 038 150 (19,3%) |
|||||
At the same time, the number of sanatorium-resort institutions continues to decline from year to year. Naturally, over the past five years, the number of adult citizens of the Russian Federation who received sanatorium-resort treatment in sanatoriums in Russia has decreased by 381.1 thousand people, mainly in the Central (-130.1 thousand people), Privolzhsky (-114.9 thousand people) ) and Ural (-48.6 thousand people) federal districts.
In addition, the irrational use of hospital beds is noteworthy. The actual work of a sanatorium-resort bed in the federal districts and in the Russian Federation as a whole is 215-253 days, in contrast to the standard 320-350 days.
The modern system of organizing sanatorium-resort treatment in the Russian Federation is represented by sanatorium-resort organizations of various forms of ownership, various departmental affiliations, financed from different sources, operating not on a territorial-administrative principle, unevenly located on the territory of the Russian Federation due to their location in resorts and medical centers. health-improving areas that do not have the same type of natural healing resources, have insufficient material and technical equipment and a shortage of personnel.
These patterns lead to low availability of sanatorium-resort treatment for the population, and as a consequence, to the lack of stages in the provision of medical care.
Financial support for sanatorium and resort treatment on the territory of the Russian Federation is provided from 6 sources: the federal budget, regional budgets, funds from the compulsory social insurance fund, funds from organizations, personal funds from citizens, funds from state corporations.
The state's obligations to provide sanatorium and resort treatment to citizens of the Russian Federation are fulfilled through:
· budgetary allocations from the federal budget, if there are medical indications for sanatorium and resort treatment for certain categories of citizens entitled to receive state social assistance in the form of a set of social services, and the provision of public services by federal executive authorities for social and resort treatment of certain categories of citizens;
· allocations provided for by the budget of the Social Insurance Fund of the Russian Federation: this is payment of expenses for medical rehabilitation in organizations providing sanatorium and resort services to insured persons who have suffered health damage due to industrial accidents and occupational diseases, including after the provision of inpatient or outpatient care during a period of temporary incapacity for work in connection with an insurance event until the demand for work ability or the establishment of permanent loss of ability to work, and payment of expenses from the amounts of insurance contributions for compulsory social insurance against industrial accidents and occupational diseases , sanitary and resort treatment of workers engaged in work with harmful and (or) dangerous production factors.
It should be noted that the percentage of satisfaction of applications for sanatorium-resort treatment of privileged categories of citizens does not exceed 60%, which undoubtedly has a negative social significance.
All this determines the need to change the organizational structure of the sanatorium and resort service in the Russian Federation. Detailed proposals for the development of sanatorium- resort industry within State program development of healthcare in the Russian Federation, developed jointly with leading specialists from the Ministry of Health of Russia and the Federal Medical and Biological Agency, were submitted to the Ministry of Health of the Russian Federation.
Subprogram 2 “Development of medical rehabilitation and sanatorium-resort treatment, including for children” of the State Health Care Development Program provides for two stages: Stage I - 2013-2015, Stage II - 2016-2020. Resource support at the expense of the federal budget in 2013-2015 - 32,423,852.9 thousand rubles. As a result, the target indicator (coverage of patients with sanatorium-resort treatment) will increase to at least 45% by 2020 (2011 - 3.5%, 2012 - 6%).
The developers are: Department of organization of medical prevention, emergency, primary health care and sanatorium and resort affairs of the Ministry of Health of Russia, FSBI “SSC FMBC named after. A.I. Burnazyan", Federal State Budgetary Institution "Russian science Center medical rehabilitation and balneology of the Ministry of Health of Russia", FGU "Pyatigorsk State Research Institute of Balneology" FMBA of Russia, FGU "Tomsk Research Institute of Balneology and Physiotherapy" FMBA of Russia.
The following main directions of modernization of the sanatorium-resort treatment system can be identified:
· Increasing the availability of sanatorium-resort treatment. This stage includes the development of modern scientifically based indications and contraindications for spa treatment of adults and children; development and implementation of procedures for organizing and standards of sanatorium-resort treatment.
· Optimization of activities, restructuring of sanatorium and resort organizations in the Russian Federation. As part of this stage, it is necessary to determine the need for sanatorium-resort treatment according to the morbidity of the adult and child population of Russia; update the profiles of sanatoriums in accordance with the type (profile) of the resorts where they are located; repurposing beds depending on need in the presence of appropriate natural healing resources.
