paternalistic social policy. The main features of the paternalistic model

Today, politicians, sociologists, economists and lawyers continue to argue about which model of the state can bring more benefits to social development. Some of them are supporters of liberalism, others are trying to prove that only a paternalistic model of relations in the state and between individuals can underlie progress. Details of what the second model is will be discussed in the review.

Definition of paternalism

The term "paternalism" comes from the Latin "pater", which translates as "father". Paternalism refers to a type of relationship that involves the patronage and guardianship of the elder over the younger. The paternalistic model characterizes:

1. Type of international relations.
2. The form of government and its ideology.
3. The vector of economic development of society.
4. The direction of social policy.
5. Communication model: between citizens, in the field of medicine, jurisprudence, in other industries professional activity.

Consider the application of the paternalistic model of relationships in each of these areas.

Paternalism in international relations

In international relations, paternalism is manifested in the fact that large countries provide patronage to the weaker ones. Often, this approach characterizes contacts between mother countries and colonies. This was especially evident in the policy of Great Britain, for example, in relation to Australia. Missionaries were sent there by the government of England, who carried the Christian faith to the savages in order to save their souls. And also various technical innovations were introduced, without which, according to the British, the natives could not survive.

At first glance, such a paternalistic model carried a positive beginning. However, as a result of violence against the original culture and a way of life that has been established for centuries, the local population has actually died out. And also the reason was that along with the care there was a monstrous exploitation of both the Australians themselves and natural resources distant continent.

State paternalism

At the state level, paternalism means that society is built on the principle of a single close-knit family. It is headed by a wise, caring father, who is the state and its organs. The people are seen as children and other members of the family who fully trust and obey paternal authority. At the same time, “children” are protected from social and economic cataclysms, but at the same time they are completely deprived of independence.

The state of the paternalistic model is the distributor of benefits in accordance with the hierarchy existing in society. And also a generator of ideas that the people should share in in full. Although public organizations exist, they only play the role of an instrument that strengthens power. Such a system was inherent in the USSR, other socialist countries, as well as states with a patriarchal tradition, such as Japan and Spain.

Economic paternalism

Under socialism, the paternalistic model in the field of economic policy means the leading role of the state in literally all economic areas. It is reflected in a number of principles such as:

1. The responsibility of the state to citizens, which obliges it to take into its own hands any administrative levers to achieve its goals. Other subjects - enterprises and public associations - act only on behalf of the state or are tightly controlled by it.
2. Priority of state goals over the goals of individual economic units.
3. The primacy of administrative methods of management over economic ones.
4. Responsibility for the use of state aid in accordance with its intended purpose.
5. Free support for citizens and businesses.
6. Equality in the consumption of social goods and their general availability. Each citizen is provided with a minimum level of income and the volume of social services.
7. Dynamic development of the social sphere as the most important condition for sustainable development.
8. The primacy of the decisions of the central government over the local.
9. Existence of an extensive public sector, protectionism against industry, Agriculture and the banking sector.
10. A large amount of social obligations inherent in the budgets of all levels.

Paternalistic model of the welfare state

Such a model implies a comprehensive responsibility of the state for the socio-economic situation of its citizens, care both directly for each of them and for economic entities.

It is inherent in socialist countries, where state and economic paternalism is established, as described above. This is possible due to the state monopoly on all benefits, including social benefits, as well as the principle of their centralized distribution. The social sphere is under special attention and control of the state.

The social sphere is understood as a complex of industries that determine the standard of living of people regarding their pensions, education, health care, culture, catering, utilities, public transport, some types of communication.

Tasks, advantages and disadvantages of this social model

The main tasks inherent in the paternalistic model of social policy are:

1. Ensuring public welfare.
2. Raising the material standard of living of citizens.
3. Creation of the necessary conditions that provide equal social opportunities for various segments of the population (the principle of social justice).
4. Building a mechanism social protection in the form of pensions, scholarships and allowances.
5. Comprehensive development of the social sphere.

This system has both advantages and disadvantages.

• The advantages of the model include: social security and stability of the economic life of people.
• Its shortcomings are: the great dependence of a person on the state, the distribution of benefits according to the equalizing principle, the impossibility of economic prosperity, the lack of entrepreneurial initiative.

Instruments of social policy under capitalism

It should be noted that elements of social paternalism are inherent not only in socialist states. They are also used under the capitalist system, although they are selective.

As an administrative instrument of the paternalistic model social development different kinds of social standards come into play here. These include the following:

1. Determination of the amount of wages at the minimum level.
2. Living wage guarantee.
3. Calculation of the consumer basket for certain categories of citizens.
4. Setting the minimum amount of pension payments and scholarships.
5. Availability of a compulsory health insurance system.

In addition to the administrative levers already mentioned, countries with a liberal economy apply such economic measures as:

1. Reducing tax rates in industries serving social facilities.
2. Subsidies given by the state to reduce the percentage of taxation.
3. Adoption of mortgage housing lending programs.
4. Implementation of co-financing mechanisms.

Paternalistic model of communication

This model is inherent in relations in the field of medical care for the population. This is a classic model of the relationship between doctors and their patients. It is characterized by the patient's complete trust in the representatives of the "medical department". In such relationships, the doctor plays the role of a father who has high authority as a bearer of special knowledge and takes care of the patient as if he were his own child. He takes full responsibility for the health and life of the ward.

In this case, the patient acts as an absolutely passive side. He is not involved in making decisions regarding the treatment process. The main disadvantage of this approach is depriving the patient of the opportunity to control his own destiny. He is not able to determine which of the methods of treatment is the most optimal for him.

This principle is rooted in the distant past, based on the provisions of the Hippocratic oath, according to which the doctor undertakes to act in accordance with his skills and abilities. In our country, the traditions of the paternalistic model of the relationship between the doctor and the patient are continued in the Oath of the Doctor of the Russian Federation.

Innovations in the doctor-patient relationship

Today, there is a growing trend around the world to abandon this model. A new type of interaction between doctors and patients is gradually being introduced. In the United States, in 1972, a bill was passed regulating the rights of patients to comprehensive information about their health status and methods of treatment. Thus, the transition to the principle of cooperation, which is called "Informed voluntary consent", is carried out. Its main content is as follows:

1. Informed consent is a fundamental right of the patient and a protection mechanism for both himself and the doctor. His necessary condition is the procedure for informing the patient (his representative) of the treatment regimen and obtaining from him approval for specific types of examinations and treatment procedures.
2. For this, preliminary explanatory work is carried out with the patient. The doctor in an accessible form gives detailed information about the proposed medical intervention, possible complications, various methods of treatment. As well as the conditions for the provision of services.
3. Consent is taken in accordance with current medical and research ethics guidelines.
4. The fact of voluntariness is characterized by the absence of pressure on the patient in the form of the medical worker imposing his opinion, misinformation, threats.

A striking example of the paternalistic model of the state is the Soviet Union. To this day, not only in our country, but throughout the world, disputes do not subside about what was more in the realities of that era - comprehensive social justice and economic stability or suppression of initiative, violation of individual rights and the use of forced labor. It is definitely impossible to answer this question.

On the one hand, many of those people who lived in Soviet socialist society recall that they experienced a sense of unity with the people, respect for leaders, and pride in great achievements. They had free housing, the opportunity to give their children the best education in the world at the expense of the state, a stable salary, and rested on trade union vouchers at the best resorts. Basically, this opinion can be heard from ordinary people.

At the same time, other people who lived at that time, for example, representatives of creative professions, say that they were subjected to ideological pressure, could not print or perform works from the stage that were subjected to merciless censorship. They could not openly express their opinion about the existing shortcomings in society, and even more so criticize the authorities, freely travel abroad. And also they did not have the opportunity to live in comfortable conditions, earn more money, drive foreign cars.

Conclusion

It seems that both sides are right in their own way. In the USSR, both those and other facts took place. The question is, in the name of what a person decides to give up economic stability and a quiet life. It's one thing if he wants to buy an expensive car and go abroad through the success of several dubious financial transactions. Another is the desire and ability to conduct free economic and political activities for the benefit of oneself and the people, while being a rich person. Unfortunately, the second, with all the inherent advantages of a paternalistic system, is unattainable.

In medical deontology, four models of the relationship between a doctor and a patient are distinguished: paternalistic, informational, interpretive and deliberative.

According to S.G. Stetsenko, there are the following models of the relationship between the doctor and the patient:

paternalistic (the doctor instructs the patient to do just that, and not otherwise);

liberation (the doctor informs the patient about the disease, leaving the patient the right to choose a specific method of treatment);

technological (the doctor and the patient are guided by the readings of diagnostic equipment);

interpretation (the doctor talks with the patient, explaining the essence of the patient's disease).

paternalistic model(from lat. paternus paternal) suggests that the doctor, having carefully examined the patient's condition, establishes the most appropriate treatment for each specific situation, aimed at complete recovery.

Types of communication models between doctor and patient

The last word in the choice of treatment measures remains with the doctor. It is understood that the patient may not agree with the prescribed procedures, however, he is not quite competent in this matter and will subsequently understand the correctness of the choice made by the doctor, i.e. in case of discrepancy between the patient's opinion and objective medical indications, preference is given to the latter. In the model under consideration, the doctor acts as a guardian (father), providing the most adequate, from his point of view, treatment. The autonomy of the patient is reduced to his consent with the medical discretion.

As you can see, the paternalistic model is embedded in the relationship between the patient and the doctor by a number of factors: among them, the doctor's special knowledge and the already mentioned dependence of the patient on the doctor and fear of him due to the doctor's right to dispose of the patient's health.

Therefore, relationships where the doctor rules, especially in the low cultured, uneducated society of past centuries, when the education and culture of the doctor were very different from the whole strata of society, were natural, simply because the patient could not understand the complex reasoning of the doctor. Hence the familiar address to the patient on you, with the help of which the doctors became fathers for the patient, hoping that their every word would be heard and executed with sons or daughters devotion and faith.

