Relevance of the dissertation research topic.

The crime situation in the country is characterized by an increase in the scale of corruption, permeating all spheres of society, including healthcare.

For healthcare, any manifestation of corruption is more dangerous than for any other area public relations. After all, healthcare is the basis for the development of any society and state, since it allows for the achievement of such goals as natural population growth, a high standard of living for all members of society, and equal opportunities to satisfy the living conditions and working conditions of different social strata. At the same time, corruption in the healthcare sector hinders the implementation of tasks that are priorities for the socio-economic policy of any state.

Based on and in pursuance of international documents, the Russian Federation adopted a number of federal laws and regulations on anti-corruption issues. However, taking into account the constant variability, adaptability to new realities of reality and high degree Due to the latency of corruption, it has not been possible to develop a comprehensive and long-term plan to combat it. Moreover, corruption in healthcare tends to grow, largely outstripping in its development the anti-corruption measures taken by the state. In this regard, corruption in healthcare and measures to combat it need further study and improvement.

The degree of scientific development of the topic.

The study of corruption crimes committed in the healthcare sector was carried out, in particular, by such authors as

A.P. Soloviev, E.V. Chervonykh1. At the same time, in modern scientific literature there are no special criminological studies devoted to the problems of corruption in healthcare. So, until now they have not been considered personal characteristics criminal-corruption and the victimological aspect of corruption in medicine; there was no analysis of the causes and conditions of corruption crimes in the area under consideration; problems have not been studied in depth legal regulation combating corruption, including taking into account criminological recommendations and the practice of combating it specifically in healthcare. Thus, a unified criminological study, the subject of which would be exclusively corruption crimes in healthcare, in Russian science absent.

The purpose of the dissertation research is to assess the effectiveness of the regulatory framework for combating corruption in healthcare, establishing negative patterns associated with its manifestations, and developing scientific and practical proposals and recommendations aimed at preventing the spread of corruption crimes in healthcare.

To achieve this goal, it is necessary to solve the following tasks:

Investigate corruption in Russian healthcare from the perspective of criminological science;

Identify the structure of corruption crime in healthcare;

To characterize persons who commit corruption crimes in healthcare and to develop a typology of the personality of a corrupt criminal in healthcare;

Expand the concept of a victim of a corruption crime in healthcare;

1 See: Soloviev A.P. Crime prevention in the healthcare sector: Diss. . Ph.D. legal Sci. - M., 2007. Chervonnykh E.V. Crimes committed in the healthcare sector and their prevention: Diss. . Ph.D. legal Sci. - Saratov, 2009.

Determine the conditions and reasons contributing to the formation and development of criminal corruption in healthcare;

Create a set of measures to prevent corruption crimes committed in healthcare.

The object of the study is the social relations that have developed in the healthcare sector of Russia related to violations legal norms and moral and ethical requirements, expressed in the commission of corruption crimes both by medical workers occupying a certain official position and by ordinary medical workers.

The subject of the study is corruption crimes as acts of individual corrupt illegal behavior and corruption crime as a massive set of corresponding crimes, as well as negative social phenomena accompanying these processes.

The methodological basis of the study was dialectical, statistical and comparative legal methods of cognition. Besides, wide application The work used a sociological method - a survey in the form of questioning of various categories of respondents.

Theoretical basis dissertation research consisted of the provisions of criminological science, criminal law, sociology, psychology, presented in the works of domestic scientists Yu.M. Antonyan, G.A. Avanesova, V.V. Astanina, I.Ya. Bogdanova, S.B. Borodina, V.N. Burlakova, K.V. Vishnevetsky, A.K. Vozzhenkova, B.S. Volkova, E.A. Gorobets, A.I. Dolgovoy, V.G. Ivshina, K.E. Igosheva, P.A. Kabanova, I.I. Karpets, A.I. Kirpichnikova, V.N. Kudryavtseva, N.F. Kuznetsova, V.V. Luneeva, S.B. Maksimova, A.B. Malyutkina, G.M. Mishina, A.B. Naumova, D.V. Rivmana, V.E. Eminov and others.