· Providing sanatorium and resort treatment to certain categories of citizens as part of the provision of state social assistance. As part of this stage, it is necessary to provide sanatorium-resort treatment in the presence of medical indications for citizens - to receive a set of social services in order to prevent major diseases. It is necessary to change the methodology for determining the amount of federal budget funds allocated to finance services for sanatorium and resort treatment of privileged categories of citizens; plan rhythmic financing of funds from the Social Insurance Fund of the Russian Federation and the constituent entities of the Russian Federation within the framework of delegated powers; reduce the duration of procedures for selecting a sanatorium and resort organization; develop clear standards for sanatorium-resort treatment.
· Providing sanatorium and resort treatment to insured citizens injured as a result of industrial accidents and occupational diseases, as well as those employed in work with harmful and (or) hazardous production factors. Rehabilitation is required in organizations providing sanatorium and resort services to insured persons who have suffered health damage as a result of industrial accidents and occupational diseases, including the provision of inpatient or outpatient care during the period of temporary disability in connection with an insured event until restoration of working capacity or establishment permanent disability; sanatorium-resort treatment of workers engaged in work with harmful and (or) hazardous production factors.
· Providing sanatorium-resort treatment for patients with socially significant diseases (tuberculosis, children with oncohematological diseases).
· Development of the rehabilitation stage of sanatorium-resort treatment (formation of a state order for the sanatorium-resort stage of medical rehabilitation of patients after the provision of specialized, including high-tech, medical care for North Kazakhstan region different forms property; increasing sanatorium-resort treatment in federal medical treatment facilities of the Russian Ministry of Health after specialized, including high-tech, medical care. The main problem here is the significant lack of bed capacity to provide the sanatorium-resort stage after the provision of specialized, including high-tech, medical care.
· Objectification of statistical observation.
Improvement personnel policy. It is necessary to change the staffing schedules of sanatorium-resort organizations with an increase in the number of specialists in physiotherapy, physical therapy, medical rehabilitation, and improve the qualifications of medical specialists; strengthen the motivational link. It was decided to hold a meeting with members of the specialized commission on sanatorium-resort treatment in order to develop a thematic improvement program for doctors and nursing staff in the latest technologies sanatorium-resort treatment for the 3rd stage of rehabilitation. A draft program has been prepared, and a separate program has been developed for nursing staff.
· Preservation of resorts and health-improving areas, natural healing resources. At the same time, it is necessary to preserve the status of resorts and health-improving areas as specially protected natural areas; bring the status of resorts in accordance with the current legislation on natural healing resources, medical and recreational areas and resorts; to update the sanitary (mountain sanitary) protection districts of resorts.
The main directions for improving the sanatorium and resort service are the development of public-private partnerships in the sanatorium and resort industry in the regions within the framework of the functioning of special economic zones of the tourist and recreational type in the areas; the introduction of “high health technologies” in combination with recreational and sanatorium-resort services, which will contribute to the expansion of the forms and types of functioning sanatorium-resort facilities in the regions; improving the organizational structure of sanatorium and resort services in the region through the formation of sanatorium and resort clusters.
Resort- mastered and used for therapeutic and prophylactic purposes, specially protected natural area, which has natural healing resources and the buildings and structures necessary for their operation, including infrastructure.
Sanatorium and resort organizations- enterprises, institutions, organizations of various forms of ownership and departmental affiliation, located both on the territory of resorts, medical and recreational areas, and outside them, carrying out medical and recreational activities using natural healing factors.
Today, the Russian resort complex has more than 2.3 thousand sanatorium-resort and health-improving institutions with 371.2 thousand beds. Every year more than 5 million people undergo treatment and recovery there. In recent years, there has been a tendency to reduce the total number of health resorts while increasing the number of places in them, i.e. to the consolidation of sanatorium and resort organizations.
Russian health resorts are not evenly distributed throughout the country: the majority (approx. 50%) are located in the Southern and Volga Federal Districts.
According to the magazine "Resort Vedomosti", the largest number of sanatorium and resort organizations in 2008 were located in the Southern Federal District (28.8% of the total number Russian sanatoriums). The second place in terms of population was occupied by the Volga District (22%). Third - Central federal district, where 16% of Russian sanatoriums are concentrated. The fewest sanatorium and resort organizations are in the Northwestern (7.8%) and Far Eastern (3.6%) districts. Only 9% of these organizations are located in the Urals Federal District. This distribution is quite comparable with the natural and climatic conditions in Russia.
According to the All-Russian Center for the Study of Public Opinion (VTsIOM), more than half of Russians (68%) did not go on vacation last summer (in 2007 this was 60%), of which every fifth (21%) stayed at home due to lack of money , every second (47%) “minds his own business.” In the summer of 2008, a smaller number of Russians did not vacation anywhere - 60%, among them 24% indicated that there was no money for this.