Now the situation (the rapid growth of education, liberalization and emancipation in society) has changed at such a speed that the medical community did not have time to respond to this by creating a new sustainable model of relationships between medical personnel and the patient. Obviously, the paternalistic model in relation to a person who is often more educated in general than a doctor cannot be acceptable. Moreover, she begins to play not for the doctor, but against him, since she achieves a result that is directly opposite to both what she wanted and what she had before, the denial of the doctor and distrust of him, since the same thing you said to a stranger, even if he is a doctor, puts him in the position of a violator of the canons of elementary ethics created by modern society.

Technological model relationships, where the doctor does not actually communicate with the patient, is a kind of paternalistic model, since it is wrong to expect that the patient understands the indications of the equipment to the same extent as the doctor. If we assume that this is so, then the doctor becomes simply not needed. The fact that the trend towards this model exists abroad is caused by complex standardization processes and a technological breakthrough, but this does not mean that the doctor is not involved in the processes of diagnosis and treatment. The interpretation of the data obtained requires a lot of knowledge from the doctor, and the need to explain to the patient what is happening to him only becomes more difficult due to the amount of data received. In any case, in this model it is not clear who makes the decision, the doctor or the patient, and in the process of making a decision, both the patient (to the best of his knowledge and to the extent of the doctor’s explanations) and the doctor should be guided by the readings of the equipment.

In accordance with information model(it can be combined with liberation) the doctor is obliged to provide the patient with all essential information regarding the disease. The patient independently makes the choice of treatment, which the doctor must follow, despite the possibility of some patient bias. The patient is ultimately responsible for the choice of treatment. Thus, the concept of autonomy of the will of the patient according to this model is to control the formation of a medical decision.

has much in common with this model. interpretation model, which also implies the duty of the doctor to interpret information for the patient as fully as possible about the state of his health, the risk and benefits of possible interventions.

A characteristic feature of this model is the active role of the doctor, who should not impose his point of view on the patient, but make every effort so that the choice falls on the only reasonable solution. The doctor in this case is an adviser, supplying the patient with the necessary information, explaining why this, and not any other medical intervention, most fully satisfies the patient's needs.

The last of the models deliberative. It has a number of common features with interpretation. The doctor in the deliberative model acts as a friend or teacher, engaging the patient in a dialogue to determine the best course of action. He explains to the patient all possible treatment options and one of them, which, according to the specialist, is the most suitable. The concept of the patient's autonomous will lies in the fact that he has the opportunity to choose a treatment method based on a detailed discussion with the doctor of all alternative options and determine the optimal one.

Recently, there has been a shift towards an information model of the relationship between a doctor and a patient, which is primarily associated with a gradual departure from the administrative-legal approach in the field of healthcare in favor of the civil law one.

Meanwhile, it should be assumed that the most correct basic model among those described is the deliberative one, since the doctor should not lose his opinion regarding the diagnoses of patients and the methods of his treatment: this is unnatural! The desire of the patient to be treated by a doctor contrary to his opinion will not bring a positive result, turning the doctor into a cynic and a kind of weak-willed appendage of medical knowledge.

Therefore, the most correct model, in my opinion, should be considered contractual (or partnership), which, being based on the deliberative, leads to an agreement between the doctor and the patient to act together, combining their efforts, will and knowledge to fight the disease.

On the other hand, if such an agreement is not reached, then how to treat and be treated? After all, trust in the doctor is at least 50% of the success of treatment.

In this sense, the culture of the patient becomes an important element, which I have already mentioned in part above. After all, if the patient goes against the opinion of the doctor and is not able to explain why he is doing this, the doctor loses the opportunity to make the right choice, which will almost certainly not have the best effect on the result of treatment. Patients are citizens with different levels of culture. This is almost the main difficulty of the medical profession. For some patient with a low level of culture and education, it is vital to maintain the paternalistic model, and with someone it is necessary to agree on the risks.

Paternalism is a cultural tradition in medicine. Causes of the crisis of the paternalistic model in modern medicine

The Hippocratic Oath contains the following words: “I will direct the regimen of the sick to their benefit in accordance with my strength and my understanding ...” A centuries-old tradition medical practice It is based on the fact that in each case it is the doctor who decides what is the benefit of the patient. This approach is usually called paternalistic (from the Latin "pater" - father), since the doctor acts as if in the role of a father who not only cares about the welfare of his unreasonable child, but also determines what this welfare consists of.

The term "paternalism" by its origin refers to the language of socio-political theories and characterizes this type of relationship between the state, on the one hand, and subjects or citizens, on the other, in which the state initially considers itself an unconditional representative and spokesman of their welfare and their interests, t .e.

PATERNALIST MODEL

makes decisions and acts on their behalf, without worrying in the least about identifying and taking into account their opinions. They themselves, in turn, proceed from the fact that the state is empowered to decide for them what is their benefit, but at the same time is obliged to take care of them, to patronize them. Thus, there is an alienation of the rights and freedoms of citizens, who in this case actually turn out to be not so much citizens in the strict sense of the word as subjects, in favor of the state. Kant considered the essence of the "paternalistic government" (imperium paternale) to be a generous restriction of the freedom of its subjects, that is, subjects, and characterized it as the worst imaginable despotism.

Being a phenomenon of the social and political culture of society, paternalism extends not only to the relationship between the state and citizens, but also to all those spheres of society where relations of power are manifested in one way or another, that is, the domination of some and the subordination of others. One of these areas is the healthcare sector.

Medical paternalism suggests that a doctor can rely only on his own judgments about the patient's needs for attraction, information, and counseling. The position of paternalism allows one to justify coercion of patients, their deception or concealment of information from them, as long as this is done (from the doctor's point of view) in the name of their good. Here it is necessary to say that in Russia the traditions of paternalism in general and medical paternalism in particular have deep roots. They were in the highest degree are characteristic of tsarist Russia, where the determining type of relationship between a doctor and a patient was the situation, repeatedly and brilliantly described in our fiction, in which a selfless zemstvo doctor takes care of the health and well-being of dark, illiterate peasants. The latter, by virtue of their downtroddenness, naturally, are not able to reasonably determine what their good lies in. With certain modifications, these traditions were continued and in some ways even intensified in the Soviet period, although the semi-literate peasant ceased to be the main, predominant type of patient.

However, if we talk about the healthcare sector, then all over the world, paternalistic positions in it remained predominant and were not questioned until the middle of our century. The sharp, almost spasmodic departure from them that began at that time was due to the action of a number of reasons, including the rapid growth of the population's literacy and the realization of the fact that in a pluralistic society where, of necessity, coexist different systems values, the values ​​of the doctor, and consequently, his ideas about the welfare of the patient, may not coincide, sometimes very significantly, with the values ​​of the patient himself and his ideas about his own welfare.

SITUATIONAL PROBLEM No. 10

Doctor-Patient Relationship

The Swedish model of the welfare state is often called socialist, they talk about the phenomenon of Swedish socialism. Indeed, the principles of social policy pursued in Sweden largely coincide with the principles of social policy pursued in the USSR.

It should also be noted that with all the diversity of the model of building a welfare state in Western countries, it was inevitable that in one volume or another they assumed: control and participation of the state; involvement of formal social procedures; the existence and formation of the main instruments by which the state seeks to guarantee a minimum level of well-being and through which it redistributes resources in non-market ways. Thus, fundamentally, Western doctrines gravitate towards the idea of ​​state guardianship over the social sphere, i.e. the basic principles of the paternalistic model are not alien to them. Therefore, the characterization of the model of state paternalism seems to us very appropriate.

So, in the directive economy of our country and other socialist countries, the so-called paternalistic model of social policy was implemented. It was paternalism that was the most important feature of this social model. The Hungarian sociologist and economist J. Kornay defines paternalism as follows: "the central leadership assumes responsibility for the economic situation and at the same time claims to use any tool from the arsenal of administrative means that seems to it the most appropriate."

At first glance, the state, concentrating in its hands the bulk of the resources necessary for economic and social development, can distribute them with the greatest efficiency, satisfying, as far as possible, the most urgent needs of members of society. However, under the conditions of totalitarian rule, paternalism turns into the dominance and lack of control of the bureaucracy, which creates the prerequisites for the emergence of corruption, the adoption of ineffective decisions, and the intervention of the state into privacy citizens. An even worse consequence of paternalism is the growth of social passivity of citizens, reliance on the state as the highest authority in resolving all social problems.

One of the characteristic features of the paternalistic model is the strict directive regulation of the production, distribution and exchange of social goods and services. The consequence of this in the USSR was not only an exorbitant burden for the state - an attempt to directively balance the volume and structure of supply and demand for goods and services, but also a sharp decrease in the manufacturer's interest in studying the consumer market, which ultimately led to the complete dictate of the manufacturer.

The next feature of the paternalistic model is etatism, the nationalization of the social sphere, its individual branches and institutions. Etatism is a logical continuation of paternalism and serves as an instrument of direct state intervention in the functioning of the social sphere and ousting from it any entities that can not only compete, but also offer cooperation in solving social problems.

The famous Russian sociologist O.I. Shkaratan in his work "Type of Society, Type of Social Relations" gives the following characterization of etatism as a manifestation of paternalism. He assesses the social structure that developed in the USSR by the early 1930s and persisted until the 1990s. as etacratic. “It was a new social system,” Shkaratan writes, “which was neither capitalist nor socialist, which arose in the USSR and was later extended to other countries. It has specific and steadily reproducing features that mark the formation of a new independent socio-economic and political system, which can be called etacratic (literally, the power of the state from French and Greek). Etacratism is not a chain of deformations and deviations from some exemplary model of capitalism or socialism, but an independent stage and at the same time a parallel branch of historical development modern society with its own laws of functioning and development".

