Mandatory Medical Insurance (OMS)
In June 1991 the law On Medical Insurance of the Citizens of the Russian Federation
was adopted. The changes concerning healthcare financing were as follows:
- the enterprises transfer insurance premiums for mandatory medical insurance of
active population; the premiums have tax character;
- insurance premiums for mandatory medical insurance of non-active population
are paid by the state control bodies at the expense of budgetary resources;
- the volume and conditions of free medical assistance within the framework of
OMS are defined in the base OMS program confirmed by the government, and in
regional OMS programs adopted by regional authorities and corresponding to the base
program; the volume of insurance premiums are established in accordance with the
adopted OMS programs;
- besides mandatory insurance, voluntary medical insurance (DMS) at the
expense of resources belonging to enterprises and private resources of the population
can also take place.
The insurance health model stipulated radical innovations. New entities - private
insurance medical agencies appeared within the framework of the healthcare system.
The enterprises and state control bodies which act as insurers must sign contracts with
insurance agencies which, in their turn, select medical institutions and pay for
preventive and general treatment rendered to the insured persons. The new model
stipulated that new financial institutions should appear within the framework of the
branch. These institutions accumulate budgetary and non-budgetary resources and
have a legal right to effect transactions involving these resources.
Since the second half of 1993 the enterprises and institutions were obliged to transfer
insurance premiums for medical insurance of their workers equal 3.6% of their payroll
funds. Since 2009 it is 3.1%. These resources started to be accumulated on the
accounts of regional and federal OMS Funds. However according to the prime-minister
Vladimir Putin the Government plans to increase the insurance premiums from 3,1% to
5.1%. This will provide extra 460 billion RUB to the OMS budget. The government is
also planning to give all citizens a possibility to choose insurance company themselves
not via an employer.
The Table N2 Financing of Healthcare services in Russia (based on the Healthcare
Development Concept of the Russian Federation until 2020) illustrates the main bodies
involved and their relationships. A key feature of the new financing system is the
establishment of a federal mandatory medical insurance fund (Federal OMS Fund) and
territorial OMS Funds (one in each subject of the Federation) at the regional level