Be treated by law
They waited for him for a long time, they discussed vigorously, a lot of amendments were made, the only thing that united everyone was the long-overdue need for a radical renewal of our medicine.
A particularly painful discussion touched upon “paid medical services”. So will medical care be affordable, high-quality and free, as the Constitution promises us? Representatives of the Ministry of Health assure that now medical services will only become more affordable. But this is all in theory, but what will happen in practice?
Paid and free services
The following types of medical care are available to us for free: * PRIMARY (pre-medical, medical and specialized);* SPECIALIZED, including high-tech;* FAST (EMERGENCY)including specialized brigades;* PALLIATIVE (help to hopelessly sick people). So, having attached to a particular clinic, you are served there for free, and all types of examinations, including high-tech, such as MRI and computed tomography, are also free of charge. But only in the presence of medical indications and the appropriate doctor's prescription. If a person ends up in a hospital, they should provide him with free procedures, medicines, dressings and, if necessary, deliver him to another clinic for diagnosis and treatment. All consumables and medical nutrition are also laid absolutely free - as part of the testimony and in accordance with honey. standards. Here are just medicines will cost us free if they are included in the federal list of vital and most important. In order to receive free medicine outside of this list, indications alone are not enough, a certain persistence of the patient is needed. Parents of sick children up to 4 years of age have to be hospitalized and have free meals. The fact of hospitalization of the baby implies free hospitalization of the mother. And even if the child is older than 4 years old, but he needs a complicated operation and needs individual care, then the mother is also required to provide a place next to him on the basis of the recommendation of the attending physician. This rule is valid until the child reaches the age of 18. If you refuse to do this, contact the insurance company or the health department.
If you are dissatisfied with the quality of medical care, you have the right to file a complaint with an insurance company or health department
PAID MEDICAL HELP
Now it is fixed at the official level in state medical institutions. For example, if you need to see a specialist in a district clinic (and they are usually not enough) or need some types of examinations (and with the availability of working equipment problems), sign up in a queue, the length of which depends on the capabilities of the medical institution. If you want to be examined quickly, you have to pay. You need to get to a specific medical center or hospital, and there is a turn for six months? Pay, and they will immediately accept you. Actual legalization of paid services takes place, which contradicts Article 41 of the Constitution of the Russian Federation, which guarantees free medical care in state and municipal medical institutions. It turns out that skeptics who assure us that treatment has always been paid, and now especially, are right, sadly enough.
Health Care Standards
The whole civilized world has long been treated for them, and our Ministry of Health has developed uniform standards for the treatment and diagnosis of various diseases for all regions of Russia. But if earlier they were only of a recommendatory nature, now, according to the new law, they have become mandatory. Each standard has clear indications of the number of recommended studies and analyzes for a particular typical case, methods of treatment and its duration. So far, there are only 500 of them, and this is clearly not enough, but this is already good. We, potential patients, need to remember that doctors are obliged to treat on the basis of standards, and if we are not satisfied with the quality of medical care, we have every right to information. That is, the doctor at your request is required to show the standard appropriate to your disease. And you have the right to find out why you were not assigned the necessary tests, studies, etc. This has a good stimulating effect on the medical staff, especially if you back up the request with a promise to file a complaint with the insurance company. You will find the coordinates of the insurance company on the back of your MHI policy.
The choice of a clinic or doctor
This can be done only once a year, and the choice itself requires reciprocity - that is, the consent of the chief and attending physicians. There is a risk that for his own peace of mind, the doctor can afford to choose young and more healthy patients. And if people come with a "bouquet" of diseases, where is the guarantee that they will be satisfied with the treatment and will not write complaints to the doctor, despite the fact that the clinic will be "expensive"? But you can only attach to one medical institution, which must work without fail in the system of compulsory medical insurance (compulsory health insurance). Moreover, the place of registration does not matter. How to choose a clinic? The best option is recommendations and reviews of friends and acquaintances. You can also go to the clinic’s website (if available) or go there and look around yourself. If the contact with the doctor has not worked out, you can change it: for this, a statement is written to the head doctor of the clinic, in which you indicate the reason for your dissatisfaction. In case of refusal, you have the right to contact a higher healthcare institution (Department of Health and the Department of Health) or an insurance company. And note: even if the patient is in critical condition in an ambulance, he has the right to choose a hospital.
Rights and obligations of patients and doctors
If everything remains the same with the former, then the doctor will now be obligated to read his rights to the patient. And in the future, from 2015, the doctor will be required to have not only a diploma of higher medical education, but also a certificate of accreditation, which must be passed at least once every 5 years. And private clinics are now not allowed to procure donor blood and its components, transplant organs and tissues, conduct biomedical studies in humans, sanitary and epidemiological activities, or terminate pregnancy for more than 12 weeks.