The most preferred types of recreation for Russians are beach (30%), treatment in sanatoriums (28%), educational recreation (21%) or sports (19%). Rest in boarding houses (16%), at home 14%), at the dacha and in the garden (12%) are less often noted. It is worth noting that in a 1999 study, 27% of Russians also preferred sanatoriums.
Table 1 - Results of the VTsIOM survey
|
What type of holiday do you prefer? (any number of answers) |
||||||
|
Total respondents |
Age, years |
|||||
|
60 and older |
||||||
|
Beach holiday |
||||||
|
Treatment in sanatoriums |
||||||
|
In holiday homes, boarding houses |
||||||
|
Hiking (hiking, cycling, kayaking, etc.), fishing, hunting |
||||||
|
Educational recreation - excursions, trips to historical and memorable places |
||||||
|
Rest in the country house, garden |
||||||
|
Rest at home |
||||||
|
I haven’t decided yet, it’s difficult to answer |
The problems of developing tourism and the resort and recreational complex are important for almost every person, because, in essence, we are talking about health. Social, environmental and economic factors are closely intertwined in these problems.
According to Russian President Vladimir Putin, in general, the resort business in Russia is still ineffective: “We have not achieved noticeable success here: infrastructure resort regions worn out and slowly being reconstructed; there is no rush to create here necessary conditions for the development of the market for sanatorium and health services; monopolism and outdated management methods prevail; as a result - high price vouchers, rather poor service. It turns out that people simply have nowhere to relax in their own country.” Since the beginning of the 1990s, the sanatorium-resort complex in Russia has experienced better times. If in 1990 there were 3.6 thousand sanatoriums and resorts operating on the territory of the Russian Federation, then by 2000 their number decreased by 1.5 times. The number of people recovering their health decreased almost 2.7 times: from 12,562 thousand people to 4,682 thousand. Since the mid-1990s, positive development trends have emerged in the Russian resort industry. The sanatoriums, boarding houses and rest homes that survived the transition period began to purchase modern equipment and develop new types of services.
Young people prefer the beach and hiking; the middle generation - the beach and educational excursions, the older generation - sanatorium treatment and home relaxation. Russians with education:
* below average, usually attracts sanatorium treatment and home rest;
* with average and average special education- beach and treatment in sanatoriums;
* with higher and unfinished higher education - beach and educational holidays.
The main reason for “abstinence” from vacation is the lack of funds - the share of those who stayed at home for one reason or another in the summer is reduced from 86% in the group with per capita income of no more than 1,500 rubles per month to 46% in the group with income over 5,000 rubles.
Almost every second Russian (46%) did not intend to spend money on summer rest last year. The most typical planned amount for one vacationing family member was less than 5,000 rubles, indicated by 15% of respondents, 12% planned to spend from 5,000 to 10,000 rubles. An amount of up to 25,000 rubles per person was indicated by 7% of respondents, above this - 3%. Every sixth respondent found it difficult to name possible expenses.
According to the Public Opinion Foundation, the majority of Russians surveyed believe that only rich people have the opportunity to go to a resort or on an excursion tour. A similar point of view applies to:
* 84% of respondents are interested in holidays abroad;
ѕ in relation to holidays in Russia - 77%.
The vast majority of survey participants considered this form of recreation inaccessible for themselves personally: only 13% of the survey said that people of their circle and social status could afford to go on vacation abroad, and a quarter (24%) - that they could afford to relax at a Russian resort or during an excursion tour around Russia.
Noteworthy is the fact that holidays in their own country, associated with a long trip, seem to Russians to be only slightly more affordable than holidays abroad. At the same time, it turned out that many survey participants in any case would not want to vacation away from their home - even if their financial situation allowed them to do so, and respondents refused the hypothetical opportunity to vacation abroad more often (31%) than hypothetical opportunity to go to a resort or on an excursion tour around Russia (20%). This position was held not only by older people, who may be stopped, among other things, by health considerations, but also by young respondents. It is obvious that the opportunity to go on vacation (especially abroad) is blocked not only by financial circumstances, but also by the cultural attitudes and habits of Russians.
Half of those surveyed (52%) believe that they would feel insecure or awkward while vacationing abroad, and a third (30%) said that they would not experience such a feeling.