O.I. Shkaratan names the main features of the etacratic model:

The isolation of property as a function of power, the dominance of relations such as "power - property";

The predominance of state property, the process of constant deepening of nationalization;

State-monopoly mode of production;

Dominance of centralized distribution;

Dependence of technology development on external incentives (technological stagnation);

Militarization of the economy;

Class-layer stratification of a hierarchical type, in which the positions of individuals and social groups are determined by their place in the power structure and are fixed in formal ranks and associated privileges;

The corporate system as the dominant form of the implementation of power relations, and accordingly - the hierarchical ranking and the volume and nature of the privileges of members of the society;

Social mobility as a selection organized from above of the most obedient and loyal people to the system;

The absence of civil society, the rule of law and, accordingly, the existence of a system of citizenship, partocracy;

Imperial multi-ethnic type of national-state structure, fixation of ethnicity as a status (when defining it "by blood", and not by culture or self-consciousness).

In his consideration of the features of the etacratic system, O.I. Shkaratan refers to the assessment of this phenomenon by M. Castells, one of the world's leading sociologists: “In the 20th century, we lived, in essence, under two dominant modes of production: capitalism and statism.

What is the ideal doctor like?

... Under statism, control over economic surplus is external to the economic sphere: it is in the hands of the holders of power in the state (let's call them apparatchiks or, in Chinese, ling-dao). Capitalism is focused on maximizing profits, i.e. to increase the amount of economic surplus appropriated by capital on the basis of private control over the means of production and distribution. Etacratism is oriented (was oriented?) to the maximization of power, i.e. on the growth of the military and ideological capacity of the political apparatus to impose its goals on more subjects at deeper levels of their consciousness".

O.I. Shkaratan notes that statism was imposed on the countries of Central and Eastern Europe by the USSR. At the same time, the peoples of countries with extensive experience in a market economy, democratic institutions, and belonging to Catholic and Protestant Christian cultures, showed particular resistance to the new system. At the same time, statism quite voluntarily and independently grew in states that did not know mature bourgeois relations that went to others. historical way than Europe - in China and Vietnam, Mongolia and Cuba, which confirms the non-randomness of its occurrence.

According to O.I. Shkaratana, all the variety of lines existing in the world today community development ultimately based on the differences between the two dominant types of civilization, which can be conventionally called "European" and "Asian". The first comes from the ancient policy. This is a chain of societies characterized by private property, a balance of relations "civil society - state institutions", a developed personality and the priority of the values ​​of individualism.

The second type is historically associated with Asian despotisms, the dominance of state property, the omnipotence of state institutional structures in the absence of civil society, allegiance, the priority of communal values ​​in the suppression of individuality. In world history, in general, both in space and in time, this type of civilization prevailed. It was in these countries, where this second, non-European line of development historically dominated, that in the middle of the 20th century. established statism.

A direct consequence of etatism is the extremely weak development, and often the absence, of market relations in the sectors of the social sphere. Moreover, the level of development of market relations is very different by industry.

In the USSR, in such sectors as education, health care, social security, paid forms were almost completely absent, and resources for their development were directed from the state and local budgets and from the funds of enterprises. In the fields of culture, communications and physical culture, market relations in passenger transport took a modified form, providing for paid forms of public service, but at the same time, prices for the services of these industries were set lower than the cost price, requiring constant and ever-increasing subsidies. In the third group of industries - in trade, public catering, consumer services - elements of the real market were historically preserved, there was also a certain share of private property. But especially actively market relations in these sectors developed in the form of a "shadow" economy.

Another essential feature of the paternalistic model is egalitarianism - equality in the consumption of material goods and services.

This principle of social policy has played an important role in ensuring the general availability of social benefits. On its basis, universal literacy was achieved in the USSR, the living conditions of millions of people were improved, the incidence of most diseases was reduced, and life expectancy was increased. At the same time, egalitarianism reduced the incentives to work among the population and negatively affected the quality of services provided. At the same time, the egalitarian principles declared by the state often came into conflict with the numerous privileges of the nomenklatura class.

The next feature of the paternalistic model of social policy - guaranteed universal employment - was due to the absence of a real labor market. With the intensification of social production, the policy of general employment faced significant difficulties, in particular, in creating new jobs. At the same time, the underdeveloped system of retraining and retraining of personnel, combined with mass primary training of personnel, did not allow prompt response to requests National economy. On the other hand, there was hidden unemployment in the country, not only in the form of employment in the household and personal subsidiary plots, but also due to the inefficient use of working time, especially on the part of engineering and technical workers and junior management personnel.

It should be recognized that the application of the paternalistic model of social policy to Russian realities was largely predetermined historically, corresponded to the peculiarities of the Russian mentality and, in addition to the nature of the Russian socio-economic and political situation, for several decades gave positive results in various areas of the social sphere. However, at a certain stage in the development of society, the paternalistic model of social policy became a significant brake on improving socio-economic relations. Therefore, as Russian society was being reformed, alternative models of social policy were required.

Returning to the typology of G. Esping-Andersen's social policy discussed above, we note that the social security system in the late 1980s. in Russia, as in other socialist countries, it formally approached the social-democratic model, which implies a large role for local governments; high level social security costs; high employment stimulated by the state; availability of private sector organizations providing services; emphasis on compulsory insurance; tax redistribution of funds, with the main sources of funding being the state and municipalities.

However, in reality, under the pressure of the mono-party ideology, the social policy of the socialist regime was practically deprived of independence, therefore, the main characteristics of the socialist system of the welfare state in the interpretation of Esping-Andersen are anti-liberal orientation, hierarchy, static, a mixture of socialist ideas with conservative elements of politics.

Publication date: 2014-11-03; Read: 2746 | Page copyright infringement

Paternalism

1. Patronage and care from the father, the elder in relation to the younger, the child or the ward. 2. In the social sciences, this term denotes guardianship on the part of the state in relation to the citizen and the corresponding worldview, the content of which is the expectation of help and protection from the state to the individual.

PATERNALISM

from lat. paternus - paternal) - eng. paternalism; German paternalism. 1. The type of leadership, in which leaders provide satisfaction to the needs of subordinates in return for their loyalty and obedience. 2. Patronage, "paternal authority" of an individual or group over another individual or group considered weak. 3. Ideology and social. practice in the field of labor relations, which is manifested in charity and the care of entrepreneurs for their employees. 4. The policy of industrialized countries to assist developing countries, in fact fixing the economy. and watered, the dependence of the latter.

Paternalism

from lat. paternus - paternal) - a type of relationship that manifests itself in the patronizing attitude of the state, company, individual to subjects dependent on them. Behind guardianship and protection is total power: the flock cannot live without guardianship, is not capable of independent existence. This phenomenon was studied in the works of J. Locke and M. Weber. An example of paternalism is the attitude towards the aboriginal peoples of the North. At the corporate level, paternalism manifests itself in a system of lifetime employment, in receiving a large retirement benefit, in a system of automatic salary increases depending on age and length of continuous work. Traditions of paternalism allowed Japan to achieve success in the economy. In Russia, its consequences are not so positive.

Paternalism

paternalism), an authoritarian model of leadership of subjects (employees), which involves the establishment of such relations, which are formed between imperious but benevolent parents and children. P. is especially characteristic of the relationship of the owner and slave on the plantations of the Old and New Worlds, for prom. enterprises of the first years of industrialization in Europe and the USA. However, something similar to P. is observed in our time on many others. s.-x.

Models of doctor-patient relationship according to Robert Veitch.

and prom. enterprises, in the state institutions (clientelism). in the USA in the 1920s and 1930s. on the initiative of company owners, local unions of workers were created, to-rye, together with housing construction programs and equipment for staff recreation areas, aimed to interest the workforce in the well-being of their company. A similar policy was pursued by the Japanese. entrepreneurs. In both cases, the desire of the owners of the enterprise to neutralize the dissatisfaction of the workers and exclude the influence of branch trade unions (trade unions) on them was reflected.

PATERNALISM

paternalism is a system by which a government (organization) treats its subjects (employees), creating an authoritarian model of family relations, that is, the relationship of an authoritative but benevolent father with his child. The stronger one seeks to legitimize social, economic and political inequality, declaring that domination is best in the interests of the oppressed one, and the latter is declared immature and unable to take care of his own affairs, so the government (organization) must act in loco parentis (instead of parents). Paternalism is widely used as a legitimation ideology in pre-industrial societies, in colonial regimes, and in personal relationships. These include patron-client relations, the "civilizing" mission of the European powers in Africa, master-slave relations under the slave system, and certain relations between teachers and students.

PATERNALISM

P ATERNALISM) This term refers to the relationship between father and child, however for the most part used to describe the relationship between superiors and subordinates. The analogy with a father and a child was used by M. Weber when developing a model of traditional political authority in the form of patrimonialism, within which the features of the authority of the head of the family (patriarchy) extend to the management of entire territories. In the case of politics, subordinates respond to the "patriarch" with loyalty and obedience in exchange for his patronage. Paternalism is correlated with the organization of economic productive units, both agricultural and industrial, designating this term as a way of regulating relations between the owners of the means of production or their agents and subordinates, which is also associated with the patriarchal model. Paternalism has the following features. (1) It is associated with differentiated access to power and resources: the subordinate depends on the paternalist, because he does not have sufficient resources for self-sufficiency. (2) The ideological aspect of paternalism is related to the justification of submission, emphasizing the caring role of the paternalist. (3) Paternalism is a collective form of social organization, whereby the paternalist may be an individual, while his subordinates are seen as a collective. (4) In modern industry, paternalism tends to be systematized and institutionalized, forming part of the system of organizational rules. (5) Paternalism is usually a widespread attitude, covering all aspects of the life of subordinates and affecting the personality as a whole, not limited to individual activities of the individual. Paternalism differs from traditional capitalist relations in the following ways: (1) it assumes an inequality of power, whereas the official ideology of capitalism is that economic exchange is an agreement between equal sides; (2) the full inclusion of subordinates in paternalistic relations contrasts with the usual capitalist employment relations based on the partial involvement of workers in these relations and the separation of work and non-work life, when the only ties that bind employers and employees may be monetary relations. The classic examples of agricultural paternalism are relations on the plantations of the Old and New Worlds. Industrial paternalism in Europe and America is mainly limited to the initial period of the factory system and the transition to a modern industrialized economy. However, paternalism persisted in Japan in the second half of the 20th century. in modern large corporations. See also: Latifundia; Patron and customer relationship.

