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In 2018, there will be another increase in the salaries of doctors, which will ensure the implementation of the May presidential decrees. Officials note that next year’s budget provides resources for indexing the salaries of medical staff. However, experts believe that imbalances current system compulsory insurance, may jeopardize the implementation of the authorities’ ambitious plans.

In 2018, the goals set out in the May decrees will be achieved. In particular, the salary of medical staff will reach the target level, representatives of the Compulsory Medical Insurance Fund emphasize. As a result, the authorities plan to achieve the following ratio:

1. Doctors' salaries should be twice the regional average.
2. The remuneration of junior and mid-level medical staff should correspond to the average salary in the region.

The budget for next year provides for MHIF revenues at the level of 1.89 trillion rubles. At the same time, the fund’s expenses will exceed 1.99 trillion. In such conditions, the targeted increase in medical salaries in 2018 is under threat, the Accounts Chamber warns. In addition to the planned deficit, the fund's real expenses will be higher by 43.1 billion rubles, which will call into question the future indexation of income.

IN this year The government implemented two stages of indexation of doctors’ salaries:

• by 7.5% at the beginning of the year;
• up to 180% of the regional average from October 1 (for middle and junior medical staff this figure should be 90% and 80%, respectively).

Previously, representatives of the Ministry of Health noted structural problems of the current insurance system, which could interfere with the targeted increase in the salaries of doctors from January 1, 2018.

Finding the necessary resources

The government planned to attract resources for the planned increase in wages for health workers from three sources:

1. MHIF funds (including support from the federal budget).
2. Regional finance.
3. Internal optimization (staff reduction, sale of property, etc.).

The revenue portion of the Compulsory Medical Insurance Fund is generated from insurance premiums, the Ministry of Health emphasizes. At the same time, fund representatives are quite optimistic about future income, which may not correspond to economic realities. According to Rosstat, this year the income of doctors in the public sector continues to lag behind the average (especially for junior medical workers).

Table of salaries for doctors in 2013-2017, which calls into question the fulfillment of targets for 2018:

The Ministry of Health warns that compliance with the established standards will increase the MHIF budget deficit by 95 billion in 2019 and 170 billion in 2020. HSE representative Sergei Shishkin believes that next year the government will be able to carry out targeted adjustments wages for health workers. During 2016-2017 The MHIF was able to create a reserve financial resources, which will be used for future increases. However, in the future, the authorities will have to choose one of the alternatives:

• adjust contributions to the Compulsory Medical Insurance Fund, which will provide the fund with the necessary resources;
• increase transfers from the state treasury.

Some regions cannot cope with the planned rate of salary increases, which forces local authorities to turn to the federal center for help. Experts from the Health Foundation also emphasize that in many regions of the federation the target indicators for 2016-2017 have not been achieved, which casts doubt on future salary increases. Local budgets should provide 30% of future wage increases for medical personnel, experts say.

Internal optimization did not bring the expected savings in financial resources (officials planned to finance up to 30% of future salary increases from this source). The number of personnel has decreased by only 5-7%, and the plan for the sale of property is systematically not being implemented. As a result, 70% of the upcoming increase will be financed by the Compulsory Medical Insurance Fund (including taking into account transfers from the federal budget). Given the lack of fund resources, future salary increases will be provided from the state treasury.

Analysts believe that the planned increase in salaries of public sector employees (including doctors) in 2018 will lead to a significant increase in the budget deficit. As a result, much will depend on the dynamics of the oil market, which forms the lion's share of state treasury revenues.

Oil factor

Increase in oil prices to 60-65 dollars per barrel. significantly increased the government's financial capabilities. However, the dynamics of the oil market remain unstable, which could provoke a new collapse in oil prices.

The pessimistic scenario allows for a reduction in the cost of a barrel to $40. In this case, in federal budget will not necessary resources for financing social sphere. In addition, during the crisis, the reserves of the Reserve Fund and the National Welfare Fund decreased significantly.

As a result, the government will be forced to use the following tools:

1. Increase borrowing volumes.
2. Increase tax burden for business representatives.
3. Devalue the ruble, which will provide additional share premiums.

Putin promised doctors an increase in salaries:

Recent news deprives doctors of hope for a significant salary increase in 2018. Despite the fact that the May decrees promised an increase.

Statements made by the head of the Ministry of Health, M. Skvortsova, indicate that the government intends to fulfill its promises. And the promise was about increasing wages to the level of one hundred and eighty percent of average salary across Russia. But most experts believe that this should not be expected in the near future.

According to the May decrees, salaries for doctors were expected to increase in 2018 to 66 thousand rubles.

Experts' opinions regarding the growth of wages for medical workers are divided. One half of the experts is inclined to believe that salary calculations are possible in a new way, since the amount of accumulated reserve funds governments are sufficient to implement the presidential decree to increase doctors' salaries in 2018.