Perhaps one of the most remarkable results of the survey is the fact that in the perception of Russians, holidays in Russia are associated more with staying at resorts, and holidays abroad are more associated with excursion trips. So, if respondents had the opportunity to choose between an excursion tour around Russia or any other foreign country, 44% would prefer to travel abroad, and 31% would prefer to travel around Russia. If respondents had to choose between a Russian and a foreign resort, 40% would choose the Russian one, and 30% would choose the foreign one. Another indicator: among those survey participants who would not refuse, if given the opportunity, to relax in Russia, 45% would choose a resort and 27% would choose an excursion.
Apparently, in the mass consciousness there is an idea that going abroad is an opportunity to “see the world” (and that this is how you should vacation abroad), and you can sunbathe, swim, and get treatment at Russian resorts, without experiencing psychological discomfort that, in the opinion of many, accompanies staying abroad. In addition, judging by the data received, some Russians believe that the conditions for excursion and educational trips in our country are worse than abroad.
There is an opinion that holidays abroad are cheaper and the conditions are better. Now, according to tour operators, tours to Turkey, Egypt, the UAE, Bulgaria, Greece and Croatia are in greatest demand.
The development of Russian health resorts cannot be achieved without state support. Now a number of direct and indirect measures are aimed at strengthening the sanatorium and resort complex. Firstly, the flow of vacationers has increased significantly due to the provision of discounted vouchers. Secondly, the tax benefits that the territory can receive will contribute to the development of sanatorium and resort organizations.
For the first time, the idea of national projects capable of concentrating government efforts and financial resources on solving specific issues was put forward in September 2005 by Russian President Vladimir Putin.
Measures to solve the main health problems involve optimizing the expenditure of budget funds, shifting the emphasis of medical care to primary care (pre-hospital stage), and a preventive focus on health care.
Table 2 - Results of the VTsIOM survey on the advantages of foreign and Russian resorts
|
Russian resorts |
Foreign resorts |
|
Why would you prefer to vacation at a Russian/foreign resort? |
|
|
1. Our resorts are not inferior to foreign ones (“our resorts are no worse”, “ good places there are, they are not inferior to foreign ones”, “the service is excellent, almost like abroad”). |
1. Abroad better service(“More civilized service”, “higher level of service”, “high quality”, “more comfort”, “they are more comfortable”). |
|
2. I am a patriot (“it’s better in my homeland”, “I prefer my country”, “my own, closer in spirit”, “it’s better at home”, “I’m a patriot of my country”). |
2. Abroad is interesting, you can get new impressions (“Out of curiosity”, “it’s more interesting there”, “get to know the world”, “broaden your horizons”, “get to know other countries”). |
|
3. Holidays in Russia are safer, calmer (“safer in your own country”, “it’s dangerous to travel abroad”, “safer and more reliable in Russia”, “calmer in your homeland”). |
3. Abroad high level medical care (more responsibility for treatment”, “better treatment”, “the treatment is better there”). |
|
4. Abroad is far away (“Closer”, “you can’t travel far at my age”, “it’s far to go there”, “I don’t like the long road”, “closer to home”). |
4. Haven’t been abroad (“I have such a dream”, “haven’t been abroad”, “I want to go abroad”). |
|
5. Russia has a suitable climate and ecology (“The climate is different”, “the climate and nature are more suitable and richer”, “ climatic conditions closer”, “our nature is better”, “familiar climate”). |
5. I want to see the life of people in other countries (“For comparison purposes”, “it’s interesting to see how they live there”, “it’s interesting to see how everything works there”, “to look at another life”). |
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6. In Russia you feel freer, more confident (“here you feel more confident”, “it’s simpler”, “you feel freer”, “more familiar”). |
6. Abroad is better, calmer in general (“in Russia you will definitely run into something”, “the society there is stable, safer”). |
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7. Absence of a language barrier (“They speak Russian”, “you need to know the language abroad”, “there is no language barrier, it’s easier among your own people”, “among your own people”, “communication with your own people”). |
7. Traveling abroad is cheaper (“it’s cheaper there”, “it’s cheaper than vacationing in Russia”). |
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8. Russia has a high level of medical care (“I trust my doctors more”, “our doctors are better”, “I trust our doctors”). |
8. There is no desire to travel around Russia (“I’ve been to Russian ones”, “I’m tired of my own”, “I’ve already been everywhere here in Soviet times”). |
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9. Holidays in Russia are more accessible, cheaper (“More accessible”, “cheaper”, “would save money”, “such a trip is cheaper”). |
9. The nature is better abroad (“the nature is different, I’m tired of my own”, “the sea is clean there”, “the nature is cleaner there”). |
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10. I want to get to know my country (“we haven’t seen Russia yet,” “to see my country,” “I haven’t been to many places in Russia yet”). |
The main goals of the national healthcare project:
ѕ strengthening the health of the Russian population, reducing the level of morbidity, disability, and mortality;
* increasing the availability and quality of medical care;
* strengthening primary care health care, creating conditions for the provision of effective medical care in prehospital stage;
* development of preventive healthcare;
* meeting the population's needs for high-tech types medical care.