PATERNALISM is a system of ideas and social practice built on the paradigm of the relationship between "father" and "children".

For paternalism, the following are the keys to paternalism: -no-chi-va-et av-no-miya or freedom of sub-chi-nyon-nyh, pre-principal-ni-ma-et these or other actions without their co- gla-this, mo-ti-vi-ru-et their actions-st-via for-bo-that about their good-for-be-chii, in-te-re-sah and required-but- tyah. Forms of paternalism are different-but-about-different. In the inter-folk-from-no-she-ni-yah, under him in-no-ma-et-sya op-ka krup-ny-mi go-su-dar-st-va-mi more weak and separate ter-ri-to-riy. In the sphere of labor, from-no-she-ny paternalism is dis-smat-ri-va-et-sya as a way of ru-ko-vo-dstva on the creation of feelings -st-va common-no-sti at the pre-pri-yati-yah, special-bay “for-bo-ta” about workers. Manifestation-la-et-xia in the system of benefits, sub-si-diy, conditions for hiring, or-ga-ni-for-tion of medical assistance, incentives le management and others (a classic example is Japan). In the sphere of from-no-she-ny go-su-dar-st-va and general-st-va, paternalism is better from-ra-zhe-nie in special government measures in relation to the groups on the se-le-niya, the least protected in the so-qi-al-nom and eco-no-mic plan. In the scientific literature, sometimes from-me-cha-ut-the non-positive consequences of paternalism: dan-sko-th society-st-va, in-ro-g-yes-et Izh-di-Viennese moods. One-time-men-but-not-rarely-you-say-y-va-et-sya to me that non-acceptance of paternalism is a characteristic trait of Western societies, while in Asian and Latin American societies, he is part of the historical and cultural tradition ; at the same time, specify that paternalism and its individual forms (for example, kli-en-te-la) are preserved in something -ryh European states-su-dar-st-wah (Is-pa-niya, Italy and others). Applied to the Russian society, paternalism, along with this tiz, sometimes basic "cultural ar-he-ti-pov".

Understanding paternalism from-no-sit-sya to the number of disc-kus-si-on-nyh. The model of “father” and “de-tei” is already in deep antiquity used-pol-zo-wa-las for ha-rak-te-ri-sti-ki so-qi -al-nyh from-but-she-ny. She was mentioned in the works of So-kra-ta, Pla-to-na, Ari-sto-te-la, Plu-tar-ha; she played a special role in the works of Kon-fu-tion, considering that the state-su-dar-st-vo, built-en-noe on under -chi-not-nii “de-tey” “ro-di-te-lyam”, yav-la-et-xia is the most-bo-lee gar-mo-nich-noy form-my or-ga-ni-za -tion of society. Within the framework of the con-ser-va-tiv-noy tradition, paternalism is ras-smat-ri-va-et-sya as a sample of-but-she-ny pra-vi-te-lei and under-data, pat-ri-ar-khal-naya family is considered to be the standard of the state device-swarm-st-va (L. Bo-nald, Austrian poly -to-log E. von Ku-nelt-Led-din and others). In the Russian political thought, is the thesis about you-building-va-nii from-but-she-the tsar with the people as a “father” with “children” times -vi-va-li slav-vya-no-fi-ly. M. Weber trak-to-shaft paternalism as a form of traditional political domination (pat-ri-mo-nia-liz-ma), within the framework of someone the swarm uses av-to-ri-te-tom "pat-ri-arch" provides-pe-chi-va-et with its under-chi-nyon-ny for-shi-tu, for that the next pay him with lo-yal-no-stu and under-chi-no-no-eat.

With the development of li-be-ra-lis-ma, paternalism was subjected to cri-ti-ke. J. Locke in the work “Two treatises on rights” (1690), speaking against the views of R. Phil-me-ra about God- st-ven-nom and not-from-men-nom ha-rak-te-re of the power of the "father" (mo-nar-ha) over the "children" (under-dan-us-mi) , do-ka-zy-val, that according to the ro-zh-de-niyu "de-ti" is not-la-yut-sya ra-ba-mi "from-tsa", but ob-la-da-yut "es-te-st-ven-us-mi great-va-mi." In the book "On freedom" (1859) J.S. Mill advanced the "harm principle" (harm principle), according to someone-ro-mu the only-st-ven-nym-no-va-ni-em for fire ra-ni-che-niya svo-bo-dy in-di-vi-yes yav-la-et-sya on-not-se-nie them harm-yes to another in-di-vi-du. The “principle of harm” became central to the subsequent discussions about paternalism, as a result of which you-de-li-moose several points of view. Side-no-ki liber-ta-riz-ma you-stup-pa-yut against any form of paternalism (R. No-zik, F.A. von Hayek). J. Dvor-kin considers paternalism to be allowed only in those cases when an in-di-species, whose freedom is under-ver-ga-et- Xia og-ra-no-che-no-pits, good-ro-free-but with-gla-sha-is-sya on them, consider-smat-ri-vaya them in ka-che-st-ve ra- tsional-nyh. The American philosopher J. Fein-berg put forward a con-cep-tion of “soft-to-pa-ter-on-liz-ma”, according to a voice, but someone swarm su-dar-st-vo has the right-of-o-ra-no-chit-bo-du in-di-vid-ov in two cases: for not-to-for-go-ing not-good-ro-free actions from their side and for the must-ta-new-le-niya of that, are their actions good-ro-will-us-mi. They also talk about the models of “shi-ro-ko-go” and “narrow-ko-go” paternalism, paternalism of mo-ra-li and paternalism of good-go-po- lu-chia and others. Discussions about paternalism play a big role in bio-ethics, criminal law, management-management and other fields of knowledge .

Big Russian Encyclopedia(BDT)

Literature

• Susak V. Paternalism // Sociology: theory, methods, marketing. 2007. No. 3
• Aycan Z. Paternalism: towards conceptual refinement and operationalization // Indigenous and cultural psychology: understanding people in context / Ed. by U. Kim, K. Yang, K. Hwang. N. Y., 2006
• Brennan S. Paternalism and Rights // Canadian Journal of Philosophy. 2004 Vol. 24. No. 3
• Kleinig J. Paternalism. Totowa, 1984
• Paternalism / Ed.

  Models of the relationship between the patient and the doctor

  by R. Sartorius. Minneapolis, 1983

• Dworkin G. Paternalism // Monist. 1972 Vol. 56. No. 1
• Mill J. Utilitarianism. About freedom. SPb., 1900

Article posted by

Shibin Vladimir Eduardovich

Social policy plays a huge role in the domestic policy of any state, since the problems that arise in the social sphere are directly related to the development of the economic and political life of the country, and therefore are a kind of indicator of the development of society.

Social politics- this is the activity of the state and / or public institutions related to the relations between social groups and communities regarding the conditions for the creation and distribution of a social product, which makes it possible to reconcile the fundamental interests and needs of these population groups with the long-term interests and goals of society.

In a narrow sense, social policy can be defined as a system of measures aimed at the implementation of social programs, in particular, at maintaining incomes, the standard of living of the population, providing employment, supporting social sectors, and preventing social conflicts.

The main indicators of social development that are under the influence of social policy are: income as material sources of subsistence; employment; health; housing; culture; education; environment. The social policy of the state is implemented through the mechanism government programs social security and social service systems.

The main goal of social policy is to ensure the dynamic development of the socio-political system by creating conditions for able-bodied citizens to maintain their well-being through their work and enterprise, and for disabled, socially vulnerable segments of the population to guarantee social protection and support.

Social policy includes four main parts:

Creation of legal, organizational and financial conditions for social organizations to meet the various needs of members of society;

Creation of legal, organizational, production prerequisites for independent earning of funds by citizens to maintain the necessary standard of living;

Creation of conditions for meeting the needs of the population through the development of social infrastructure owned and / or at the disposal of state or municipal authorities;

Organization of production, distribution and consumption of certain goods and products at manufacturing enterprises and social institutions owned and / or at the disposal of state or municipal governments.

There are various models:

· Social democratic model (Scandinavian model)

In this type of social policy model, a significant part of social spending is borne by the state, and the main redistribution channel is the budget. The state bears the main responsibility for the social welfare of its citizens and is the main producer of social services. Services (education, health care, care for children and the elderly, etc.) are in most cases organized by the municipalities. This system operates through redistribution (for example, the budget or social insurance funds), and the share of social spending is very high. This model is to some extent embodied in the policies of such countries as Sweden, Finland, Denmark, Norway.

conservative model (continental)

In this model, the state, as a rule, is only responsible for issuing social benefits to recipients, that is, for social security, but does not organize social services. Here, the budget allocations and insurance contributions of the employee and the employer for social events are approximately equal, and the main channels of redistribution are both public and private (but under state control) social insurance funds. This model is followed by Germany, France, Austria, Belgium.

liberal

This model is characterized by minimal participation of the state in the social sphere. financial basis the implementation of social programs is primarily private savings and private insurance, and not the state budget. The state assumes responsibility only for maintaining the minimum income of all citizens and for the well-being of the least weak and disadvantaged sections of the population. However, it maximally stimulates the creation and development in society of various forms of non-state social insurance and social support, as well as various means and ways for citizens to receive and increase their income. A similar model of the welfare state is typical for the USA, England and Ireland.

· Pan-European model of social policy

The basis is the principle of combining economic efficiency and social solidarity. Emphasis is placed on the balanced development of European social policy, transparency and respect for the interests of all EU member states. There is a process of reorientation of social programs from a universal level to an individual one, which is much cheaper and more efficient, since targeted assistance is provided only to those who really need it.

· Other..

However, all existing models of social policy, with all their differences in different countries world as a whole implement two main approaches.

State paternalism . It is focused on the definition by the state of qualitative (ideology) and quantitative (social sphere) parameters of all forms of relations in society without exception and the elimination (prevention of occurrence) of alternative types of these relations.

