The health insurance system in Russia is part of the structure according to which citizens receive government services. Within the framework of a market-oriented economy, this industry has undergone many changes. 
History of health insurance in Russia
The first partnership that dealt with this problem was opened in St. Petersburg in 1827. In general, the development of health insurance in Russia has gone through several stages:
- From March 1861 to June 1903. During this period, important regulations were adopted. In particular, in 1861, elements of compulsory insurance were introduced on a legislative basis. The year 1866 was marked by the adoption of the Regulation, which provided for the establishment of hospitals at factories.
- From June 1903 to June 1912. During this period, one of the most important Laws was adopted. He established compensation payments to citizens, employees and workers, as well as their families, injured in accidents at the enterprises of the mining, mining and factory industries.
- From June 1912 to July 1917. At the beginning of this period, the social sphere of the country was significantly updated. The State Duma put a lot of effort into this. So, in 1912, on June 23, a law was passed regulating workers' insurance in case of accidents or illness. In December of the same year, a Council was created to deal with this issue. In 1913, Presences for insurance affairs were opened in St. Petersburg and Moscow. Since July this year, sickness funds have been formed in many areas of the country. In January 1914, partnerships began to appear on the issues of providing compensation to workers in accidents. In accordance with the Law of 1912, at the expense of the entrepreneur, hospital assistance was provided in 4 forms:
- Obstetric care.
- First aid in case of accident and sudden illness.
- Ambulatory treatment.
- Stay in a hospital with full content.
4. From July to October 1917. After the February Revolution, power passed into the hands of the Provisional Government. His first actions were reforms in the insurance industry. On July 25, a special Regulation was approved. In accordance with it, the circle of insured was expanded. However, it did not cover all working categories.
5. From October 1917 to November 1921. The Soviet government began its activities in the field of medical insurance with the adoption of the Declaration of the People's Commissar of Labor. Further, on December 31, 1918, the Decree was approved. It regulated the provision of social security for workers. In February 1919, Lenin signed the Decree, according to which all the medical power of the former cash registers was transferred to the People's Commissar of Health.
6. From November 1921 to 1929. During this period, new regulations were adopted governing health insurance.
Only with the adoption of the Law on Insurance in 1991 can we talk about a qualitatively new stage in the development of the system. After its approval, this normative act has undergone several changes and additions. In accordance with it, medical insurance in Russia acts as a form of protecting the interests of citizens in the field of health care. 
Government Security: General Information
In the international practice of organizing medical services for the population, certain economic directions of the functioning of health care have formed:
- State.
- Private
- Insurance.
In the framework of public services, direct financing of health care organizations is provided. Due to this, the population receives free medical care. Private service provided individually by practitioners. Their activities are ensured by charging patients. Medical social insurance in Russia is based on the principle of participation of entrepreneurs, enterprises and citizens in direct financing of health care or through authorized organizations. The aim of the latter direction is to provide assistance to citizens in case of accidents due to accumulations. Along with this, in the framework of this sphere, financing of preventive measures is carried out.
general characteristics
Health insurance in Russia is more appropriate to consider from two sides. In a broad sense, it is a special public health structure, which is financed from special organizations. The Russian Health Insurance Fund is formed from various sources of income. The main ones are contributions from enterprises, workers and entrepreneurs, as well as state budget funds. In a narrow sense, medical insurance in Russia is the direct flow of resources and their subsequent expenditure on the provision of medical and preventive care. Its nature and scope are established in accordance with the contract.
Compulsory health insurance in Russia
In the framework of this area, all citizens of the country acquire equal opportunities in obtaining medicinal, medical and preventive care. Its volumes and terms of provision are established by relevant state programs. Compulsory health insurance in Russia is regulated by the Federal Law. It is an element of public policy. The development of the basic compulsory medical insurance program is carried out by the Ministry of Health. It is agreed with the Ministry of Finance and the Federal Insurance Fund. After that, it is approved by the Government. The basic program includes primary medical and sanitary care, rehabilitation and inpatient treatment. The implementation of these measures is carried out on the basis of agreements concluded between the subjects of compulsory medical insurance. They are:
- Medical institution.
