Introduction. Many developed countries have recognized the social sphere, including healthcare, as a full-fledged manufacturing sector of the economy, creating a significant share of value added in the sectoral structure of GDP. As part of the study, a comparison was made of the share of gross value added in the GDP of the United States, EU countries and Russia created by healthcare in 2018, as an example of the analysis of the impact of healthcare in different countries on gross value added, which is a significant indicator for assessing the correctness of the organization of healthcare financing.Material and methods. Used a comprehensive, statistical, comparative and retrospective analysis of available data.Research results. The data obtained indicate that the share of Russia's GDP created by healthcare is many times less than that of the United States and EU countries, which limits the growth of the Russian economy, causes poverty for a significant part of medical workers and hinders investment in the healthcare system and its demand for innovation.Discussion and conclusion. The authors see the root cause of the problems in the mistake of choosing the mandatory health insurance income system, the linkage of which to formal employment in a largescale shadow economy leads to the “free rider problem” (Free-Rider Problem) and a pronounced payment imbalance between providers and consumers of public health care due to its payment at deliberately unprofitable (below actual cost) tariffs. The most optimal solution is considered to be the replacement of salary-linked compulsory medical insurance contributions with a universal targeted tax for automated payment transactions.
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The subject of the research is the models of collection and consolidation (pooling) of resources for payment of public (free at the place of delivery) medical care to the population in developed countries and in the Russian Federation. The purpose of the study is to develop practical recommendations on the development of a system for financing medical guarantees for the population of the Russian Federation. The relevance of the study is due to the lack of resources to pay for public health care for the entire population in our country. The scientific novelty lies in the comparison of single-channel and multichannel pooling models used by developed countries in terms of their financial-economic and medico-social efficiency with the conclusion about a higher level of costs of the multichannel model with a comparable level of coverage with medical services of the population and indicators of its health compared to the model single payer. The research methodology is based on the use of complex, statistical, comparative and retrospective analyzes. It was concluded that the use of a multichannel pooling model in the financing of healthcare in the Russian Federation with the participation of competing insurers and the use of different channels of budgetary financing for different groups of the population is an important reason for the low efficiency of the Russian healthcare system. The prospect of further research is in the formation of a scientific and methodological justification for replacing the multichannel pooling model, which has historically developed in healthcare in Russia, with a single-channel model of a single payer represented by the Federal Compulsory Medical Insurance Fund (hereinafter- CMIF).