This approach to social policy assumes that the state assumes full responsibility for the level of income of citizens (households), their social security in the absence of deviant behavior of a citizen (which differs from the ideology adopted by the authorities).

All costs associated with social policy, when using this approach, are financed from public sources - the state budget, special funds for social purposes. The state strictly controls the measure of consumption of able-bodied members of society, setting the wages of workers, regardless of the economic performance of the enterprise where they work.

At the same time, the state plans the volume of production of consumer goods and services, distributing the resources necessary for this among producers. Prices for manufactured products are set by government pricing agencies, regardless of the level of commodity filling of the respective markets. As a rule, the state allocates a list of socially significant goods, the prices for these goods can be below cost (for example, children's assortment, housing and communal services) and "luxury" items, the prices of which, as a rule, are significantly higher than cost (cars).

The state also takes care of providing households with housing, if necessary, of distributing land plots for the development of natural agricultural production.

Dignity social policy of state paternalism is the so-called "confidence in the future" for the bulk of the population. Excluded as social phenomenon unemployment. The size of wages and social benefits, the list of free guarantees in health care, education and other areas of social life are known in advance. Stable are the prices of essential goods and services. There is a development of the intellectual potential of the nation, which, however, in many cases remains unclaimed. The state protects the economic and social rights of ideologically obedient citizens in the sphere of labor and employment, but often at the expense of economic efficiency.

TO shortcomings this approach first of all, the shortage of goods and services, including goods and services of prime necessity. The state is forced to intervene in the sphere of their distribution, replacing the money turnover in certain sectors of the consumer market with the turnover in one way or another of documented rights to purchase goods and services. By tightly controlling the ratio between the measure of labor and the measure of consumption, the state does not allow the development of economic activity on a significant scale in the non-state sector of the economy, which could lead to an uncontrolled increase in income. The level of well-being of citizens depends not so much on the results of their activities, but on belonging to a particular organization: based on political priorities, the state, in conditions of a commodity deficit, uses the mechanism of funded distribution of goods and determines the organizations where they are sent in a priority order. The development of independent intellectual centers and self-organizations of citizens - potential opponents of the existing model of organization of society and the social policy pursued in it - is not encouraged. The appearance of economically independent households in any significant numbers is also not encouraged.

Social policy based on the model of state paternalism was carried out in the former USSR and the Russian Federation as one of its constituent republics from the late 1920s. (when the so-called "socialist" industrialization began, which required the concentration of resources in the hands of the state) until the end of the 1980s, when the laws "On cooperation", "On the state enterprise (association)", a package of regulatory documents "On radical restructuring" were adopted economic management". The expansion of the economic component of public life at that time due to the abolition of part of the administrative and ideological restrictions led to the rapid collapse of the social policy being pursued - new economic opportunities turned out to be much wider for a part of the population than the existing social guarantees.

liberal approach to social policy. It is based on the postulate of the division of members of society into economically strong and economically weak. Society's duty is to take care of the weak and create conditions for the development of the economic potential of the strong.

The economically weak have the right to count on social support financed from budgetary resources. The state establishes the rules for the access of citizens (households) to these systems, the types of social support and their amounts. At the same time, the principle of targeting is widely used, according to which households with per capita incomes exceeding a certain minimum are excluded from potential consumers of social support. The economically weak are guaranteed to receive various social benefits from the budget, including means-tested benefits, disability pensions, social pensions granted in the absence of work experience, and some other payments. For the economically weak, there is also the possibility of free rental housing in municipalities, but the quality of this housing is significantly lower than that purchased on the free market.

In addition, the state creates prerequisites for the development of charitable activities of legal entities and individuals, expanding the possibilities of social support for economically weak households.

In the event that the state is interested in solving any major socio-economic problems, it provides social support to both economically weak and economically strong households at the same time. Such a situation may arise, in particular, when stimulating the migration of the population from labor-surplus regions to labor-deficient regions through the provision of special housing subsidies to households. But the size of these subsidies, as a rule, is differentiated depending on various factors, and above all on the size of per capita income in households.

As for economically strong households, they are in most cases excluded from social support systems financed from the state budget. This, however, does not mean that they are not entitled to such support - what is important is that it comes from other sources of funding.

These sources, with a liberal approach to social policy, are formed at the expense of mandatory social insurance contributions. During the period of their employment, the employee and the employer are obligatory participants in state insurance systems that ensure the payment of monetary compensation in the event of such major insured events as, for example:

a) reaching the retirement age and length of service sufficient for the appointment of labor pensions;

b) a disease associated or not associated with professional activity, and temporary loss of working capacity. In this case, reimbursement of the cost of medical services related to treatment under compulsory medical insurance programs is carried out, and the employee is reimbursed for temporary disability benefits;

c) recognition of a citizen of working age as disabled (determination of disability), as a result of which he is assigned a disability pension;

d) the loss of a workplace by a citizen of working age and his registration as unemployed, after which he is assigned unemployment benefits.

The state establishes the principles and algorithms for determining the payment of mandatory social benefits in the social insurance system, promotes the development of non-state social insurance.

The salary of employees, with the exception of those who are employed in organizations financed from the budget, is set by employers independently, depending on the results of the economic activity of the organization.

The production of goods and services for the population is carried out not in accordance with the approved state plans, but on the basis of the existing solvent demand of the population.

Main dignity liberal approach Social policy is focused on revealing the abilities of members of society (primarily for productive and creative work) in the interests of an unlimited increase in the level of their consumption by the state and partial redistribution of resources in the interests of social support for households in need of it. In households that constantly participated in mandatory social insurance systems (primarily pensions) with their contributions, the level of income in the event of insured events (for example, reaching retirement age) decreases slightly. The consequence of the economic and social self-realization of citizens is the independence of most households from the state, which is a factor in the development of civil society.

Flaws this approach are manifested in significant differences between the levels of consumption of economically strong and economically weak households; the values ​​of social payments made from the state budget, on the one hand, and social insurance systems, on the other hand. These differences for different categories of households also occur in the case of receiving social benefits from the same funding sources.

Operating at the turn of the XX-XXI centuries. in Russia, the Federal Law "On Employment in the Russian Federation" established a significant differentiation in the amount of unemployment benefits for registered unemployed, depending on their work biography - from the minimum wage to the subsistence level established in the corresponding region - a subject of the Russian Federation. At the end of 2000, the difference between the minimum (100 rubles) and the maximum (1285 rubles on average in the Russian Federation) monthly unemployment benefits amounted to almost 13 times.

General between the considered approaches to social policy lies in the fact that in the event of extreme (force majeure) situations due to natural (earthquakes, floods, etc.) or man-made causes (accidents, terrorist attacks, etc.), assistance from the state budget is provided to everyone without exception households regardless of their income level.

The social policy pursued in Russia in the 1990s was of an eclectic nature. It combined elements of the social policy of state paternalism and a liberal approach. Elements of targeted social support were introduced, for example, to receive monthly child allowances in the late 1990s and early 2000s. only those households with children whose per capita income did not exceed 100% of the established subsistence minimum could apply. In the regions, various models for assigning need-based benefits were tested. The non-state sector of the social sphere developed, providing its services at market prices in health care, higher education. In these sectors, free social services provided for by the Russian Constitution were preserved. At the same time, the majority of the population still paid for housing and communal services and partly for transport services at prices below their cost, in connection with which the regional and local budgets provided for the allocation of funds for subsidies to enterprises providing these services.

All existing models of social policy are, in principle, variants and combinations of the two main approaches discussed above. They can differ in the values ​​of their basic indicators, which allow one of them to be attributed to state paternalism, and the other to liberal models.

In particular, with a liberal approach to social policy, the degree of participation of the employee and employers in mandatory payments to the social insurance system can fluctuate significantly. So, if in the mid-1990s. Employee contributions in Denmark exceeded employer contributions by almost 4.2 times, and in the Netherlands - 3.4 times, while in Sweden almost all social insurance contributions were made by employers, and the share of employees was only 0.7%. This share was also low in Iceland (3.9%) and Finland (5.5%).

In turn, models of social policy of state paternalism can differ in the degree of rigidity, the presence or absence of opportunities for the population to receive income in cash and in kind from alternative state sources. An example is the agrarian policy in the former USSR, when the personal household plot of citizens was considered either as an obstacle to full-fledged work in the collective farm (late 1950s - early 1960s), or, conversely, as a factor in increasing agricultural production in the country (1970s - 1980s)

The paternalistic (authoritarian, traditional) model of the “doctor-patient” relationship is that the doctor manages the treatment, makes a decision, informs the patient to the extent that he considers it necessary, and the patient is passive, completely subordinate to the doctor.

The goal of this model is the health of the patient.

This model is the earliest in the history of medicine. It arises simultaneously with medicine and subsequently consolidated due to the following circumstances. First, initially and to the present time, the doctor and the patient are unequal parties, primarily in medical terms: the doctor is a professional, the patient is a layman in most cases. Secondly, by virtue of the foregoing, the patient is forced to trust the doctor. Thirdly, there have always been and will always be situations in medicine when, in order to save the health and life of a patient, a doctor takes full responsibility: ambulance and emergency care, intensive care, resuscitation. Fourthly, in some countries the paternalistic model is fixed as almost the only possible one: authoritarian and totalitarian regimes. Thus, in the USSR, the paternalistic attitude of the state towards citizens was fully correlated with state publicly available free medical care.

In the Hippocratic Oath we find a written confirmation of this model. The oath orients the doctor to avoid harming the patient, but at the same time insists on the patient's tacit submission to the doctor. One of the norms of the oath recommends, for example, to a doctor - “one should not tell the patient anything about the current and possible future state of his health.” In accordance with the Hippocratic oath, the doctor is given the full right to solve the problem of informing the patient without the participation of the latter.

The paternalistic model implies that the relationship between the doctor and the patient is similar to the relationship between parents and children (“pater” - lat. - father): patronage, full responsibility and care on the part of the doctor and thus the patient's dependence on him in everything.

