Regional Health Care under the Conditions of National project «Health» and delimitation of budgetary powers in the Republics of Mariy El and Tatarstan

Abstract

The purpose of the article is to identify the key aspects of the transformation of health care policies under the condition of National project «Health» and delimitation of budgetary powers in the capitals and other cities and towns of Tatarstan and Mariy El. Comparable size of municipal incomes and expenditures despite substantial differ ences in the levels of economic development and growth make it possible to compare the processes of creation of new mechanisms in the coordination of the state and mu nicipal levels of the health care system. The article presents economical, organizational and social problems associated with the realization of the law on delimitation of budget ary relations between the federal center, the provincial governments and municipal gov ernments. It also shows the impact of the reforms on accessibility and efficiency of the health services transferred to municipal budgets, namely: emergency care, primary medical care in ambulatories and hospitals, medical care for pregnant women, including pre and postnatal care, evaluate economic and social risks of the reform.