Chairman of the State Duma Committee on Labor and Social Policy Andrei Isaev said that from 2006 “it is necessary to begin to restore the system of sanatorium and resort treatment for workers as part of compulsory health insurance.”
Speaking about sanatorium-resort treatment for the privileged category of citizens, Isaev noted that in 2005, more than 1 million benefit recipients, or 7.5% of those who have the right to receive a social package, rested in sanatoriums. For comparison, he cited figures from 2004, when only 234 thousand people spent their holidays in sanatoriums.
On June 5, Russian President Vladimir Putin signed the Federal Law “On Amendments to the Federal Law “On Special Economic Zones in the Russian Federation,” adopted by the State Duma on May 19 and approved by the Federation Council on May 26, 2006.
The law introduces a new type of special economic zones /SEZ/ - tourist and recreational special economic zones, the purpose of which is the development and efficient use tourism resources in Russia.
A special economic zone of a tourist-recreational type (hereinafter - SEZ) is a status assigned by a decree of the Government of the Russian Federation to a part of the state and customs territory of the Russian Federation (resort, recreational zone, health-improving area), on the territory of which there is a special regime for conducting business and investment activities.
Special economic zones of resort and recreational type are created for the purposes of:
ѕ stimulation of investment activities aimed at the preservation, development and effective use of resort and recreational resources on the territory of the Russian Federation;
ѕ creation of modern resort, tourism, transport, housing, communal and other types of infrastructure on the territory of special economic zones of resort and recreational type;
ѕ concentration of resources to achieve the development goals of the resort and recreational complex of the Russian Federation.
The creation of zones of this type will be especially important for small and medium-sized businesses, since the development of a tourist and recreational zone is associated with the expansion of the service sector, the operation of a large number of hotels, catering establishments, etc.
Tourist and recreational SEZs are created in one or several areas of the territory of the Russian Federation. Moreover, they may be located on the territory of several municipalities or include the entire territory of any administrative-territorial entity. On the territory of the tourist and recreational SEZ, the development of deposits of mineral waters, medicinal mud and other natural medicinal resources is allowed.
The Government of the Russian Federation is given the right to determine types of activities the implementation of which is not allowed in the special economic zone. It is also possible to transfer a number of functions of the SEZ management body joint stock company, 100% of whose shares belong to the Russian Federation.
The State Duma adopted a law granting a special tax regime to tourist and recreational special economic zones (SEZ).
Amendments to the Tax Code of the Russian Federation and the Law “On Foreign Investments in the Russian Federation” introduce special taxation for SEZ resident organizations. For 5 years they are exempt from paying property tax and land tax. In addition, it is possible for the laws of the constituent entities of the Russian Federation to establish a reduced rate of tax on profits subject to credit to the budgets of the constituent entities of the Russian Federation. Moreover, its size cannot be lower than 13.5 percent.
According to Mikhail Rychev, Deputy Head of the Federal Agency for SEZ Management, several territories of the Siberian Federal District have a chance to win the new competition. In particular, the relevant documents for the competition are being prepared by the administrations of the Republic of Buryatia and the Irkutsk region, which plan to create a tourist and recreational zone around Lake Baikal. The Altai Republic also announced their readiness to participate in the competition. Altai region, Kemerovo region.
Tourist zones will have the most liberal regime among all SEZs; there will be no restrictions on either the territory or the number of entities that can participate in one zone. Also, according to him, in such zones there will be no restrictions on the volume of investments, the validity period of the zone will be 20 years. More than 40 constituent entities of the Russian Federation can apply for the creation of tourist and recreational SEZs.
In addition to the tax benefits that will be provided to some health resorts as part of the introduction of tourist and recreational zones, there is also a line in the budget aimed at providing Russians with sanatorium and resort treatment.
Table 3 - Federal budget expenditures on sanatorium and resort treatment
Of course, people go on vacation not only at the expense of the state. At least as much of your own money as the federal budget and the Social Security Fund allocate, Russian citizens spend on sanatorium-resort holidays. Sanatorium and resort industry is experiencing a period of deep reforms, the main features of which are the abandonment of state funding for sanatorium treatment and the deepening of market relations. And this means that financial well-being The industry is increasingly reliant on the individual consumer paying for their own holiday travel. Apparently, the new vacationer has a slightly different recreational behavior from the previous one.