The long existence of the paternalistic model testifies to its certain historical justification, to the constant trust in doctors by patients. Opinion polls conducted by the Medical Association of Finland testify to a high level of trust in doctors: 76% of respondents said that a doctor should act in each case at his own discretion, not agreeing with the patient; 90% of those surveyed admitted that they had never disputed the diagnosis.

Due to the fact that the patient in this model acts as an object, the paternalistic model contains the possibility of a neglectful, inattentive attitude towards inner world patient, to his mental and moral state. This is evidenced by the language forms (replicas) that are formed in the process of healing and in domestic medicine: “have lived, grandmother, and that’s enough”, “your heart is older than you”; in the X-ray room - “lay down, mother, now we will remove your head”, etc. Here we see a clear violation of deontological norms, and it is caused, not least, by the low general and professional culture medical personnel.

For domestic medicine, the dominance of the paternalistic model is due, in addition to the above reasons, to the long-term existence of authoritarian social relations, in which the rights of the state, society, collective, and not an individual, a citizen, have always been a priority.

In the middle of the 20th century, the paternalistic model of the “doctor-patient” relationship faced serious difficulties, the main of which were the growing self-awareness of a person as a citizen and as a patient; raising the status of health, life as the highest value of a person, threatened by modern medical technologies. The time has come for new models of “doctor-patient” relationships, including the “informed consent” model.

Introduction

1. Models of social policy
2. Principles of the strategy of social and economic development of Russia
3. Social Policy Priorities
4. The current stage of development of social policy in Russia

Conclusion

Bibliography

Introduction

The transformation of Russian society has given rise to qualitatively new phenomena in all spheres of life. It deeply affected the level, and especially the quality of life of Russians, demanded an adequate social policy.

Adopting a range federal laws and programs that provide for a change in the structure and directions of social protection activities, in itself, unfortunately, did not remove the acuteness of vital important issues many categories of the population. In society, there are always social strata, families and individuals who find themselves in difficult life situations. For them, in addition to providing general living conditions, additional social protection is required, including targeted social support and social services.

The system of social protection of the population of the Russian Federation has entered the second decade of its development. Since 1991, having been revived as a new type of professional activity, it has gone through a certain path marked by rapid development.

The main purpose of writing this term paper is to determine a new course for the development of social policy in Russia. To achieve this goal, it is necessary to solve a number of tasks:

Consider the main models of social policy;

Outline the main principles of the strategy of social and economic development of Russia;

Identify social policy priorities;

Consider the situation in the development of social policy at the present stage.

To consider this topic, textbooks and periodicals by such authors as Goncharov P.K., Laikam K., Pronin S., Ishaev V., Karelova V. and others were used.

1. Models of social policy

States in the post-socialist space have common problems in the social sphere. Among them, one of the main ones is the presence of huge state social obligations inherited from the socialist system and not provided with financial resources.

In the modern history of the post-socialist period, there are two main models for the development of social policy: the paternalistic model and the targeted social system.

paternalistic model social development was borrowed from the practice of regulating the social sphere of the Soviet Union. It is characterized by a strict definition by the state of human behavior in the social sphere and social protection coverage of almost the entire population. . (5)

For models of targeted social policy performance differentiation is characteristic social functions the state in relation to various segments of the population, the redistribution of state social expenditures in favor of the most vulnerable groups of the population, increasing the efficiency of the social system, reducing social tension in society.

The period of transition to a more effective model of social policy is characterized by the complexity and depth of the necessary changes and requires a comprehensive, systems approach. Reforming the social sphere cannot be considered and implemented in isolation from the implementation of macroeconomic reforms, reform state power. During this period, a specific transitional model.

The level of social tension, the volume, and the nature of the accumulated social problems require a step-by-step, evolutionary approach to building a new model of social policy. In the process of transition to a targeted social system, the following main stages can be distinguished:

Anti-crisis management of social processes in society;

Achievement of social stability;

Sustainable development of the social sphere.

Social policy in post-socialist Russia, as in many other countries with economies in transition, was focused primarily on maintaining the scale of social services provided by the state. At the same time, efforts aimed at improving the effectiveness of social programs receded into the background. Against the background of a rapid decline in GDP, there was an increase in the share of social spending in total government spending.

The main form of social protection of the population in countries with a market economy is social insurance. The modern system of social insurance is still characterized by the main features and problems of the paternalistic model of social development. The process of reforming the system, which was formed in the conditions of centralized, planned management and leveling grounds, is far from being completed.

State extrabudgetary social funds formed the basis of the state insurance system: the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Compulsory Medical Insurance Fund and the State Employment Fund. In addition to extrabudgetary funds, the source of financing for social policy is a three-level budget system, including the Federal budget of the Russian Federation, regional and local budgets. (4)

The increase in the share of social spending that occurred in the 1990s could not prevent a decline in the standard of living of the population, including workers in social sectors. It only led to a further rapid increase in the problem of the budget deficit.

In general, the paternalistic model of social development shows its low efficiency in regulating social processes in modern society. Among its many shortcomings, the following should be highlighted:

• inconsistency of the financial capabilities of the state with the volume of legally defined social obligations;
• unreasonably high (in terms of financial capacity) spending on the social sphere;
• insufficient interdepartmental coordination of bodies involved in the formation and implementation of social policy;
• cross implementation of social programs causing duplication social assistance;
• imperfect system for evaluating the effectiveness of spending on the social sphere;
• lack of a systematic approach to the formation of social protection of the population.

The imbalance of resources and obligations of the state is the most acute budgetary problem, the solution of which is singled out as one of the strategic tasks of the country's development at the present stage.

The problem of the fuzzy delineation of expenditure and tax powers between budgets of all levels has a significant impact on the effectiveness of the implementation of social policy.

So the social system modern Russia carries an archaic structure of the distribution of social services by type, category of recipients, sources of funding and place of assistance.

However, application to initial stage socio-economic transformations in Russia, the paternalistic model of social policy was justified due to a number of objective reasons:

A sharp drop in the standard of living of the majority of the population;

Lack of experience in solving such large-scale tasks in the field of social policy;

Insufficiency of technical and normative-methodological means for solving many problems of social reforms;

Insufficient certainty of the socio-economic priorities of the state;

Immaturity social structure society;

The need to make full use of those resources, forms and methods of work that remained from the pre-reform system of social protection.

In view of the scale and significance of the accumulated problems, the reform of the social policy of the state is defined as one of the strategic tasks of the country's development at the present stage. Social reform is seen as an inseparable part of the state's economic and financial strategy.

The priority direction of social reforms is the transition to a more effective model - a model of targeted social policy, implemented taking into account the resources and opportunities actually available to the state and focused on supporting the most socially vulnerable groups of the population.

The targeted approach will make it possible to redistribute resources allocated to social policy in favor of the most needy categories of the population, increase the amount of benefits and other payments, while reducing the burden of inefficient government spending. Particularly needy categories of the population, in favor of which it is planned to redistribute state social expenditures, first of all, should include families with children, the elderly, the disabled and the unemployed with incomes below the subsistence level.

The main target characteristics of the targeted social policy model include the following:

• differentiation of the social policy of the state in relation to various segments of the population;
• correct allocation of categories of recipients of social assistance;
• using the principle of targeting as a means of redistributing social assistance to the most needy groups of the population;
• "municipalization" of social policy by transferring a significant part of the powers to determine the amount and forms of social assistance to the regional and municipal level;
• transfer of the social insurance system to the principles of voluntary social risk insurance;

a clear delineation of powers in the implementation of social policy between the levels of the budget system.

One of the fundamental problems of the targeted model of social policy is the problem of minimizing the costs associated with the correct definition of the recipient of social assistance. The challenge of developing effective and inexpensive means testing methods that are well adapted to local conditions is one of the most important for the phase of social policy reform. Existing means testing methods based on legal income are imperfect and insufficient.(7)

The strategic goals of social policy in Russia, defined at this stage of development, are:

• achieving a tangible improvement in the material situation and living conditions of people;
• ensuring the efficiency of employment of the population, improving the quality and competitiveness of the labor force;
• guarantee of the constitutional rights of citizens in the field of labor, social protection of the population, education, health protection, culture, housing;
• reorientation of social policy towards the family, ensuring the rights and social guarantees provided to the family;
• normalization and improvement of the demographic situation, reduction of the mortality of the population, especially of children and citizens of working age.

Achieving the goals defined above involves a phased transition to a targeted model of social policy, within which the following main tasks are identified:

• a significant increase in social policy;
• streamlining state social obligations;
• concentration of efforts on solving the most acute social problems;
• significant improvement of social infrastructure;
• development of new mechanisms for the implementation of social policy.

As part of the implementation of the targeted model by the social system of the Russian Federation, the following main stages can be distinguished.

The current situation in the social sphere can be considered as a stage of anti-crisis management of social processes.

The task of social policy in the near future is to achieve social stability in the development of society. Social stability is such a state of social processes in the country, which allows for the progressive development of the economy, maintaining political stability in society.

The social stability of the development of society is ensured by the implementation of an effective social policy of the state, based on the following basic principles:

• recognition of the need for dynamic development of the social sphere as one of the most important conditions for the sustainable development of society;
• clear definition of priorities in the field of social policy, supported by state level;
• ensuring controllability of social processes on the basis of maintaining the unity of the social space and ensuring federal minimum guarantees in the field of social protection of the population;
• ensuring the unity of social policy in various levels management.

The state of sustainable development of the social sphere is characterized by a constant improvement in the qualitative indicators of the social sphere, the absence of a threat to the social stability of the development of society and the presence of potential for further development.

The sustainable development of the social sphere is becoming a fundamental feature of the long-term strategy for the socio-economic development of the Russian Federation, which is being formed at the present stage. (4)

2. Principles of the strategy of social and economic development of Russia

The state in a market economy acts as an organizer of the economic order, responsible for establishing the rules of the game and being the guarantor of their stability and implementation, and as a spokesman for public interests. The transition to the modern market is the problem of choosing between the speed of transition and the achievability of the expected effect. Under the current conditions, the evolutionary formation of an effective market economy in Russia takes a long time, will predetermine its further lagging behind the countries leading economic development and will be accompanied by a large-scale loss of production and resource potential, unacceptably high social costs.

