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"The Healthy Future"
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Does a patient need an insurance agent?

Does a patient need an insurance agent?

The Ministry of Health has come up with a new idea: to establish a network of insurance agents. We asked Yuri Zabolotnikov, the legal adviser of the Non-Profit Partnership "The Healthy Future" and Igor Petrushin, Head of Marketing Research and Consulting, Aston Group to comment on the news.

Yuri Zabolotnikov stated that creating this new structure seems at least questionable at the moment: "We have a huge number of underfunded and understaffed medical facilities in the country where the quality of care leaves much to be desired. This initiative won’t help at all to solve these burning issues but instead may pull on insufficient financial resources intended for patient needs.

Receiving the answers to some of the questions could have provided insight into the situation. For example, what will be the size of the new structure? Will the agents be employed by the medical facility or by an insurance company? What will their salary be based on?  What will their workload be? If one agent will have to deal with ten thousand patients it is unlikely that he will be able to remember all of these people, let alone their individual problems".

Similar questions were posed by Igor Petrushin. "At present, the assessment of the quality of treatment and patient management is the responsibility of the health insurance organizations. As a rule, they are motivated to provide the best expertise possible as it directly affects the amount of payment to the contracted provider", explains the expert.

"We may assume that the Health Ministry was not satisfied with the quality of services delivered by the health insurance organizations and decided to set up this new institution hoping that it will manage more efficiently. But the question remains whether or not the insurance agents will really perform any better, and what are the prerequisites for this? It is clear that considerable investment will be required to begin with... And the first outcomes would be visible no sooner than in five years. But given the vague goals of this undertaking, there is an obvious concern that a lot of money and time would be wasted for no benefit. The solution to the problem could be extending the list of mechanisms available to the insurance companies to prevent possible violations. In addition, I can say, that engaging insurance agents would have probably made sense if they focused on assisting the patients entitled to social benefits (by overseeing the provision of such patient with medications guaranteed to them by the government) – but this has not been suggested by the health authorities", says Igor Petrushin.

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