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On November 26, 2013, the expert roundtable “Future of Medical Insurance” was held in the Russian Presidential Academy of National Economy and Public Administration based on the regular interactive discussion platform “Viable Healthcare”. The discussion was dedicated to the urgent problems of the compulsory medical insurance and optimal solutions for these problems.

The participants of the event were Nelli Naigovzina, Deputy Chief of the Government Staff of the Russian Federation, Airat Farrakhov, Deputy Minister of Health of the Russian Federation, Ildar Fatikhov, Deputy Minister of Health of the Republic of Tatarstan, Svetlana Kravchuk, Chief of Department of the Compulsory Medical Insurance Organization of the Federal Fund of Compulsory Medical Insurance, Dmitry Kuznetsov, President of the Interregional Union of Medical Insurers (IUME), Vadim Vlasov, President of Novartis Group Russia, Irina Dorokhova, Director Government Affairs for Russia, Central and Eastern Europe at Johnson & Johnson, as well as representatives of field-specific federal agencies, heads of medical and educational institutions and the leading experts in the fields of public health and insurance.

The moderators of the roundtable “Future of Medical Insurance” were Vladimir Starodubov, Vice President of the Russian Academy of Medical Sciences and Vladimir Nazarov, Director of the Federal State Government-Financed Institution Research Financial Institute (RFI).

The event was opened by the Deputy Minister of Health of the Russian Federation Airat Farrakhov. In his speech, he stressed the relevance of the event agenda and the need to develop solutions aimed at improving the compulsory medical insurance system with the assistance of the expert community, "In 2014 there will be major changes not only in shares and funding of the compulsory medical insurance system, but in methods of treatment through the compulsory medical insurance system as well, and it means that a lot of organizational issues be addressed taking into account the adopted strategy."

In his speech, Vladimir Nazarov emphasized the significance of the new architecture of the compulsory medical insurance. There is an opinion that the system of compulsory medical insurance does not justify itself, as the insurance intermediaries absorb budget money and this reporting system is the only useful part of the compulsory medical insurance. Some claim that the quality compulsory medical insurance system has not been yet created and does not meet the existing demands. Insurance companies are not aware of the risks and cannot manage them. These issues, which are relevant for both the country's leaders and the Open Government, must be clarified and dealt with.

Addressing the discussion participants, Vladimir Starodubov drew the attention to the necessity to look for alternative approaches and the importance of taking into account the already existing experience of compulsory medical insurance system work.

Within the framework of the discussion, the President of the Interregional Union of Medical Insurers (IUME) Dmitry Kuznetsov, presented a report and suggested practical solutions for enhancing compulsory and optional medical insurance systems. In his report, Christopher Davis, Head of the Laboratory of Economics of Healthcare Reform of the Social Analysis and Forecasting Institute at RANEPA, shared foreign experience in compulsory medical insurance systems reforms. In particular, he stressed that both the model and implementation approach are the key factors of the successful implementation of the compulsory medical insurance system.

Discussing the international practice, the roundtable participants remarked that still there are no examples of successful implementation of the “risk” insurance system and that it is necessary to take into account the implementation experience of such problems in Germany and the Netherlands.

Anna Fedorova, Representative of A.T. Kearney in Russia, spoke about the prospects of introducing drug insurance system based on international experience. "It is necessary to keep the opportunity to choose between compulsory and optional medical insurance: for Russia, the best possible variant would be to maintain the compulsory drug insurance for the entire population," said the expert. According to Svetlana Kravchuk, Chief of Department of the Compulsory Medical Insurance Organization Federal Fund of Compulsory Medical Insurance, the cost of development and implementation of the compulsory drug insurance system will amount to 120 billion rubles.

"We have a pretty chaotic market: over 20,000 drugs are registered and there is no mechanism for withdrawing ineffective drugs. In these circumstances and given the risks, substantial funding is needed, but it requires careful assessment," noted Nelli Naigovzina, Deputy Chief of the Government Staff of the Russian Federation, in her speech.

Irina Dorokhova, Director Government Affairs for Russia, Central and Eastern Europe at Johnson & Johnson, gave a report on investments in medical innovations as economy development factor. She also said that this year, within the framework of the B20 working group on innovations, a group on biotechnologies has been formed. In addition, the speaker noted that healthcare has become a priority for G8.

The key takeaways of the roundtable will be sent by the moderators as proposals to the field-oriented federal executive and legislative agencies.