The regulatory framework for the study was made up of international legal acts, the Constitution of the Russian Federation, the Criminal Code of the Russian Federation, the Criminal Procedure Code of the Russian Federation, federal laws, laws of the constituent entities of the Russian Federation and by-laws, including intradepartmental and interdepartmental ones, relating to the legal regulation of public relations in the field of healthcare.

The empirical basis of the dissertation research was the statistical reporting data of the Main Information and Analytical Center of the Ministry of Internal Affairs of the Russian Federation, the Ministry of Justice of the Russian Federation, data of the Main Directorate of Economic Security and Anti-Corruption of the Ministry of Internal Affairs of the Russian Federation, the Main Directorate of the Investigative Committee of the Russian Federation for Samara region, as well as the results of a sociological survey conducted by the author in 2008-2012 on the study public opinion on the problem of corruption and the implementation of measures to prevent corruption crimes in healthcare. 228 people took part in the survey: patients undergoing outpatient or inpatient treatment in healthcare institutions of the North-Western and North-Eastern administrative districts of Moscow; medical workers of healthcare institutions; students of the Russian National Research Medical University named after N.I. Pirogov (RNIMU) and Moscow State Medical and Dental University (MGMSU); law enforcement officials and Moscow residents.

The scientific novelty of the dissertation research lies in the fact that one of the first comprehensive criminological studies of corruption in healthcare in the conditions of modern Russia was conducted at the monographic level.

The following provisions are submitted for defense.

1. The forms and types of corruption are distinguished, and the characteristics of each selected element are given. A classification of corruption crimes committed in healthcare is given, dividing all corruption crimes into three groups:

1) corruption crimes directly related to the official activities of medical workers;

2) corruption crimes related to property relations in healthcare;

3) corruption crimes by medical workers directly related to medical activities.

2. The author’s definition of corruption in healthcare is given - it is a recurring and constantly evolving complex negative socio-legal phenomenon, which is expressed in the selfish use by medical workers of their official position in the public and private healthcare systems for the purpose of unlawfully obtaining material, non-material benefits and advantages, as well as in the illegal provision of such benefits to individuals or legal entities, which has caused or is capable of causing significant harm to the interests of society and the state in the field of protecting public health, as well as destroying normal social relations in the sphere of realizing the rights of citizens to protect health and receive medical care.

3. A complex structure of the subject composition of corrupt officials has been established, since not every health care worker can be the subject of a corruption crime. The criteria used by the author to establish the status of an official in the healthcare sector include the following:

Work in a medical organization, regardless of its form of ownership;

Carrying out organizational and administrative or administrative functions in a given medical organization;

Performing these functions either on a permanent basis, or temporarily or under special authority;

Carrying out medical activities;

Providing medical care.

Low level of legal awareness, expressed in deliberate violation of criminal law;

Inflated self-esteem and weakened control over one’s own behavior;

Acquisitiveness and personal enrichment always come to the fore, the interests of both individual citizens and society as a whole are belittled;

No relapse.

5. Based on the conducted research, the following generalized criminological portrait of a corrupt official in the healthcare sector is proposed: a middle-aged man with a higher medical education, usually having family traditions medical profession, occupies a high official position, enjoys authority among colleagues, has a family, at the same time does not feel sympathy for patients, is confident that the main thing is material wealth, uses his official position for personal gain, criminal liability was not involved.

6. The causes and conditions that give rise to corruption crimes in healthcare are classified into six groups:

1) economic (sharp differentiation of the population based on property, economic instability, etc.);

2) political (underdevelopment of the institution of public control, insufficiently high level of training of management personnel, corruption in training in medical universities, etc.);

3) social (discrepancy between the growth of needs and opportunities to meet them, inequality of working and living conditions of various categories of medical workers, public dissatisfaction with the state of healthcare in the country, etc.);

4) organizational (shortcomings of control and audit measures, making decisions inconsistent with representatives of the professional circle of medical workers, low level professionalism of law enforcement officers who are unable to identify and investigate crimes in healthcare, general distrust of the population in the law enforcement system, insufficient regulation of the official activities of medical workers, shortcomings personnel policy upon appointment to leadership positions in healthcare);

5) legal (presence of corruption norms and legal gaps in the legislation);

6) moral and spiritual (reflection of moral norms, general approval of deviant corrupt behavior, etc.).

