Social Policy of the state in the healthcare system: the revival of the Semashko Model

The relevance of the study is due to the growing positive interest in the Semashko model in modern Russia from the “medical” and “historical” parts of the scientific community, medical specialists, the population of Russia and the state. The article uses general documents, speech by top public officials, official statistics. The overthrow of the Semashko model in early post-Soviet Russia was due to public demand for market-oriented models, epidemiological transit. However, new circumstances (a new public demand for socially oriented models, a new epidemiological wave, as well as a permanent shortage of personnel and underfunding) forced the state to turn again to the experience of the Semashko model. A new epidemiological wave has raised questions: on the return to the centralization of management and financing and on the re-optimization of epidemiological resources. The official authorities proposed to centralize the management of the sanitary and epidemiological service and the means of compulsory health insurance (CHI) in the budget of the Federal Health Insurance Fund. It is also planned to expand the epidemiological base through the construction of new hospitals, increase the staff of epidemiologists and infectious diseases doctors.

1. Artemenko D. A., Sokolov A. A. Transformation of public health in Russia: balance analysis. Finansy i kredit=Finance and Credit. 2017;(42):2498–2510. (In Russ.). DOI: 10.2489/fc.23.42.2498

2. Tikhomirov A. V. Branch organization of healthcare. Glavnyi vrach: khozyaistvo i pravo = Chief Physician: Economy and law. 2010;(5):17–25. (In Russ.).

3. Tragakes E., Lessof S. Health care systems in transition: Russian Federation. Copenhagen: European Observatory on Health Systems and Policies; 2003. 212 p.

4. Rockmore T. Marx After Marxism. The Philosophy of Karl Marx. Oxford; Malden, MA; 2002. 224 p.

5. Trefilova O. A. Nikolai Semashko — social activist and health care organizer. Istoriya meditsiny = History of medicine. 2014;(3):65–72. (In Russ.).

6. Korotkova M. N. The state policy in the sphere of healthcare: the problem of staff shortage. Politika i Obshchestvo = Politics and Society. 2016;(7):1008–1017. (In Russ.). DOI: 10.7256/1812–8696.2016.7.19626

7. Sokolov A. A. The analysis of international practice of modernization of national Health systems. Nauchnyi Vestnik Yuzhnogo instituta menedzhmenta=Scientific Bulletin of the Southern Institute of Management. 2017;(2):96–103. (In Russ.).

8. Arsentyev E. V., Reshetnikov V. A. To the biography of N. A. Semashko: on the work of the first People’s Commissar of Health in 1920–1925. Istoriya meditsiny = History of Medicine. 2018;(3):217–229. (In Russ.). DOI: 10.3897/hmj.5.3.32480

9. Skvirskaya G. P., Volnuhin A. V. Basic directions of improving scientific, educational, and practical activities in the field of public health and health management in modern conditions in the Russian Federation. Sovremennye problemy zdravookhraneniya i meditsinskoi statistiki = Current problems of health care and medical statistics. 2020;(2):348–366. (In Russ.). DOI: 10.24411/2312–2935–2020–00051

10. Popovich L., Potapchik E., Shishkin S., Richardson E., Vacroux A., and Mathivet B. Russian Federation: Health system review. Health Systems in Transition, 2011;13(7):1–190.

11. Sheiman I., Shishkin S., Shevsky V. The evolving Semashko model of primary health care: the case of the Russian Federation. Risk Management and Healthcare Policy. 2018;(11):209–220. DOI: 10.2147/RMHP.S 168399

12. Arsentyev E.V., Reshetnikov V. A. To the biography of N. A. Semashko. Istoriya meditsiny = History of Medicine. 2017;4(4):447–460. (In Russ.). DOI: 10.17720/2409–5583.t4.4.2017.09i

13. Kurakova N.G., Son I.M., Petrov A.N. The transition to a model of personalized medicine: barriers and possible solutions. Manager Zdravoochranenia = Health Care Manager. 2017;(8):53–67. (In Russ.).

14. Kuzenkova N. N. To withstand competition and maintain the availability of medical care. Moskovskaya meditsina = Moscow medicine. 2017;(5):20–22. (In Russ.).

15. Buranbaeva L. Z., Yakshimbetova G. I. Socio-economic priorities of per capita financing of healthcare. Vestnik BIST (Bashkirskogo Instituta Sotsial’nykh Tekhnologii) = Bulletin of BIST (Bashkir Institute of Social Technologies). 2017;(4):70–75. (In Russ.).

16. Sheiman I. Rocky road from the Semashko to a new health model. Bull World Health Organ. 2013;(91):320–321.

17. Egorysheva I.V. The role of the Russian Federaion Health Care People’s Commissariat in the development of rural services in 1920–1929. Byulleten’ natsional’nogo nauchno-issledovatel’skogo instituta obshchestvennogo zdorov’ya im. N. A. Semashko = Bulletin of Semashko National Research Institute of Public Health. 2017;(1):89–91. (In Russ.).

18. Shishkin S.V., Sheiman I. M., Potapchik E. G., Ponkratova O. F. Analysis of the state of insurance medicine in Russia and prospects for its development. Moscow; 2019. 100 p. (In Russ.).

19. Ulumbekova G. E. Healthcare of Russia: 2018–2024. What to Do? Moscow; 2019. 416 p. (In Russ.).

20. Starodubov V.I., Kadyrov F. N., Obukhova O.V., Bazarova I. N., Endovitskaya Yu.V., Nesvetailo N. Ya. The impact of the COVID-19 coronavirus on the situation in Russian healthcare. URL: https://mednet.ru/images/materials/news/doklad_cniioiz_po_COVID-19–2020_04_26.pdf. (In Russ.).