The strategy should be based on high, worthy of Russia and at the same time achievable long-term goals. This is the transformation of Russia into a dynamically developing power, provided on the basis of intensive work and business initiative, reasonable and consistent economic policy, the average European standards of living in Russian natural and climatic and geographical conditions. (6)

The condition for successful economic development is social consolidation. In order to launch interdependent processes of social consolidation and strengthening of the state, the following conditions are necessary:

• the choice of such a strategic goal, which has a consolidating potential, is able to unite the efforts of different social groups. Formation of a social contract mechanism between the state, government, business, society, on which, in particular, the institutions of the legitimacy of the state and property will be based;
• creation of a new system of social order that regulates the behavior of the main social actors in the context of the implementation of the strategic goals of the state.

A successful strategy for the development of the state according to the principle of well-being for the majority will be determined by the dynamics of the formation of a mass middle class. The formation of the middle class presupposes the formation of a new model of consumption of the Russian welfare standard. Such a standard should include quality housing, a high endowment of durable goods, and quality health care and education.

Currently, only 5-7% of people live in accordance with Western standards of well-being. And the entire current Russian class, which has retained the pre-perestroika standard of living, is no more than 20%. The layer of poverty, in which the average per capita income does not even cover the subsistence level, covers almost 60 million, or about 40% of the country's population. At the same time, almost 30 million people live on the verge of poverty, which has become stagnant.

Mechanisms for achieving strategic and socio-economic goals. The decisive condition in ensuring economic growth, and consequently, the entire strategy for the development of Russia as a social state in the next 10 years, is investment breakthrough. He suggests:

Forced growth of capital investments;

Investment support for a number of key sectors;

Innovative filling of investments.

But for investments to become a significant factor, the role in their material support should be played by domestic production of investment goods, in particular engineering. This implies an accelerated modernization of this sector based on domestic and imported equipment and technologies.

It is necessary to take into account a number of threats to economic dynamics:

1. Lack of domestic demand.
2. external debt.
3. Unpreparedness of the investment complex for large-scale investments.
4. A disproportionately high rate of growth in prices for fuel, electricity, transport tariffs.

An effective trajectory of economic growth in the medium term naturally falls into three periods.

First period- high growth rates and increased investment, based on the involvement in the economic turnover of the as yet unused potential and the associated opportunities for a significant increase in the efficiency of resource use. Within this period, it is possible to achieve growth rates of 8-10%.

Second period- a significant decrease in dynamics due to the depletion of reserves and the delay in the commissioning of new capacities, carried out at the expense of investments in recent years. Calculations show that its duration can be two to three years. At the same time, economic growth rates may drop to 2-4% per year.

Third period. Starting from 2006, it is possible to enter a stationary development trajectory with the growth rate remaining at a level of at least 5% per year for a decade. The task is to create conditions for expanded reproduction based on predominant domestic savings and investment opportunities.

About the budgetary policy. A balance is needed between social commitments and its ability to mobilize financial resources, both at the federal and regional levels.

The federal budget deficit simply shifted to the budgets of the constituent entities of the Russian Federation. This is due to the fact that the social obligations of the regions, which are also state obligations, are not taken into account, i.e. financial resources are transferred to the federal budget, while obligations and responsibilities remain in financially disadvantaged regions. The elementary truth is that a single state should also have a single state budget, which must take into account the entire amount of income and expenditure for the corresponding year on the territory of the country.

The general principle of achieving a balanced and real deficit-free budget is not to reduce expenditures, which the last government is constantly doing, but to outstrip the growth of revenues to the budget, which is based on revenues received by the real sector. (10)

1. Social Policy Priorities

The most important objectively determined requirement for the social policy of the period of transition to a market economy is the observance of the principle of maintaining social balance in the process of moving society to a qualitatively new state. In this regard, attention should be paid to the following significant points.

First. Social balance in a modern industrial society is a policy that reflects the interests of the majority of the nation.

Second. Social balance is maintained by the following methods: in the social sphere - by ensuring equal social rights, the policy of social stability and equalization of living standards and incomes of social groups, global and local mechanisms of social protection against shocks or "failures" of the market. In the economic sphere - state regulation of the economy, prices, incomes, employment, financing of social infrastructure as a nationwide system of social reproduction and social guarantees. In the political sphere - broad, mass democracy, a system of institutional mechanisms for ensuring the democratic and social rights of citizens, including mechanisms for the real influence of citizens on politics.

The establishment of the principle of social balance as a fundamental basis for stability and development is a historical turning point in the development of modern states. It is this circumstance that gave impetus to the development of modern social policy as a means of ensuring such a balance, both in the current and in the long term. A whole set of medium-term and long-term guidelines was developed, based not on intuition, but on scientific forecasts of social and economic development trends.

Social policy is distinguished by the specifics that it does not have its own autonomous tools, mechanisms that ensure the implementation of goals. Social policy is born by legislation (social, labor, economic), as well as economic policy. Strictly speaking, a genuine economic policy takes place when and only when society and the state perceive social goals as priority areas. Moreover, social policy is a mechanism for ensuring permanent transformational processes. At critical stages of development, this mechanism is especially important, since then the transformation is always associated with profound changes within the social structure, the growth and expansion of some social groups, the narrowing and disappearance of other groups, changes in their incomes, status and prestige, quality of life. All this inevitably leads to a serious breakdown of the existing system of differentiation of social groups on the macrosocial income scale.

From this point of view special attention deserve basic models of social differentiation. There are certain optimal and marginal levels of income differentiation, if we consider this phenomenon from the point of view of efficiency and welfare criteria. Conventionally, 4 main models of differentiation can be distinguished: superpolar, moderately polar, moderate and egalitarian (non-market).

Superpolar Models development for modern conditions is extremely unstable and fragile. This instability and fragility everywhere have the same manifestations. In social terms, this is the insecurity of the majority, often in the form of outright poverty and destitution, and social discontent. In economic terms, this is a drop in efficiency, destimulation and demotivation of productive activity, a sharp separation of the interests of the elite, employers and workers. It is these models of development that are models of social exploitation, when the luxury and fabulous wealth of certain groups and the miserable existence of others. Such models are explosive in their social architecture, and their sustainability is maintained largely by direct repressive means. Now this model is typical for most underdeveloped countries. For such societies, the level of income differentiation between the extreme decile groups (the ratio of incomes of 10% of the richest and poorest) is at least 20-30: 1.

Moderately polar patterns. Society is aware of the need for certain changes and introduces partial elements of social regulation. They are characterized by the fact that social policy is carried out by the state in a limited field, and very narrow tasks are set before it. Such models are characterized by decile differentiation of the order of 10-15:1, which took place in industrial societies in the first half of the 20th century, and now in parts of developing countries.

moderate model- the type of model now dominant in the industrialized countries of the West and Japan. With certain features, it is generally characterized by a more consolidating social differentiation, a softer scale of social hierarchy compared to a moderately polar model. The income differentiation between the extreme decile groups ranges from 3:6 to 6:1.

Along with market models, non-market models are also possible, which arose to some extent as a reaction to the super-polar differentiation of incomes. These models existed in the former socialist countries, and now in Cuba, in the DPRK. Such models can be attributed to the models of the so-called planned differentiation, which, in addition to undoubted positive advantages, also demonstrated serious shortcomings, primarily in the economic sphere. They did not contribute to effective economic growth under normal conditions, when total resource mobilization was not required; these models are generally characterized by a very low level of income differentiation - up to 4:1. (9)

The main strategic task for Russia during the reforms was the implementation of a set of adequate political and administrative organizational measures that would ensure a relatively smooth transition to a moderate model of social differentiation without shocks and cataclysms. Despite the difficult economic situation in 1990 - 1991, Russia had every opportunity for this: a modern industrial structure, a fairly high technological level, a skilled workforce, a strong social infrastructure and low level social differentiation. The problem was only to find an integrating model for combining all these advantages with the principles of a market economy and political democracy. Such a model would give the necessary impetus to the economy and welfare.

What happened in Russia in the 90s. years, one cannot but qualify as a historical failure, a rollback back to the system of social differentiation that existed in Russia at the end of the last - the beginning of this century. Changing this situation is one of the main priorities of social policy. At the same time, it is obvious that the solution of the fundamental problems of positive development is far from completely dependent on the realities socio-economic situations in the 1990s and the presence or absence of an optimal program of action. There is a wider set of conditions that determine the success or failure of such a program, and these conditions are outside economics and social policy.

Firstly, the new social strategy is doomed to failure without a radical transformation of the entire system of state power. It's about on the formation of a system of more effective, balanced power, responsible to the people. It is necessary to develop and put into effect mechanisms that ensure the moral purity of government, as well as business. The problem of "purity" of state power in Russia in the 90s. has reached a critical point. The criminalization of the economy and corruption have reached proportions that threaten national security.

Secondly, it is necessary to significantly strengthen administrative power, its more active and large-scale impact on socio-economic processes. Without this, the formation of an effective market economy is simply impossible.

Thirdly, the consolidation of society is required at the most difficult phase of development, when the foundations of an effective market policy are being formed. In this regard, it is important, in particular, that the information transmitted by the media about the socio-economic and political development of the country be of an objective nature and be socially neutral.

All these conditions associated with the formation of a system of socially effective and responsible political power are essential for the implementation of effective social programs.

And, finally, it is necessary to carry out a deep revision of the basic principles of the concept of Russia's socio-economic development.

The success or failure of income and employment policies is critical to effective social development. The issue of forming an effective market mechanism for regulating income and wages remains topical. Such a mechanism should be based a system of close interconnection and parameters of the price of labor and the cost of labor. Only such a system is able to put into action the mechanisms of human capital, and, consequently, the entire set of motivational mechanisms. (9)

Established in the 90s. income distribution system is highly inefficient in social relations. Extremely low incomes for the overwhelming majority of the active population have become in Russian conditions one of the mechanisms for wasting human resources. A mechanism of super-polar differentiation of incomes and a sharp gap between the indicators of price and the cost of labor has been formed.