7. It has been established that corrupt behavior medical worker largely predetermined by the behavior of the victim. The victim of corrupt behavior is defined by the author as a physical or entity, as well as a group of persons to whom (or whom) corruption activities caused physical, material, moral or reputational harm or in relation to whom (whom) the danger of causing such harm was created. It is important to note that the victim of corruption crimes in healthcare, as a rule, is individual who needs medical care and has applied for it to the appropriate medical institution.

The behavior of a victim of corruption crimes in healthcare can be neutral, positive or negative.

In relation to corruption in healthcare, several types of victimization are distinguished: individual, group and mass; objective-specific and subjective-specific; guilty and innocent.

8. It has been proven that corruption crime in healthcare is non-personalized, anonymous, and widespread. The victims of the crimes studied tend to have innocent behavior and are in direct or indirect threat of harm from one or more acts of criminal corruption.

9. General social measures to prevent corruption crimes in healthcare have been developed in relation to the areas of society in which they should be implemented:

In the sphere of socio-economic relations, this is carrying out economic reforms aimed at suppressing corruption as a means of solving business issues, including in healthcare;

In the sphere of political relations - strengthening statehood; strengthening democratic principles; development of public control; development of interactive feedback systems between the population and representatives of state and municipal authorities;

In the spiritual realm public life- introduction of mechanisms for anti-corruption education of the population; development of ideas of social justice;

In the field of intellectual technologies and scientific development - identifying and summarizing manifestations of corruption in healthcare; constant study of the causes and conditions conducive to the development of corruption;

In the legal sphere - clear legislative regulation of anti-corruption measures; eradication of legal gaps, duplication and ambiguity of law; continuous improvement of the methodology for conducting anti-corruption examination of legislative acts.

10. Special criminological measures to prevent corruption crimes in healthcare include the following:

Development and application of new educational standards and methods in order to improve the level of legal culture of young specialists, as well as to develop responsible professional and highly moral behavior of medical workers;

Improving the remuneration system for medical workers;

Introduction of a mandatory accounting system expert opinion the medical community in the development and adoption of legislative acts in the field of healthcare;

Unconditional openness of the activities of medical institutions;

Development of a culture of compliance with ethical principles by medical workers, including the development and adoption of a unified Code of Medical Ethics;

Organizational control over medical activities;

Informing patients about their rights and responsibilities and a multi-level mechanism for protecting their rights;

Implementation of victimological prevention measures.

11. It is proposed to amend Article 285 of the Criminal Code of the Russian Federation (hereinafter also referred to as the Criminal Code of the Russian Federation), indicating in additional paragraph 6 of the Note to this article that medical workers are equated to officials, as well as to Article 201 of the Criminal Code of the Russian Federation, setting out part 1 as follows: “Use of powers by a person performing functions in a commercial or other organization, as well as by a medical worker.”

The theoretical significance of the dissertation research lies in the fact that the research, according to the author, contributes to the deepening of criminological knowledge in the field of characterization and classification of corruption in healthcare based on comparative analysis with corruption in the country as a whole.

The practical significance of the study is determined by the implementation of the research results with further improvement of anti-corruption legislation, development methodological recommendations to identify corruption crimes in healthcare, develop a mechanism in Russia to prevent corruption and protect the rights of patients, as well as in the development of state programs to combat corruption in healthcare and carry out control and preventive measures at the level of individual medical institutions.

Approbation of research results. The dissertation was prepared at the Department of Criminology and Criminal Executive Law of the Moscow State legal academy named after O.E. Kutafin, where its discussion and review took place. The author published 11 articles on the topic of his dissertation research in scientific journals and collections, with a total volume of 4.9 pp. (including 5 articles in journals recommended by the Higher Attestation Commission of the Russian Federation). Certain provisions of the dissertation were presented at the International Congress on Health Law of the CIS Countries and Eastern Europe, held in Moscow (November, 2012); fifth International scientific and practical conference “Law as a basis modern society"(Moscow, 2012); Eighth International Interuniversity Scientific and Practical Conference of Students and Postgraduate Students “Traditions and Innovations in the System of Modern Russian Law” (Moscow, 2009).