Thus, today the Russian resort complex has more than 2.3 thousand sanatorium-resort and health-improving institutions with 371.2 thousand beds. Every year more than 5 million people undergo treatment and recovery there.
The effective development of the sanatorium and resort complex in Russia will have a positive impact on the health of the population, will help reduce the level of morbidity and disability, and reduce the cost of treating patients in clinics and hospitals. It will lead to an improvement in the state of the infrastructure of resorts and health-improving areas, ensuring economic stability and profitability of the entire sanatorium-resort complex, will allow preserving and rationally using the most valuable natural healing resources of Russia, and increasing the level of provision health resort services and the competitiveness of the domestic resort complex in the international market.
The experience of domestic balneology is almost 300 years old, but currently the volume and quality of sanatorium-resort services and treatment has decreased significantly due to a decrease in budgetary allocations for healthcare and the amount of funds allocated by the Social Insurance Fund for these purposes. Thus, according to statistics, from January to September 2014, only 4.6% of disabled people over the age of 15 took advantage of the right to sanatorium-resort treatment; 61.1% of disabled people have never been to sanatorium-resort treatment; they have undergone sanatorium-resort treatment more than 5 years ago 22.2%, from 2 to 5 years ago - 9.5%. At the same time, the morbidity rate of the population is growing; from 2002 to 2014, the number of registered patients diagnosed for the first time increased by 8,661 people; from 1990 to 2014, the morbidity rate increased from 96,322 people to 114,989 people, despite the development of medicine. The total number of disabled people has decreased slightly since 2009, but at the same time, there has been an increase in the number of disabled children and people with disabilities since childhood - from 2012 to 2015, 44,428 people joined this category. In the field of injuries during performance labor responsibilities The situation is also not developing in the best way, against the backdrop of deteriorating working conditions and concealment of the facts of industrial accidents.
Benefits for sanatorium and resort treatment are established by the legislation of the Russian Federation as a measure of additional medical and social assistance to the population. Subsidies for preferential stay in a sanatorium are awarded to certain groups of citizens recognized as needing sanatorium treatment for medical reasons.
The fundamental legal framework establishing the procedure for providing this type of subsidy is:
Order of the Ministry of Health and Social Development of Russia dated December 29, 2004 No. 328 “On approval of the procedure for providing a set of social services to certain categories of citizens.”
Issuing preferential vouchers to a sanatorium is an application process. That is, the person himself must express his desire and request a voucher. Sometimes the attending physician independently recommends sanatorium treatment, but this is not a necessary or sufficient condition.
In order to receive a subsidized voucher to a sanatorium, the applicant must simultaneously meet two requirements:
Belonged to the group of persons entitled to such a subsidy by law; Had medical indications.
Many people mistake such subsidies for a free vacation package. In fact, benefits for spa treatment are directly related to the applicant’s health status. To receive a subsidy you must obtain certificate 070/U-04. The doctor issues it if he comes to the conclusion that staying in the sanatorium is really necessary. In addition, no earlier than 2 months before departure to the resort, the applicant must receive a resort card. It is issued by the same doctor who issued certificate 070/U-04.
It is important to remember that form 070/U-04 has a validity period of 6 months. After this period, the certificate will need to be issued again.
After receiving certificate 070/U-04, the citizen must write an application for a subsidy at the local branch of the FSS (Social Insurance Fund), where he will be issued a voucher.
You must bring the following documents with you to the sanatorium: Travel voucher;
Medical policy;
Sanatorium card; Passport.
In some cases, another conclusion is required medical and social examination. As a rule, this applies to people with disabilities, since some diseases imply contraindications to sanatorium-resort treatment in medical institutions of a certain type. In addition, in some regions, in order to receive a voucher, you may be asked to present a certificate of pension amount.
Due to the fact that since 2005, a system of monetization of benefits has been in place in Russia, in order to receive free travel At the sanatorium, the pensioner must formally refuse to provide monetary compensation for this type of social assistance.
The decision to issue a voucher or to refuse to issue it must be made within 20 working days from the date of receipt of the application and the documents attached to it. However, you will not be able to get a voucher right away - referral to the sanatorium is carried out on a first-come, first-served basis.
