4. Paying for services
Adequate funding for health is important to manage the excess demands on the health system. This section considers how countries are PAYING FOR COVID-19 SERVICES. Health financing describes how much is spent on health and the distribution of health spending across different service areas. The section also describes who is covered for COVID-19 testing and treatment, whether there are any notable gaps (in population coverage and service coverage), and how much people pay (if at all) for those services out-of-pocket.
4.1 Health financing
Since 21 March, the Russian Government has issued a series of financial decisions for the COVID-19 response, mostly allocations from the Federal Reserve Fund:
- 46.7 billion RUB for incentive payments (bonuses): 42 billion RUB to healthcare workers providing treatment, care and prevention to COVID-19 patients over April, May and June 2020 through regional authorities and 4.7 billion RUB to other professionals involved in anti-COVID-19 measures; increased by 3.6 billion RUB for social service workers (http://government.ru/news/39971/) and 7.5 billion RUB for medical workers in direct contact with patients to cover the period until 15 September
- The government will allocate almost 22 billion rubles more to support medical workers. More than 321 million rubles will be spent on payments to employees of the Federal Medical and Biological Agency centres. More than 1.8 billion rubles - to employees of social institutions: nursing homes, residential care homes for the disabled. To prevent the spread of coronavirus, employees are temporarily residing in these facilities and one work shift lasts 14 days (http://government.ru/news/40314/).
- 33 billion RUB for the operationalization of new hospital beds for COVID-19 patients, oxygen devices and PPE plus an additional 3.5 billion RUB for federal tertiary hospitals and 32.4 billion RUB allocated to regional budgets for the same purposes
- 15.8 billion RUB for federal educational, scientific and medical organizations to compensate their income decrease and the costs associated COVID-19 related measures
- 11,5 billion RUB for insurance payments to healthcare workers infected with COVID-19
- 10 billion RUB for production and purchase of equipment and products for diagnosis, detection, prevention and treatment of epidemic diseases, personal protective equipment, medicines and medical devices 7.5 billion RUB for the purchase of artificial lung ventilation systems and extracorporeal membrane oxygenation
- 8.8 billion RUB to the Ministry of Defence to build 16 infectious disease centres in 15 regions, followed by 1.9 million RUB for equipment and PPE
- 5 billion RUB for the purchase of thermovision display registrators, non-contact thermometers and air disinfection systems
- 5.2 billion RUB for the purchase of ambulances by the regions
- 4 billion RUB to the Institute for Virology “VECTOR”, to the Anti-Plague Research Institute, and to several Rospotrebnadzor labs to spur vaccine and drug development.
- 3.5 billion RUB to the Institute for Virology “VECTOR” for the production of COVID-19 PCR tests (36 million tests).
- 2.4 billion RUB to the Federal Penitentiary Service for the purchase of PPE and medical equipment
- 969 million RUB to co-finance the construction of the COVID19 hospital in Kola, Murmansk
- 640 million RUB for re-profiling healthcare facilities in monocities built around a single industry and closed cities of strategic importance.
- 160.5 million RUB for the fight against coronavirus infection in the Tuva region (https://tass.ru/sibir-news/8992883)
On 15 July, Deputy Prime Minister Golikova indicated that overall, 76 billion RUB had been allocated from the federal budget alone for reprofiling and equipping beds at the federal and regional levels (http://government.ru/news/40023/). Recipients (most often the regional authorities) must conclude an agreement with the Ministry of Finance on the use of these funds. These agreements include reporting forms, following usual practice. In addition, 300 billion RUB were transferred to regions for flexible use for COVID-19 related measures (see Section 6). SMEs and non-profit organizations received subsidies to cover the costs linked to the purchase of PPE.
Additional financing measures have been taken at regional or municipal level. For instance, on 27 May, the St Petersburg Government allocated 600 billion from the Municipal Governmental Reserve Fund for lump sum payments to injured medical workers (see Section 2.2)
According to the Federal Compulsory Health Insurance Fund, 22.3 billion RUB were spent in relation to the new coronavirus infection between March and May, and 40 billion RUB including the month of June according to preliminary estimates (http://government.ru/news/40023/).
In the 1st quarter of 2021, the Government will allocate 49 billion Rubles for special payments to healthcare workers who provide care to COVID-19 patients. 25 billion Rubles will be allocated to the regions for additional financing of hospitals and polyclinics (http://government.ru/news/41518/#rp348-r).
In 2021, the Government is allocating 2.7 billion Rubles for procurement of outpatient medicines for COVID-19 patients (http://static.government.ru/media/files/CkxbfyX4Cmum5zRG6emXbv0kLkuEwJJV.pdf).