On May 17, 2012, the author took part in the work round table on the topic “Anti-corruption: national and international legal instruments”, held within the framework of the Second St. Petersburg International Legal Forum.

The structure of the dissertation is determined by the purpose, objectives and subject of the research. The dissertation consists of an introduction, three chapters, a conclusion, a bibliography and appendices.

CONCLUSION

As a result of a study of corruption in Russian healthcare, based on theoretical research, collected empirical material, critical analysis of domestic and foreign scientific literature dedicated to the problems under consideration, we believe that the goals and objectives set at the beginning of the work have been achieved.

First of all, it should be noted that the complexity of the criminological characteristics of corruption crimes in healthcare is explained by the duality of the nature of corruption itself, which acts both as a legal and as a social phenomenon, which makes it difficult to accurately regulate the forms and types of corruption. Thus, there is not a single international legal document, including international conventions on the fight against corruption, in which the definition of corruption would be given sufficiently clearly and unambiguously. Russian legislation is no exception, since it also does not contain an exhaustive list of corruption crimes. At the same time, the absence of such legislative regulation significantly complicates the consideration of a unified structure of criminal corruption by researchers and law enforcement officers. This, in turn, creates obstacles to generalizing statistical material and analyzing individual groups and types of crimes under consideration.

Despite this, we were able to analyze federal and regional regulatory legal acts and present our own assessment of ongoing anti-corruption measures, as well as, through research, establish negative patterns associated with manifestations of criminal corruption in healthcare.

The results of the studies indicate that general state corruption in Russian healthcare was influenced by such socially harmful attitudes widespread in society as the perception of corrupt actions as a habitual factor in the formation and development of public relations, a focus on the maximum possible enrichment based on imperfection Russian legislation and shortcomings in the control and supervisory activities of government bodies. Such an attitude of society towards corrupt behavior has had the most Negative influence to the healthcare sector, in which the priority motive of providing quality medical services and helping sick people has been replaced by the motives of self-interest and enrichment. As a result, the most important area of ​​public relations has become infected with corruption, the forms and types of which are currently almost impossible to detect and suppress in full.

We have identified the determinants of corruption in healthcare, among which the most important are economic, organizational and moral-psychological factors, as well as shortcomings of legal regulation.

The main character traits corruption crimes in healthcare: high latency, victimological aspects of corrupt behavior, special legal status of the subject of the crime.

Among the most common forms of criminal corruption in healthcare, the following were identified:

Corrupt practices;

Abuses and violations during state and municipal procurement;

Issuance of permits for trade in counterfeit or other low-quality medicines;

Use by doctors of premises and equipment allocated by the administration of a healthcare institution to illegally receive patients;

Abuse of powers by civil servants when using federal budget funds;

Violation of the rules for conducting a clinical experiment. The study established that the central problem of corruption in healthcare is the personality of the medical worker - a corrupt official, which is characterized by the general negative content of the value-normative system and stable psychological characteristics, the combination of which encourages criminal behavior. By summarizing statistical information and materials from criminal cases, we typologized the personality of a corrupt medical worker and formed a generalized criminological portrait, emphasizing that corruption in healthcare has a great intellectual and educational overtones.

In addition, within the meaning of the criminal law, the subject of a corruption crime in healthcare has a complex legal status, which currently prevents any medical professional found to have engaged in corrupt behavior from being prosecuted. Therefore, we propose to introduce a broad interpretation of the official in relation to healthcare. We believe that it is illegal monetary reward Medical workers have acquired the character of mass extortions throughout the country. Often money is taken from patients and their relatives for what medical workers are obliged to do, since this is directly included in the subject of their employment contract. But the scale of illegal extortions has penetrated so deeply into healthcare that, even after embezzling money, medical workers still do not provide patients with the necessary medical care. In our opinion, we cannot do without radical means.

Signs of corruption crimes in healthcare predetermine the personality type of victims of criminal corruption. The most dangerous victimological trend in the spread of corruption crimes in healthcare is that although individual victimization occurs when a corruption crime is committed against one specific person, in reality there are many similar victimological situations of development of the same criminal corruption intention. As a result, individual victimization acquires the character of a mass phenomenon.