Russian legislation distinguishes two types of persons entitled to health resort subsidies. The right to visit for free once a year medical sanatorium have:
Disabled people and WWII participants;
Combat veterans;
Disabled people of groups 1, 2, 3 and disabled children;
Residents of besieged Leningrad (you must have an award badge); Home front workers during the Second World War;
Victims of radiation as a result of the Chernobyl disaster.
Family members of deceased disabled people and WWII veterans.
Along with the right to receive a free referral to a sanatorium, these persons have the right to:
Free travel to the sanatorium by ground transport. (Railway transport, except for branded trains and luxury cars; Economy class air transport; Water transport; Road transport common use(buses, etc.).
A coupon for purchasing a discount ticket is issued at the FSS office along with the voucher. In regions where travel by land is not possible, the FSS also pays for air tickets.
For disabled people of group 1 and disabled children, the law provides the right to take one accompanying person with them free of charge.
In addition to the above social groups The legislation of the Russian Federation also provides for: Benefits for military pensioners for sanatorium and resort treatment;
Benefits for pensioners for sanatorium treatment;
Benefits for sanatorium treatment for labor veterans;
Benefits for reserve officers for sanatorium and resort treatment;
It is important to remember that the sanatorium does not provide the necessary medications other than those that will be prescribed in the institution itself. All necessary medications must be obtained according to existing prescriptions in advance at your place of residence.
Order of the Minister of Defense of the Russian Federation dated March 15, 2011 No. 333 “On the procedure for sanatorium- resort provision in the Armed Forces of the Russian Federation" established the procedure and grounds for providing resort and health treatment to military personnel.
Benefits for military pensioners for sanatorium-resort treatment are also provided to members of their families. Issued discounted voucher by decision of the Department of Sanatorium and Resort Treatment of the Ministry of Defense of the Russian Federation. To receive a subsidy, a military pensioner must submit an application directly to the Main Military Medical Directorate of the RF Ministry of Defense or to the administration of the sanatorium. The application must be accompanied by a certificate in form 070/U-04 confirming the presence of medical indications.
Benefits for reserve officers for sanatorium and resort treatment are provided according to a similar scheme, provided that the service period of the transferred officer in preferential terms is at least 20 years.
The Law “On State Social Assistance” provides pensioners with the opportunity to be referred to sanatorium-resort treatment no more often than once every 2 years. The exception is the disabled and disabled children, who are provided with vouchers to the sanatorium once a year, and even more often if there are special medical indications.
In law preferential categories citizens entitled to state social assistance in the form of a set of social services can choose: to receive NSS in kind or in cash equivalent, in whole or in part.
The following have the right to receive a set of social services:
disabled people and participants of the Great Patriotic War; disabled people and combat veterans;
military personnel who served in military units, institutions, military educational institutions that were not part of the active army, in the period from June 22, 1941 to September 3, 1945 for at least six months, military personnel awarded orders or medals of the USSR for service in specified period;
persons awarded the badge “Resident of besieged Leningrad”;
family members of deceased (deceased) war invalids, participants in the Great Patriotic War and combat veterans;
disabled people and children with disabilities, citizens exposed to radiation and other categories of citizens.
The range of social services includes:
provision of necessary medications – medicines, medical products, specialized products therapeutic nutrition for disabled children;
providing a voucher for sanatorium treatment (SRT) for the prevention of major diseases;
free travel on suburban railway transport, as well as on intercity transport to and from the place of treatment.
From February 1, 2016, the cost of NSU is 995 rubles. 23 kopecks Distributed as follows:
provision of necessary medications – 766 rubles. 55 kopecks;
provision of a voucher for sanatorium-resort treatment – 118 rubles. 59 kopecks;
free travel on suburban railway transport, as well as on intercity transport to the place of treatment and back – 110 rubles. 09 kop.
If the beneficiary has already submitted an application to refuse to receive NSS in kind and intends to receive the cash equivalent in subsequent years, then there is no need to contact Pension Fund until the decision changes.
If a citizen wants to use the set of social services again from January 1 of the next year or the right to receive them has become available to him for the first time, then before October 1 he must submit an application to the Pension Fund.
It is important to note that the previous current legislation on medical care and treatment provided for the provision of vouchers for sanatorium and resort treatment to all employees of state enterprises in order to prevent and prevent general and occupational diseases, to maintain their normal physical activity and performance. However, the transition to market relations, with the emerging variety of types of enterprises various forms property, has radically reduced the possibility of providing this type of health care for employees.
Considering the existing problems of sanatorium and resort services in modern Russia, we come to the following conclusions:
1. The need for the formation of independent preventive direction in the form of Restorative Medicine (hereinafter referred to as RM) appeared in Russia against the backdrop of the emerging socio-economic crisis, which affected all spheres of society, including the healthcare system.
