The matter in the serious rise in price of medicines on the average by 7%. Medications, even mass ones, become inaccessible to people. This applies to the most basic life-saving medicines, which are subject to state regulation of prices (some enterprises simply refused to produce such drugs - with the increased cost of imported raw materials, this occupation has become unprofitable), and other mass drugs. Imported drugs, which are often needed to treat complex and rare diseases, and last year went up by 14%. So they also find difficult. And if you are sick with a heavy or rare (in professional language - "orphan") disease, the only way to get the necessary treatment is to live in Moscow or St. Petersburg. Or slowly die. For patients in the regions are sometimes forced to stand in line for the necessary drugs for up to a year and a half. Recently, the All-Russian People's Front published information that more than 70% of patients who are entitled to receive drugs at the expense of budget funds are forced to buy them for their own money. The reasons are clear: drugs are not purchased locally because of the usual lack of funds for this in the regional budgets. Problems with drug provision exist even in surplus regions, such as, for example, Tatarstan. What can we say about the subsidized. The problem is not new, it has been discussed more than once. Already the State Duma has prepared an appeal to the government and Prime Minister Medvedev with a proposal to transfer the purchase of medicines for orphan diseases (altogether 24 names in the list of orphan diseases) to the federal level, since regional budgets are badly short of funds for this, and the MoH has been tearfully asked for this (there only tearfully ask and can, because to defend the interests of citizens' health so far and have not learned). But things are still there. In 2016 year. to provide medicines for orphan patients regions spent 14.6 billion rubles. , while the shortage of funds was 30%. In 2017, this deficit rose to 38%, and expenses - to 15.2 billion rubles. In the coming year, the necessary amount for the purchase of drugs can grow to 40 billion rubles. , and it is obvious that regional budgets are not able to pay such expenses. Problems with obtaining the necessary medicines push people sometimes to desperate decisions. For example, according to the League of Patients' Advocates, up to fifty patients diagnosed with mucopolysaccharidosis were forced to move to Moscow because they were sure they would not be able to receive treatment in their region. In the Pskov region, facts are known when patients were offered to move to Moscow or the Moscow region, so that the costs of their treatment fell on the capital budget. So you can immediately offer from the cliff to push those who are unlucky to have a rare serious illness. Obviously, they simply do not want to get involved in solving situations where a slightly more non-standard approach is needed. And with current approaches is not even an hour our officials will agree to the principles of natural selection. Moreover, our functionaries, as always, on their wave, so still like to brag of their achievements. But the methods of their decisions are sometimes beyond the bounds of common sense and ordinary budget ethics. A vivid example: a letter on behalf of the Minister of Health of the Rostov region, in which she appeals to charitable foundations with a request to purchase a rare and expensive drug "Tobromycin" due to the lack of funds in the regional budget. No better situation in the Orel region. There, the governor did not ask Andrei Klychkov, but directly instructed the profile department to find sponsors and patrons who will be able to purchase medicines for the privileged categories of citizens. Of the necessary drugs to purchase 450 million rubles. in the year the budget of the Oryol region receives from the federal budget only 156 million rubles. In the summer of last year, Orel region in this regard is already "famous" - on a direct line with Putin called the resident of Eagle, who complained about delays in providing drugs. A couple of hours later, Roszdravnadzor and the Investigative Committee have already begun checking, and a little later the UK instituted criminal proceedings on the fact of the lack of medical supplies of a woman with a disability. In the situation of providing orphan patients with drugs, in addition to insufficient funding, there is also a problem with bureaucratic red tape. According to the Ministry of Health of the Crimea, 112 patients with rare and severe diseases have been registered on the peninsula and the order of preparations for them through the procedure of tenders takes 3-4 months. Officials of the local Ministry of Health are convinced that if purchases are transferred to the federal level, this period can be reduced. In the Moscow region, patients are required every six months for a new conclusion, which confirms the need for continuing treatment, without this document, the patient does not make an application for the drug. The only way to solve the problem of providing drugs in the proper amount and in the operational time is a complete transition to centralized financing. Co-financing of expenditures by the federal and regional budgets leads to constant malfunctions and imbalances. For example, the total amount spent on drugs for those diseases that plan to centralize is more than 8 billion rubles. For their part, the regions are ready to finance from them no more than 640 million rubles. on 71 subsidized region of Russia. In addition, most of these regions are in principle in no hurry to spend this money, all the while waiting for a decision on the transition to centralized funding. In the meantime, thousands of orphan patients, unwilling to wait for mercy from budgets and officials of all stripes, are forced to seek money themselves and buy the right medicines. Medicine - just the case that can not be given to the regions. They are difficult to control, they are difficult to enforce to meet financial obligations.

And if you develop the economy, improve the investment climate, create jobs in a large number of regions can be interested (this is their taxes), then the current authorities can not see the direct benefits of improving medicine,. If, on the whole, the distribution of taxes is to be shifted to regional budgets for the successful development of the country, then with medicine it is necessary to do the exact opposite, having transferred all financial management to the federal center. This is the only way to create equal conditions throughout the country.