Healthcare financing to achieve 78 years of life expectancy in Russia by 2030

Abstract

The article analyzes the dynamics of life expectancy (LE) in the Russian Federation over the past 40 years (from 1980 to 2020), the actual and projected Government spending on health care (2012-2024), identifies the conditions under which it is possible to achieve the national goal set in the Decree of the President of the Russian Federation of July 21, 2020 No. 474, to increase the life expectancy from 71.5 years in 2020 to 78 years by 2030. It is shown that in the Russian Federation from 1980 to 2019 life expectancy increased by only 5.6 years, and in 2019 it was 4.6 years lower than in the "new-8" EU countries, which are close to our country in terms of economic development, and 8.7 years lower than in the "old" EU countries. Government spending on health increased by only 33% in constant prices from 2012 to 2020, while it decreased by 4% from 2012 to 2018. The increase was provided in 2019 and 2020 due to the funds allocated additionally for the renewal of health infrastructure and fighting the pandemic. In the "new-8" EU countries, government spending on health care was 1.5 times higher, and in the "old" EU countries — 2.3 times more than in the Russian Federation. It has been established that in the Russian Federation, in order to achieve life expectancy of 78 years by 2030, it is necessary that the government spending on health care should grow by 8% annually at constant prices. These calculations are valid only if the following basic conditions are met: GDP per capita growth by 3.5-3.8% in the period 2021-2030, as well as decrease by 2030 in the consumption of strong alcoholic beverages by 45% per capita (without additional funds for fighting pandemic). This level of funding corresponds to 6.5 trillion rubles or 4.3% of GDP by2024. According to the projected public health expenditure for 2022-2024, these funds are not included in the budget. Thus, it will be impossible to solve the most acute problems of the health care system of the Russian Federation: to increase wages and eliminate the shortage of medical personnel, create a system of universal drug provision on an outpatient basis, increase the volume of free medical care, and, as a result, achieve the National Ggoal of increasing life expectancy.

Healthcare in Russia: Macroeconomic Parameters and Structural Issues

“…Meanwhile, the Russian healthcare system has for the past several years been underfinanced in comparison to OECD countries and especially to advanced economies, which many experts have indicated as one of the reasons for the country’s underperformance in terms of qualitative indicators of public health: mortality rate, life expectancy, morbidity, etc. [ 1 ]. However, the pandemic has shown that the state of a country’s healthcare system and its ability to respond to crises and shocks are not exclusively determined by the volume of allocated financial resources, but also affected by the level of availability of highly qualified personnel, high-end equipment, medicine, and a developed research base [ 2 ].…”