In addition, the implementation of the plan will be appropriate before the presidential elections. The other half of experts argue that the funds needed to make this promise a reality are not enough.

Both agree on one thing: in 2018 we should expect indexation of salaries for medical workers. Their salaries will increase to compensate for the damage caused by inflation.

We all know how important and responsible the work of health workers who have chosen such a difficult professional path is. It’s a shame, but today we can safely say that the work of medical staff in public medical institutions of the Russian Federation is valued an order of magnitude lower than that of doctors collaborating with private medical structures or foreign clinics. The government promised that this issue would be resolved this year, and the medical industry would once again become one of the most prestigious areas of professional activity.

Today, a health worker's salary includes:

— the salary itself;
— additional charges by load, complexity and intensity;
— bonus payments based on length of service and category;
— compensation with regional coefficients.

Government plans to increase salaries of Russian doctors

But the officials Russian government are more confident in assessing the prospects for increasing salaries for medical industry workers. Deputy Prime Minister of the Russian Federation Olga Golodets said that the increase in medical salaries to 200% announced earlier by President Putin in 2018 is quite realistic, and money has already been provided for these needs in the state budget. And, in general, the salary levels of doctors will be equalized in all regions of the Russian Federation.

Analysts have already managed to find a “loophole” in this statement: it is possible that an increase in income by 200% will be made relative to salaries at the level of 2012 - we recall that it was then, according to the “May decrees” of the President of the Russian Federation, that a program was launched to increase employee salaries budgetary sphere, and the end date of the program should be exactly 2018.

Russian President Vladimir Putin said that in 2018, doctors’ salaries should increase by 200% of the regional average. Junior and mid-level staff should receive 100% more wages. According to the president, there are already some changes in this area and doctors in some regions are already receiving salaries that have been increased by 180%, which is approaching the target levels.

If we talk about nurses' salaries, it is expected that with the new wage calculation, their salaries will be 80% of the national average. Today, there is significant differentiation in the income of nurses in different regions. The most low salaries today there are junior staff, so there is an urgent need to increase the income of this category of workers.

About salary calculations for nurses in 2018

If we talk about the new salary calculations for nurses this year, then they should be 80% of the average salary in the country. And this despite the fact that, according to presidential decrees, nurses’ salaries must correspond to the average salary in Russia.

There is a disappointing picture of the lag behind the salary increase schedule not only for doctors, but also for nursing staff.

According to Rosstat, today there is a significant differentiation in the income of nurses by region. This figure is higher than that of doctors. This indicates an unequal attitude towards the work of medical workers, as can be seen from different levels payments by region for the same professional responsibilities.

Speaking about the growth of salaries for medical workers, we should once again emphasize the need to increase payments to junior staff (orderlies) who have the lowest salaries. Unfortunately, it is not possible to resolve this issue at the regional level due to limited financial opportunities most of them.

Many regions lack the necessary salary increases for junior medical workers financial resources. Most of the orderlies and nurses working in rural areas, have a minimum income.

Summing up the review of recent news about the prospects for increasing salaries for doctors in 2018, we can summarize that, despite the government’s promises of a significant increase in payments, the likelihood of the plans being implemented is not high enough. The only thing they can count on with confidence medical workers– indexation of wages in order to compensate for damage caused by inflation. It's about on an increase in accruals by four percent of the salary.

Specific government steps for the healthcare system

The President assisted the activities of representatives of the medical industry. From now on, the process of salary reinforcement takes place. Their increase will only be possible if incredible efforts are made and money is reorganized in the treasury, which became possible only after cuts in funding for ambulances and those people who take preventive measures to prevent illnesses. Prevention received no money at all, and the ambulance budget was cut by two-thirds.

Funds for indexation will be allocated in mandatory, which was agreed upon by officials in advance. True, based on the results of past years, bonuses were not always carried out in full. But this does not mean that doctors are now doomed to receive less of their money every year. The fate of housing and communal services tariffs and the cost of goods is temporarily not determined, since the size of salary increases has reached 10% against the planned 5.5%. Therefore, the weight of the indexation carried out is not yet completely clear. And only the opinion of experts on this problem is called upon to correctly determine the required values.

Regarding the increase in salaries for doctors in 2018 in Russia, recent news draws everyone’s attention to some features of the adopted order of the head of state, such as the underestimation of citizens’ salaries by parliamentarians, which is the reason for more low interest rate indexing. The working masses are provided with misinformation and, as a result, a reduced rate.

The provision of informal wages is associated with the regional level of income. The totality of money due to the deliberate reduction of the average is accepted by 12 million working citizens every year. However, if funds do not pass through tax authority, then the treasury of this authority has a specific shortfall in finances, which is fraught with consequences for today.