The subject of victimological corruption in the healthcare sector is the victim of corrupt behavior. As a rule, this is an individual who needs medical care and has applied for it to the appropriate medical institution. The dependent role of the patient predetermines increased victimization, which does not allow the desire to finally strengthen in the victim’s mind the desire to resist the corrupt behavior of a medical worker.

Taking into account the peculiarities of corruption crimes in healthcare, we have developed measures to prevent them. The difficulty of implementing a system of countermeasures lies in the fact that most anti-corruption measures must be implemented at a level as close as possible to the relationship according to the “doctor-patient” formula.

General social measures include economic, political, ideological and legislative transformations pursuing such goals as eliminating sharp differentiation of the population based on property, implementing government programs to support the poor, promoting the family as the fundamental unit of modern society, developing forms of public control, eradicating legal gaps and improvement of legislative technology.

Among the special criminological measures the following are proposed:

Implementation of organizational control over paid services in all medical and preventive institutions;

Adoption of the federal law “On the rights of patients” and Model Code medical ethics in order to form and develop the legal culture of patients and medical workers;

Creation of conditions that exclude the possibility of falsification of official medical documents;

Specialization of law enforcement activities in order to improve the quality of investigative actions in criminal cases of corruption crimes in healthcare.

Thus, we believe that we were able to prove not only the existing increase in corruption crime in healthcare, but also that this growth is accompanied by an improvement in forms of corruption, a decrease in the quality of medical services provided and impedes the effective implementation by the state of the priority function of ensuring the health of citizens.

To achieve real results in the fight against corruption, sustained political will and activation of various social groups, collaboration of scientists and practitioners in the continuous search for the most effective anti-corruption measures. Legislative acts adopted by the state must ensure the inevitability of punishment for corruption crimes committed, and the ongoing fight against corruption must be accompanied by the development of forms of feedback from society to the state, implying public discussion of anti-corruption measures and legislative initiatives. Only through the joint participation of the population and the state is it possible to prevent the growth of corruption crimes and develop an anti-corruption legal culture among all representatives of society.

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The corruption infection has penetrated almost all branches of medicine - this is recognized at the highest government level. Committee State Duma on security, having analyzed the materials of the Prosecutor General's Office, the Ministry of Internal Affairs, and the Federal Service for Surveillance in Healthcare, I came to disappointing conclusions - corruption is growing both in quantitative and monetary terms.

The number of criminal cases initiated is steadily growing. If in 1999, according to the Ministry of Internal Affairs, 5,538 crimes were detected, in 2000 - 6,348, in 2002 - 7,537, and in 2004 - 6,429 crimes, then already in 2008 - more than 12,000 crimes. The amount of damage is also growing. material damage. In 2003, the damage amounted to more than 180 million rubles, in 2004 - 174 million rubles, and for 6 months of 2008 - almost 820 million rubles.

But these are just numbers. And behind them stand thousands of human lives. Enrichment at the expense of patients' health, fake certificates, embezzlement budget funds allocated for the purchase of medicines for those in need, best places in a hospital for “thieves”, a special attitude towards “paying patients” and bestial treatment towards “mere mortals”, private clinics conveniently located on the basis of public hospitals - all this is corruption in blood, the most godless of all types of corruption.

In some cases, corruption has become the only way to obtain nominally free services that the state is obliged to provide to its citizens. Corruption in medicine not only contributes to the formation of a negative moral and ethical situation in society. It deepens discrimination against citizens based on their social status, has a destructive effect on the public administration system and reduces the country’s economic growth opportunities. In legal terms, corruption in healthcare leads to massive violations of the constitutional rights and freedoms of citizens.

Worse than a bribe

The facts of fraud and enrichment at the expense of public funds in the field of healthcare undoubtedly have the most serious impact on the quality of medical services, but there are also worse things. Preparations containing narcotic substances. In small doses they are indispensable in the treatment of a number of diseases. But due to the corruption of those responsible for the safety of storage and distribution of such drugs, they end up on the drug market in large quantities. Every year, law enforcement agencies record more and more cases of theft of potent psychotropic and narcotic drugs by employees of medical institutions, people called upon to save lives and restore health. The only disappointing conclusion that can be drawn from this is that corruption in medicine, namely the situation associated with narcotic, psychotropic and other potent drugs, threatens the health of the nation. Are such facts acceptable? Who should be held responsible for the lack of control over compliance with regulations, staff selection and storage of prescription forms?