- The insured.
- Citizen.
- Insurance company.
Principal subjects
The following are insured:
- For unemployed citizens - government bodies of oblasts, territories, autonomous okrugs, St. Petersburg and Moscow, the local administration.
- For the working population - organizations, institutions, enterprises, persons engaged in entrepreneurial activity and having free professions.
Health insurance in Russia is provided by authorized organizations. They are legal entities that have state permission to conduct this activity. The Compulsory Medical Insurance Fund of Russia finances the programs adopted by the Government to provide the population with health services. The duties, tasks, rights and functions of authorized organizations are determined by the relevant Regulation. It is approved by the Government. 
Tasks of organizations
Legal entities providing medical insurance in Russia do the following:
- Settlements and payment for services of medical institutions.
- The implementation of direct control over the quality and volume of services.
- Protecting the interests and rights of their customers.
- Providing accounting and issuing insurance policies.
Work principles
The interaction between customers and the organization is through contributions. They are set as payment rates in amounts that cover the cost of implementation insurance programs and ensure the profitability of QS.The legal basis for the provision of services is the contract. It is concluded between insurance entities and reflects their duties, rights and responsibilities. The client gets the opportunity to choose an independent organization that will ensure his interests in obtaining assistance.
Policy
It is issued to each person who has concluded an insurance contract. It operates throughout the state MHI policy single sample. This document guarantees the provision of medical care. If for some reason a person cannot personally obtain a policy, he can entrust this to someone by proxy. In case of loss of a document, a duplicate is issued free of charge. As insurance object there is a risk associated with the costs of diagnostic and treatment procedures in the event of an accident. 
Additional program
On the territory of the country also operates voluntary medical insurance. In Russia, citizens have the opportunity to partially or fully compensate for the cost of services in addition to compulsory medical insurance. For services, a contract is also concluded. Voluntary health insurance in Russia allows you to choose one of the following coverage options:
- Medical procedures, diagnostics, doctor's appointments.
- Help at home.
- Dentistry
- Emergency help.
Organization Choice
When selecting an insurance company, experts recommend giving preference to those that hold stable positions in several categories of services provided. This suggests that the company has a balanced package of risks, which, in turn, means that it will be more resistant to various external economic influences.
Important points
When organizing voluntary insurance, you must pay attention to the following:
- The list of specialists and the presence / absence of restrictions on visits may vary. It depends on the chosen medical institution and the scope of the program itself.
- Dentistry is usually offered without prosthetics and cosmetology.
- Diagnostic procedures that are possible under the terms of the contract may be different. For example, a laboratory test may also contain a number of immunological, microbiological or hormonal tests.
- Emergency care is usually provided within the community.
The options above can be purchased in combination. The first option will be the "clinic" as a basic element (medical examinations, diagnostics, treatment). The cost of the policy will depend on the number of selected items and on the level of the hospital. 
Modern realities
To date, the problems of medical insurance in Russia, which need to be addressed, are quite clearly outlined. In particular, the following difficulties can be called:
- Political. Today, there is an intention to carry out the reform of the insurance system in the country. It is expressed in the annual messages of the Head of State to the Federal Assembly. However, there is no political solution to the question.
- Economic. Although the financing system existing within the framework of the programs provides for insurance for unemployed citizens, it does not determine the mechanism of this provision.
- Organizational. The formed infrastructure, different in the subjects and under the strict control of the executive bodies, does not have the ability to actually fulfill the full functional purpose in accordance with the law.
- Social. Medical insurance has no support either from doctors or from, in fact, citizens.
- Terminological. At the moment, there is confusion in concepts. Many terms were launched into circulation, distorting the idea of not only the essence of programs, but also their principles.
- Informational. There is still no provision for adequate information on the transition to insurance.Quite often, very superficial judgments on this issue appear in the media, and their authors are often not quite well-trained professional people.
