The disease often approaches imperceptibly, and it is not possible to prepare for the fight against it. In modern reality, in order to get out of this war as a winner, it is necessary to mobilize all available resources, and financial means can play a decisive role here, since the most effective treatment based on the latest scientific developments is very expensive, and you can get it far from any the clinic.
What is the treatment quota?
Not every citizen is informed that a certain state aid is provided for such a case, which he can count on, and it is provided in the form of a allocated medical quota.
The quota for treatment is the money allocated from the state budget for the provision of high-tech healthcare services to its citizens. For the rational formation and distribution of quotas, a state system of high-tech medical care (VMP) was created, within the framework of which diagnostics and treatment are provided in more than 100 clinics at the regional and federal levels. Every year, the work of these health facilities from the federal and regional budgets More than 50 billion rubles are allocated. This amount is on average divided into 350-450 thousand quotas - approximately this number of Russians will be able to use the VMP for free during the year.
Allocate more than 137 types of VMP in 22 directions. These include:
- complex surgical interventions;
- open heart surgery;
- organ transplantation;
- leukemia treatment;
- removal of brain tumors;
- help with complex forms of endocrine pathologies;
- treatment of genetic and systemic diseases;
- the use of reproductive technologies, including IVF;
- nursing newborns using modern methods, etc.
How to get a treatment quota?
There is a strictly established procedure for issuing directions for the provision of VMP, which is full of bureaucratic obstacles. In order for the outcome of the case to be successful, one must be prepared for possible difficulties. Obtaining a quota for an operation or treatment is a long and complicated procedure, requiring the preparation of a large number of documents and a number of additional examinations. All this is necessary in order for government bodies authorized to resolve these issues to be able to assess the appropriateness of the use of VMP in a particular case.
Step one
In each region, a treatment quota is drawn up according to its own rules, which in minor aspects may differ from the general one. Therefore, it is better to start with a specialist consultation by contacting the Ministry of Health of the subject of the Russian Federation. There you can find out about the availability of quotas for receiving VMP according to the existing diagnosis and clarify the application procedure.
Second step
The main package of documents is usually collected at the municipal clinic at the place of patient observation with the participation of the attending physician, who gives a referral, makes an extract from the medical history indicating the tests and examinations performed (based on the results of which a recommendation is made to hospitalize a citizen in a specialized clinic for the provision of VMP). Also included are copies of a passport, a compulsory medical insurance policy, and an OPS certificate.
Important procedure
The formed package with documents is certified by the signature of the head physician and sent for consideration to the commission under the Ministry or another health management body in the region.There are 10 days to decide on a specific case, during which the submitted documents are considered, usually without the participation of the applicant.
The final stage
When a positive decision is made, the documents are sent to the specialized medical institution that has a license for the provision of VMP. There they are examined by the next commission, which also has 10 days to make a decision, during which it must give an answer about the date of hospitalization of the patient. Usually, the period after which inpatient treatment should be started is limited to 3 weeks.
Bureaucratic Traps
When wondering how to get a treatment quota, be sure to consider the following points.
Firstly, the right to choose a specialized clinic for the provision of primary medical care remains with the healthcare management body in the region, and citizen preferences are not taken into account.
Secondly, the quota for treatment in reality often takes longer than prescribed in the rules. This is due to the fact that the time available for consideration by the commission of applications is not maintained, and the medical institution is not always able to receive the patient in due time, due to the load. Unfortunately, the nature of the disease may be such that urgent surgical intervention is required, for which the patient has no funds, therefore, a quota for surgery is needed immediately. In this case, it is necessary to speed up the work of officials by all possible means.
How to speed up the medical quota process?
There are two possible options for speeding up the process. According to the first of them, the citizen takes the steps provided for by the procedure and the steps described above, but at each stage he is actively interested in the progress of the application, makes calls to officials, writes statements requesting a reduction in the timing of the decision, makes visits at the reception hours. Perhaps some of the officials will want to send documents for further consideration more quickly, so that they will no longer be the object of a massive attack. But, of course, there are no guarantees that these measures will take at least some action and time will be reduced.