Factors such as:
A) failure to implement previously declared priorities preventive medicine;
B) the focus of existing legal, economic, social, medical health management institutions on the treatment of patients and rehabilitation of disabled people, but not on the prevention of disease;
C) lack of an integral infrastructure of preventive medical organizations and a system for training relevant specialists.
2. In the process of developing CM as a branch of medicine, gradually, based on the demands of practical healthcare and the need for the integration of various preventive technologies, the scope of competence of this new direction was expanded from restoring health in a healthy person to restoring essential functions organism at all stages of prevention.
Regenerative medicine is currently understood as a system of scientific knowledge and practical activities aimed at restoring a person’s functional reserves, reduced as a result of the adverse effects of environmental factors and activities, or as a result of illness - at the stage of recovery (remission).
3. Spa medicine is considered as an independent section of CM, with the goal of preserving, restoring health or medical rehabilitation of patients based on the use of healing natural factors. It is assumed that in the future, resort medicine should expand the scope of sanatorium and resort care - from restorative treatment of sick and disabled people to recreational activities.
Combining the concepts of restorative and spa medicine aims to emphasize their methodological unity and independent practical significance in such an important and personnel-intensive section of VM as spa medicine.
4. The amount of monetary payment established today in exchange for a voucher for sanatorium and resort treatment (in the amount of 118 rubles. 59 kopecks) is unreasonably low and cannot really compensate for the necessary treatment of a citizen.
5. It is necessary to expand the circle of people entitled to sanatorium-resort treatment by providing tax benefits to both organizations that provide their employees with vouchers and medical institutions who accept these workers for treatment.
Implementation in practice of all the listed development projects rehabilitation medicine, supported by a system of social, legal, economic, moral and ethical, cultural accents that affirm the priorities of preventive medicine will make it possible to take an important step towards creating a fundamentally new effective system management of population health dynamics. This system, built on a preventive principle, will require the participation of all state and public institutions of the country and will be able, under these conditions, to become the basis for the maintenance and development of domestic healthcare in the 21st century, in pursuance of the state strategy for protecting the health of the population of the Russian Federation for the period 2013-2020 and subsequent years.
Medical and social examination and social services disabled people. Official website of the Federal State Statistics Service.
2 Morbidity rate of the population by main classes of diseases in 200-2014. Official website of the Federal State Statistics Service.
3 Morbidity rate of the population by main classes of diseases in 1990-1998. Official website of the Federal State Statistics Service.
4Level of disability in Russia. Official website of the Federal State Statistics Service.
6 http://subsidii.net
7: http://www.soiuz.ru/
Literature and legal framework
1. Federal Law of November 29, 2010 No. 326-FZ “On Compulsory Medical Insurance in the Russian Federation” (as amended on July 3, 2016) // “Collection of Legislation of the Russian Federation,” December 6, 2010, No. 49, Art. 6422.
2. Federal Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” (as amended on July 3, 2016) // Rossiyskaya Gazeta, No. 263, November 23, 2011.
3. Order of the Ministry of Health and Social Development of Russia dated December 29, 2004 No. 328 (as amended on March 1, 2012) “On approval of the Procedure for providing a set of social services to certain categories of citizens” (Registered with the Ministry of Justice of Russia on February 7, 2005 No. 6303) // “Rossiyskaya Gazeta”, No. 31, 02/16/2005.
4. Order of the Ministry of Health of Russia dated December 10, 2013 No. 916n “On the list of types of high-tech medical care” (Registered with the Ministry of Justice of Russia on December 25, 2013 No. 30804) // “Rossiyskaya Gazeta” (special issue), No. 22/1, 02/03/2014.
5. Fundamentals of balneology, ed. V. A. Alexandrova, vol. 2, M., 1959 p.
6. Belyaninova Yu.V. Commentary on the Federal Law of July 17, 1999 No. 178-FZ “On State Social Assistance” (article-by-article) // SPS ConsultantPlus, 2009.
7. Social security law in Russia: textbook. / M.O. Buyanova, K.N. Gusov (and others); resp. ed. K.N. Gusov. - 4th ed., revised. and additional - Moscow: Prospekt, 2012. - 640 p.
8. Social security law: textbook. manual for universities / M.O. Buyanova (and others); edited by Yu.P. Orlovsky. - M.: Yurayt Publishing House, 2014. - 539 p.
9. Social security law: textbook/M.O. Buyanova, S.I. Kobzeva, Z.A. Kondratieva – Moscow: Knorus, 2017.