Non-medical consumption of narcotic and psychotropic drugs is steadily growing, which entails the growth and development of drug market structures, crimes committed on this basis and the involvement of young people in criminal activities. Such developments can only be interrupted by improving the entire system of law enforcement agencies to combat illicit trafficking. narcotic drugs, establishing strict control, as well as serious penalties for violating the rules established by law.

And yet bribes

The following are the most common types of bribes:

For receiving a certificate of temporary incapacity for work and various certificates: about unfitness for military service, about fitness to manage vehicles, on permission to perform certain jobs, on permission to engage in one or another sport, on exemption from physical education;

For the high-quality performance of the operation on the patient (i.e. not “like everyone else,” but with individual approach). In this case, the patient is guaranteed high-quality preoperative and postoperative care, the use of the best medications, sutures and dressings.

For confirmation or concealment of certain medical facts (most often - beatings and other bodily injuries)

For writing out the “right” prescription.

For distortion of the true cause of death (this conclusion is given by a pathologist). The size of such bribes is one of the largest in medicine, since in many cases they are directly related to the commission of crimes.

For the early discharge of a patient from the hospital or, conversely, for prolonging the patient’s stay in the hospital.

For issuing the “necessary” certificates about mental state patient.

Your health is for sale

In some large metropolitan hospitals, management positions appear to be for sale. There are cases when positions are sold to people who are illiterate and simply lack medical education. Isn't this one of the worst manifestations of corruption? Pseudo-leaders are completely ruining entire sections of medicine and medical care in general.

Is paid medicine a breeding ground for corruption?

IN Lately people began to increasingly turn to private clinics, with the hope that there were specialists working there who could really help them. After all, they pay money for this help, and not little at that. But what really? We pay money, but we receive the same service as in regular clinics, and maybe worse. Why does this happen? Firstly, you are not able to competently assess the quality of the service provided in this case (after all, you are not a doctor, therefore you cannot judge). That’s why there is an opinion among people that says, “Of course, you don’t have to pay if the results of treatment and the state of your health don’t bother you.” That is why, having assessed offhand the level of the patient’s solvency, the doctor already roughly estimates the estimate for which he can “milk” him, and as they say, thank God, if as a result of all sorts of unnecessary tests and examinations, a real disease is identified and appropriate treatment is prescribed. Secondly, the whole point is that private clinics are under the protection and patronage of those who are called upon to revoke their licenses. Paid medicine is a real business where huge amounts of money are made. And those who earn this money do not mind giving an official in the Ministry of Health a “paw” so that he does not send checks to his hospital. That is why all those who are supposed to punish non-professionals turn a blind eye to violations of all the rules. It turns out that by coming to a private hospital and paying money for services, we risk not only not being cured, but also suffering even more. And after this we will not be able to prove that we suffered, since all experts, even the most independent ones, will unanimously affirm that everything is fine. That is why, when we talk about corruption, in particular in medicine, it is difficult to limit ourselves to one-sided decisions - stop giving bribes to doctors (thank you), eradicate private (paid) medicine and other similar measures, since this is just a consequence. This problem should be approached more globally, that is, take the most drastic measures, in medical terms - use exclusively “surgical intervention”, since compresses and mustard plasters are ineffective in this case. After all, healthcare is one of the most important areas and corruption, which has absorbed and become completely integrated into the system, must be completely eradicated by the most in a radical way.

Who and how is tricking us into getting treatment? Fake diseases

Fictional diseases - a big problem modern healthcare. It is not so much the diseases themselves that are far-fetched, but their consequences for health. And only one prescription is given: pay for the treatment and you will be saved! But is the danger as great as it is presented to us?