According to the second option, the citizen ignores all stages with the consideration of the application by the commissions. He independently collects documents for the operation quota, for example, searches for all the necessary information about specialized clinics licensed to provide medical care and specializing in the necessary surgical intervention, and turns to the selected institution. There is a chance that the clinic will meet the patient and agree to hospitalize him, providing the required treatment on account of the quota available to the subject of the Russian Federation.
Reasons for refusal
Firstly, the commission may not find grounds for the use of VMP in a particular case. Secondly, the presence of severe concomitant diagnoses and the special nature of the course of the underlying disease often serve as causes of failure. Thirdly, at the regional level, their requirements may be presented when applying for a quota. For example, in Moscow and St. Petersburg, a quota for IVF surgery is issued to women aged 22 to 38 years, in other regions this framework may be different.
If the commission makes a negative decision, it is necessary to receive a written refusal indicating the reason. In case of your disagreement, you can contact him at the Ministry of Health and Social Development of the Russian Federation for appeal.
Treatment abroad
If domestic medicine is not able to conduct a full-fledged diagnosis or adequate therapy for an existing disease, then you have the right to ask for a quota for treatment abroad. Only in connection with this the list of required documents will be expanded, it will also increase by one number of commissions that must be passed.
If you are refused a quota abroad, you will be required to offer an alternative in providing VMP in Russia.
The problem of additional payments
A very frequent situation occurs when the patient has to cover a considerable part of the costs of his treatment, although it is officially stated that it is carried out at the expense of the state. You usually need to pay for preparatory procedures before the operation, tests, examinations.
For example, the average cost of a course of treatment for a cancer patient is 200-250 thousand rubles, and the quota for oncology treatment is 109 thousand rubles. Often a person does not have such funds to cover what they refuse to pay from the budget. Of course, charitable foundations take a large part in financing the costs of such patients, but in fact it turns out that these are unfulfilled obligations of the state, and this must be fought. A constant stream of written complaints and media outlets are effective in resolving such problems.
Queues: how to avoid them?
It is no secret that there are many more people wishing to receive VMP than the state’s ability to provide this assistance. Therefore, you can hear information in the regional health management body that there is no treatment quota for this diagnosis, since the amount of funding from the budget provided for this year has been exhausted, or you can get an answer from the clinic that there are no places for the near future and hospitalization is postponed . But in any case, do not give up. Really find one way or another.
First, you collect documents in the same way and enter your name in the quota waiting register, or you get in the queue for hospitalization. If the disease progresses rapidly, try to seek an additional quota through local health authorities, contact the media, involving the public. Then there will be a small chance that funds will be found, or it turns out that suddenly one of the patients refused treatment, and the place in the medical institution was vacated.
If you ignored all your actions, you will have to solve your health problems at your own expense, especially if there are no promises that there will soon be a quota.
For eye surgery, for example, by replacing the lens, you can try to raise funds yourself. The cost of such an intervention, unlike most others, does not exceed 70 thousand rubles. The amount is also rather big, but in a neglected state, cataract threatens with 100% blindness, and it’s not worth the risk of losing valuable time in the queues. Moreover, having kept all supporting documents, a citizen has the right to apply for compensation for the costs of providing VMP at the expense of the Ministry of Health and Social Development of the Russian Federation. In order for the return to be approved, it is necessary to prove that you are registered as waiting for help, while the course of the disease has become threatening and requires immediate surgical intervention, and the quota for the operation was not available for reasons beyond your control.
Anonymous fails
There are diagnoses that people try not to advertise because of the negative attitude of society and the associated limitations in everyday life. Such diseases include hepatitis C, the treatment of which is very expensive (about 750 thousand rubles). The state allocates funds to combat this ailment, but in order to use them, the patient must register officially. On the one hand, there is a likelihood of receiving therapy on a budgetary basis, on the other hand, there is a risk of disseminating information about the presence of the disease.
The quota for hepatitis C treatment is issued to citizens registered in specialized medical institutions, most often in AIDS centers, which operate in many cities. Only by decision of the special commission of this institution, the patient is entered into the register of expectations, since there are not enough quotas for everyone. Therefore, you can be treated anonymously only at your own expense.
