For a long time, methods for protecting the population from unfair physicians and fraudsters, knocking money from the patient and be treated, having the necessary skills and qualifications.
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Organizations in the health insurance system
If we talk about antiquity, then, for example, in the laws of the Babylonian king Hammurapi (XVIII century to our era) it is written: «If the doctor makes a person a heavy abscess by a bronze knife and causes death to a person or remove the human belly by a bronze knife and hurt a person's eyes, then he should cut off his fingers». In the 15th century, in England, the surgeon, causing damage to the patient, appeared before the court and was subjected to a sentence, imprisonment or deprived of the right to therapeutic practice.
The legal basis for health protection in our country is, above all, the Constitution of the Russian Federation, in accordance with Article 41 of which, every citizen has the right to protect health and medical care.
In order to ensure the legislation of the rights of citizens provided for by the legislation, the federal fund of compulsory medical insurance (OMS) and territorial funds have created departments for the protection of citizens' rights in the system of compulsory medical insurance. In federal and other leading medical institutions g. Moscow has created a federal reference and information service.
Territorial Funds of OMS and Insurance Medical Organizations are carried out to protect the rights of the insured. They organize (in the event of citizens' circulation) examination of the quality of medical care, detect the guilty and (if the patient is provided by the medical assistance of improper quality) apply to the guilty financial sanctions. The patient has the opportunity through an insurance company to invite an expert in cases where the quality and results of treatment cause doubts or complaints.
Rights in the system of medical insurance
An extremely important issue in the OMS system is knowledge of their rights in the medical insurance system.
In accordance with. 6 of the Law of the Russian Federation «About medical insurance of citizens of the Russian Federation», Russian citizens in the health insurance system are entitled to:
- Mandatory and voluntary medical insurance (compulsory medical insurance and DMS);
- selection of an insurance medical organization;
- the choice of a medical institution and a doctor in accordance with the contracts of compulsory and voluntary health insurance;
- obtaining medical care throughout the Russian Federation, including outside the permanent place of residence;
- Obtaining medical services corresponding to the volume and quality of the terms of the contract, regardless of the size of the actually paid insurance premium;
- The presentation of the claim to the insurer, insurance medical organization, a medical institution, including the material compensation for damage caused by their fault, regardless of whether it is provided for or not in the medical insurance contract;
- The return of part of insurance premiums in the DMS, if it is determined by the terms of the contract.
OMC standards established by this Law and adopted in accordance with it regulatory acts extend to working citizens from the moment of imprisonment with them.
The protection of the interests of citizens is carried out by the Government of the Russian Federation and the republics as part of the Russian Federation, the state administration authorities of autonomous regions and districts, edges, regions, cities of Moscow and St. Petersburg, local administration, trade union, public or other organizations.
In violation of the rights, citizens may apply not only to the above-mentioned structures, but also to the administration of therapeutic and prophylactic institution, insurance medical organization, the territorial Fund of the OMS, as well as.