This means nothing more than the absence of social policy. Therefore, the goal of the government should be to eliminate this wasteful mechanism and gradually restore the system of parallel dynamics of the price and the cost of labor, i.e., in other words, to contribute to the formation of a normal labor market.

The underestimation of human capital leads to devastating consequences, since the economy cannot function effectively as either a productive or a consuming system. Based on the fact that the main direction for the near and medium term for Russia is the fight against poverty and misery, this means that policy priority should be given to the establishment of an efficient (both socially and economically) system of income distribution and an efficient wage mechanism.

First of all, we should talk about the transformation of the minimum wage from a formally statistical indicator into an instrument of real impact on economic processes. The priority increase in the minimum wage simultaneously means a decrease in the level of income differentiation. In addition, this creates an incentive to work and increases economic efficiency, since in this case the entrepreneur will rely on more skilled labor with greater returns. The minimum wage, at least at the level of the subsistence level, is an important tool for ensuring social stability.

Of great importance is also the policy of wage equalization and the prevention of sharp differences in wages. To do this, it would be necessary to develop and adopt a Unified Tariff System to replace the current tariff system, which is formal and limited. The current tariff system essentially does not work in much of the economy. This system has long been incompatible with the principles of social justice and is discriminatory towards public sector employees.

In the medium term (for example, within 3-5 years), the legally established minimum wage should become the main element of the system of social guarantees. First, it should be subject to mandatory indexing in full, taking into account the growth in consumer prices. Secondly, it must correspond to the minimum set of goods and services included in the concept of "living wage". Thirdly, in the future it is necessary to introduce mechanisms to increase it in accordance with the pace of economic growth.

A special place should be given to government measures to regulate wages in the public sector. In this area, a socially and economically intolerable situation of a significant income gap has developed as a result of the formation of two wage systems. On the one hand, it is a privileged system that provides special payment conditions, social benefits and guarantees of stability, and it covers public administration employees (ministries, departments, etc.). on the other hand, this is the public sector itself, where wages are an order of magnitude lower than those in state administration bodies and do not provide (even for high-ranking workers) a living wage. In addition, the problem of non-payment or delay of wages has by no means lost its relevance.

1. The current stage of development of social policy in Russia

Currently, Russia is undergoing major changes in social policy. As expected, the entire system of social protection of the population is moving to a targeted model of social policy, alas, the citizens of the Russian Federation were not ready for this.

Since June 2004, a heated discussion and presentation of various bills began. There have been changes and clarifications in the definition of the division of powers between levels of power in various spheres of our life, and a new system of social protection of Russian citizens has been built. More precisely - social support.

The benefits that, in accordance with the previous system, protected different categories of citizens who needed it, were now replaced by social support measures denominated in rubles.

And this proposed change has become the hottest topic of public debate over the past two months.

When developing this reform, it was assumed:

• Benefits are not taken away, but replaced by monthly cash payments.
• This money can be obtained only by refusing free services.
• Each group of beneficiaries has its own amount, which was calculated based on the list of federal benefits due to it.
• Those citizens who have serious illnesses (oncology, bronchial asthma, diabetes mellitus) can additionally apply for state social assistance if they need it.
• No one needs to run to social security offices, or to offices of the Pension Fund now.
• Each beneficiary will receive a notice where he is offered: either just take the money to spend it on what he sees fit (even to buy groceries in the store), or receive part of the payment in the form of a so-called social package, which includes free annual travel tickets, free medicines for a certain amount and a free voucher for treatment in a sanatorium.
• If, for example, a disabled person needs medicines and treatment in a sanatorium, but he does not travel by metro or public transport, he can choose from the social package only what he needs, and get the rest with money.
• The social package will cost from 300 to 600 rubles, prices without markups, the government is going to conclude a tariff agreement with transport workers and drug manufacturers.
• Monthly payments will be indexed as pensions (that is, increase), taking into account the rise in prices in the whole country.
• Monthly cash compensation benefits will be paid along with the pension, but as a separate increase.
• The increase in pension will increase social payments to 6.5 - 7 thousand rubles a month.
• The new social assistance scheme will come into effect in January 2005.
• One of the largest groups that enjoy social benefits - labor veterans and home front workers - is not included in the group of federal beneficiaries. (12)

Table 1.

What payments await beneficiaries?

	Monthly payment (rub.)
Heroes of the Soviet Union, Russia, Socialist Labor, holders of 3 Orders of Glory and Labor Glory
Disabled people of the Great Patriotic War
Participants in the fighting
Inhabitants besieged Leningrad(not participants in the war)
Group I disabled
Group II disabled
Disabled group III
Children - invalids and invalids of childhood
Air defense members

Table 2.

How will incomes of pensioners increase as a result of compensation payments?

	Average pension (rub.)	Monthly cash payment (rub.)	Gross income will rise
Heroes of the Soviet Union, Russia, Socialist Labor, holders of the Order of Glory, Labor Glory			1.74 times
Disabled people of the Great Patriotic War			1.47 times
Participants of the Great Patriotic War			1.44 times
Participants in the fighting			1.53 times
Residents of besieged Leningrad			1.53 times
Military according to clause “h” of the Federal Law “On Veterans”			1.29 times
Participants opposed. defense			1.29 times
Disabled: Group I			1.66 times
			1.64 times
III group			1.79 times
Disabled children			1.74 times
Disabled people (SPK, from childhood, in s / p.)			1.98 times

In early August 2004, the issue of replacing benefits with cash payments was finally resolved. The results of this decision differ from the original reform plan.

There have been some changes in the list of beneficiaries: Heroes of the USSR, Russia, Socialist Labor and full cavaliers orders of Glory and Labor Glory. It was decided for them to keep benefits in kind in full, and the issue of their status is supposed to be resolved in a separate bill, which the government will prepare by autumn.(11)

The most significant seeing natural benefits decided to keep. In 2005, the discount on payment for housing and communal services will continue to operate. In addition, a so-called social package is being introduced, the cost of which - 450 rubles - will be deducted every month from the amount of payment received by the beneficiary. As a result, all beneficiaries who receive social support from the federal budget will be entitled to free commuter travel, free medicines (according to a list approved by the government), and a sanatorium voucher (for medical reasons).

Next year, the "social package" (and, accordingly, deductions from social payments) will be received by everyone, regardless of their desire. During the year, everyone will have to decide what is preferable to him: “in-kind” benefits and reduced payments or cash compensation in full. Applications for this will need to be submitted to local social security authorities or Pension Fund offices before October 1, 2005. It will be possible to refuse the entire package as a whole, and only one of the two parts - medical or transport.

The cost of the "transport" part of the social package is estimated at 40 rubles, the price of the "medical" part (medicines plus sanatorium treatment) - 410 rubles. Depending on the choice made by the beneficiary, the amount of the social payment due will be adjusted to him.

The Pension Fund was entrusted with paying the compensation sums - together with the pension. Simultaneously with the basic pension (which, according to our legislation, is indexed depending on inflation), social payments will also grow. And with the same indexation coefficient. Recall that today basic pensions are subject to increase if inflation exceeds 6 percent in a quarter (or six months). As a result, in last years basic pensions were indexed twice a year - in the first quarter and in August. This arrangement is likely to continue in the future.

It is also important that the amount of compensation payments will not be taken into account (will not be included in the calculation of family income) if the beneficiary applies for a state subsidy for utility bills. (6)

Table 3

What happened as a result of the benefits reform?

beneficiaries	What are the benefits now?	What has been offered since 2005
War invalids, former prisoners of fascism - invalids	Travel by city and suburban transport; medicines; housing and communal services; subscription fee for the telephone and its installation; travel by intercity transport; sanatorium vouchers; provision of transport with the transfer of the right to drive to family members; private security; prosthetics and dentures	2000 rubles
Participants of the Second World War, former prisoners of fascism	Travel by city and suburban transport; medicines; housing and communal services; subscription fee for the telephone and its installation; travel by intercity transport; private security; prosthetics and dentures	1500 rubles
Passed military service during WWII not in active army		600 rubles
Blockade, war veterans	Travel by city and suburban transport; medicines; travel by intercity transport; housing and communal services	1100 rubles
Persons who worked during the Second World War at military facilities	Travel by city and suburban transport; medicines; travel by intercity transport; prosthetics and dentures	600 rubles
Family members of the dead (deceased) disabled people, participants in the war and hostilities	Travel by city and suburban transport; medicines; housing and communal services; telephone subscription fee; private security	600 rubles
Disabled	Travel by city and suburban transport; medicines; housing and communal services; telephone subscription fee; travel by intercity transport; sanatorium treatment; provision of transport with the transfer of the right to drive to family members; prosthetics and dentures	Disabled (III degree) 1400 rubles Disabled (II degree) 1000 rubles Disabled (I degree) 800 rubles Children with disabilities 1000 rubles
Chernobyl	Housing and communal services, meals, travel by city, suburban transport, travel by intercity transport, medicines, sanatorium treatment, dental prosthetics, additional payment for work and accommodation in zones	Up to 1700 rubles depending on the status of citizens benefit holders
	Medications, dental prosthetics, travel by urban suburban transport, utility bills	500 rubles
labor veterans	Travel by city and suburban transport; housing and communal services; phone subscription fee	Measures of social support are established by the subjects of the Russian Federation
Home front workers	Travel by city and suburban transport; medicines; prosthetics and dentures
Repressed	Compensation for property damage, housing and communal services, travel by city and suburban transport, preferential travel on intercity transport once a year, medicines, transport, free production and repair of dentures, free telephone installation, forwarding and delivery of monetary compensation

Conclusion

Today, Russia is experiencing global changes in social policy in the country. The reform of social benefits has not yet yielded results, so it is too early to talk about the appropriateness and correctness of such changes. The bill spells out a norm of constitutional law: after the adoption of the law, the level of social protection of the population cannot be worsened compared to what it is today. It either needs to be kept or improved.

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