Guzel ULUMBEKOVA, Executive Director of the Association of Medical Societies for Quality (ASMOK):
Can something change for us in connection with the adoption of the new health law? Unfortunately, very little - the volume of free aid will remain at the same level. This is due to the fact that the law does not provide for an increase in the cost of free medicine. Of course, it should be noted that under the law, all types of medical care should be provided to our citizens free of charge, including assistance for terminally ill patients, and rehabilitation, and spa treatment. True, these types of assistance should be provided by the regions at the expense of budgets, and most of them are scarce. Today, free medicine in our country needs to be allocated at least 1.6 times more.Next, it is necessary to eliminate the shortage of medical personnel. We do not have enough doctors in polyclinics, a huge shortage of personnel in the countryside. And there is only one way to solve this problem - to raise the salaries of medical workers.It is important to provide continuing education for doctorsMoreover, they should be trained for free, using distance technologies and annual monitoring.And finally, preventionwhich should be systematically addressed. This is, firstly, a healthy lifestyle, for which we are responsible. Secondly, medical prevention and early detection of diseases, and this is the area of responsibility of doctors, with our active participation.
Alexey STARCHENKO, Doctor of Medicine, Professor, Co-Chair of the Expertise Committee of the National Medical Chamber, member of the Public Council for the Protection of Patients' Rights under Roszdravnadzor:
* About health insurance
The recently adopted law on compulsory health insurance establishes the patient's obligation to present a policy when providing medical care, which, of course, forces us to always carry it with us. At the same time, patients received the right to choose their own insurance company. All policies that are in the hands of the population continue to operate this year - even if it is written that their action ended on December 31 of last year. If a medical institution is denied medical care for this policy or is required to change it, this is a gross violation of the law. Before choosing an insurance company, look at sites, reviews, call there - do you speak politely? Talk to an expert insurance company doctor.
* About extortion
Claims from the patient for surgery, medication, anesthesia, materials for the surgical dressing unit are absolutely illegal; for this, the MHI fund allocates funds. And if it comes to emergency operations and you have been asked to pay it directly or indirectly, write a complaint to the insurance company and the prosecutor's office. Demand a fine from the hospital for the collection of funds, for limiting the availability of medical care, and also demand a refund.
* On the right to treatment in large federal medical centers
In order to get there, you need to get a referral to the clinic, if they do not give it, complain to the insurance company. If a representative of the insurance company, having examined your medical card, is convinced that you really need a specialist consultation, you should receive a referral. By the way, all federal medical institutions and all expensive high-tech medical care should enter the compulsory medical insurance system after 2013, as the former minister promised.
* About ambulance and emergency care
The provision on the provision of medical care states that prior to the elimination of a life-threatening condition, the provision of medical care is completely free. Regardless of citizenship, address and availability of documents. And almost all medical operations, except for aesthetic surgery, are usually included in the compulsory medical insurance system. The exceptions are operations for tuberculosis, some operations related to IVF, and invasive (traumatic) interventions in cardiac surgery, which are carried out at the expense of the budget on the so-called quotas received in ministries of health in all regions of Russia.
* About obstetric care
The patient herself chooses the maternity hospital, focusing on her own collection of information. MHI insurance includes everything except individual birth management under a special, paid contract. Our Public Council strongly opposes any collection of funds in the field of obstetric care.
WHAT TO DO, IF…
1 ... you are being taken to the wrong hospital where you would like to go. In the presence of doctors, call the ambulance station and demand a complaint about the actions of the brigade; telephone conversations are recorded at the joint venture station. To rewrite F. I. O. of the ambulance crew, in writing to refuse hospitalization in the proposed medical facility, motivating their refusal.
2 ... an ambulance arrives without funds (medicines) required by the brigade, and you are being hinted at paying. * Inform the brigade that, in accordance with the new law, ambulance is free, therefore payment requirements are illegal. * Before the brigade arrives, set up the voice recorder and mobile phone camera so that the entire visit can be recorded. * In the presence of the team of doctors, call the station " ambulance ”and demand acceptance of the complaint against the actions of the brigade.
3 ... you are obliged to come for examination or treatment with your materials. Call the insurance medical company, the phone number is indicated on the compulsory medical insurance policy. The expert of the insurance company should understand and advise on the legality or illegality of the payment. Checks - cash and merchandise - do not throw away the purchased medicines and medical devices, but make copies and send them with a complaint to the insurance company with a demand for a refund.
4 ... your rights have been violated in a polyclinic, hospital or sanatorium. Call the insurance company and the local health insurance fund.