Episode from life
We are constantly urged to take care of our health, not to rely on official medicine and to remember that “saving drowning people is the work of the drowning people themselves.”
A friend of mine, a middle-aged woman who works a lot, with money and an eternal lack of time, decided to undergo an examination at a well-known private clinic. That is, she had been planning to do this for a long time, but then the opportunity turned up. just a catcher and a beast, as they say. Before the New Year, she was given an advertising coupon from this very company with an offer to undergo an examination at a good discount. The clinic's branches are located in almost all areas of the metropolis. She chose the closest one. And she went. She had some tests done and was examined by a doctor. Finally, she was informed: you have been diagnosed with cytomegalovirus. You have mastopathy. It is possible that you have precancer. To provide a more accurate diagnosis, you need to undergo a more detailed examination. And then, based on the results of an already extended diagnosis, the clinic’s doctors will be able to say for sure whether you are at risk of cancer or not. You will have to pay 43 thousand rubles extra for accuracy...

Came in healthy, came out sick
Although it should have been quite the opposite. You can imagine the state of my friend - she came in healthy and came out sick. Expecting death in the very near future. She had already decided that instead of gifts to her family and a trip to warm seas pay for "advanced diagnostics". And write a will, telling in a breaking voice the terrible information to everyone who called to congratulate her on the upcoming holidays.
Completely by ACCIDENT she had a conversation with a young colleague who:
a) Educated her about viruses, saying that millions of people on the planet live quietly with millions of viruses that are in their bodies. Therefore, the presence of cytomegalovirus does not mean anything. b) Mastopathy is also present in 90% of women. c) There is no need to pay 43 thousand rubles for the examination - you can go to the district oncology center or interdistrict diagnostic center and have all the procedures done for free. True, it won't be too fast. But on the other hand, leading a woman to the idea that she is living an extra day for an extra day because she doesn’t pay for diagnostics—no one will be there either. Why assign yourself an extra patient? - There are enough real patients.

Place of "divorce"
As you might guess, this took place in Moscow. And here, the presence of a wide choice of medical institutions has played a bad joke on a person who takes responsibility for his health. It is difficult to imagine such a situation, for example, somewhere in small town. Whether you want it or not, go to one hospital or clinic. Badly? Probably not very good. But if “offerings” are required, their size will be several times smaller.
By the way, many professional doctors do not go to work (or even earn extra money) in private medical institutions for this very reason - in order to arrive, they are forced to send clients for unnecessary tests and undergo unnecessary diagnostic procedures. Those who are disgusted by this, who still see the patient and not the client, do not stay in the “private sector”...

Recently, people have begun to increasingly turn to private clinics, with the hope that there are specialists working there who can really help them. After all, they pay money for this help, and not little at that. But what really? We pay money, but we receive the same service as in regular clinics, and maybe worse. Why does this happen? Firstly, you are not able to competently assess the quality of the service provided in this case (after all, you are not a doctor, therefore you cannot judge). That’s why there is an opinion among people that says, “Of course, you don’t have to pay if the results of treatment and the state of your health don’t bother you.” That is why, having assessed offhand the level of the patient’s solvency, the doctor already roughly estimates the estimate for which he can “milk” him, and as they say, thank God, if as a result of all sorts of unnecessary tests and examinations, a real disease is identified and appropriate treatment is prescribed. Secondly, the whole point is that private clinics are under the protection and patronage of those who are called upon to revoke their licenses.
Paid medicine is a real business where huge amounts of money are made. And those who earn this money do not mind giving an official in the Ministry of Health a “paw” so that he does not send checks to his hospital. That is why all those who are supposed to punish non-professionals turn a blind eye to violations of all the rules. It turns out that by coming to a private hospital and paying money for services, we risk not only not being cured, but also suffering even more. And after this we will not be able to prove that we suffered, since all experts, even the most independent ones, will unanimously affirm that everything is fine. That is why, when we talk about corruption, in particular in medicine, it is difficult to limit ourselves to one-sided decisions - stop giving bribes to doctors (thank you), eradicate private (paid) medicine and other similar measures, since this is just a consequence. This problem should be approached more globally, that is, take the most drastic measures, in medical terms - use exclusively “surgical intervention”, since compresses and mustard plasters are ineffective in this case. After all, healthcare is one of the most important areas and corruption, which has absorbed and become completely integrated into the system, must be completely eradicated in the most radical way.