Abstract: The object of the study is the compulsory medical insurance system in the Russian Federation. The subject is the reduction of idle money in the compulsory medical insurance system. The authors conducted a financial justification for assessing the scale of one of the idle turnovers associated with the counter movement of funds in the compulsory medical insurance system: when paying insurance premiums for compulsory medical insurance of persons employed in medical organizations and forming tariffs for the provision of medical services (the cost of which includes wages with accruals for payments for wages, the share of which in some cases exceeds 90%). Particular attention is paid to assessing the volume of financial support for the implementation of the author's recommendations, which has its own specific nuances in comparison with the financial mechanism for implementing the current practice of preferential tariffs for compulsory medical insurance.
The authors used the following set of research methods: deduction, structural and dynamic analysis, synthesis, comparison, graphical tools. Scientific novelty is associated with insufficient study in domestic and foreign scientific literature of issues related to reducing the number of idle speeds. It was revealed that in 2022, at least 64.89 billion rubles are accounted for by the payment of insurance premiums for compulsory medical insurance of employees of medical organizations (which is more than 2.4 billion rubles higher than in 2021). The implementation of the author's proposals will not require additional interbudgetary transfers from the federal budget. The results obtained will be useful for practical use in the activities of the Federal Assembly of the Russian Federation, the Government of Russia, the Ministry of Health of the Russian Federation, as well as medical organizations in the framework of making and implementing decisions on the modernization of the compulsory medical insurance system.

Abstract: The subject of the study is a comparison of funding sources for public health care in OECD countries. The authors consider in detail the sources of financial support for the implementation of state guarantees for the provision of free medical care to citizens: transfers from state internal revenues (primarily general taxes: mandatory payments that do not have a target link) and insurance premiums (mandatory payments with a specific target link). The authors grouped the OECD countries depending on the share of sources of financial support for the implementation of state guarantees for the provision of free medical care to citizens. Particular attention is paid to the advantages and disadvantages of insurance and budgetary financial mechanisms for financial support for the implementation of state guarantees for the provision of free medical care. The main conclusions based on the results of the study are as follows: in the modern world, issues of improving the healthcare system as one of the key factors in improving the quality of life of citizens are being actively raised; no matter how actively the budgetary financial mechanism is currently used in the country, its use by public authorities in OECD countries is constantly increasing; the use of the budgetary financial mechanism, despite the existing shortcomings, has a number of advantages compared to the insurance one (primarily, due to the smaller direct impact during periods of reduction in the number of employees and wages, as well as economies of scale in the administration of revenues in the form of general taxes compared to insurance contributions). The results obtained can be used in the practical activities of the Federal Assembly of the Russian Federation, the Government of Russia, the Federal Compulsory Medical Insurance Fund, as well as public authorities from other countries when modernizing the state policy in the field of healthcare.

Abstract: The subject of the study is the sources of financial support for state guarantees of free medical care to citizens in the Russian Federation. Particular attention is paid to the analysis of the composition and structure of the financial support of state guarantees of free medical care to citizens (including the volume of contributions received by the budget of the Federal Compulsory Medical Insurance Fund for working citizens and for non-working citizens). The authors also assessed the potential volume of MHIF budget revenues from the payment of insurance premiums and compared the results obtained with actual data. Research methods used: structural and dynamic analysis, synthesis, comparison, as well as graphical presentation of the results obtained.
Based on the results of the study, it was revealed that contributions for the non-working population are paid from regional budgets. Taken together with the use of funds from the federal budget for the implementation of the program of state guarantees for the provision of free medical care to citizens, this allows us to conclude that the budgetary financial mechanism is predominantly used in financial support for the implementation of state guarantees of free medical care to citizens in Russia. In order to maximize the volume of funds for solving problems in the field of healthcare, as well as ensuring their more efficient use, the authors propose expanding the list of objects subject to insurance premiums, as well as a more reasonable approach to establishing various preferential regimes that reduce the volume of budget revenues of the Federal Compulsory Health Insurance Fund. The author’s calculations showed that the actual revenues of the MHIF budget are approximately half of the potential ones.