Issue 2013 no3 contents:

The article is devoted to the topical issues of the program based method of cooperation management processes in the CIS. It provides an overview of global experience in the development and implementation of international programs. There are offered their possible classification criteria and analysis of currently existing preparation and execution mechanisms of international programs and the direction of their improvement in CIS. The aim of the article is to discover deficiencies of the organizational process, to explore methodology "blank spots" оf the CIS regulations and to propose adequate solutions. The main conclusion is that the active procedure hampers CIS integration, and it has to be reworked. This article was prepared on the basis of HSE research in the development of the "Interstate program of innovation cooperation among the CIS up to 2020," adopted by the CIS Heads of Government Council, October 18, 2011.

The paper addresses the world-wide tendency of health care fragmentation and explores the ways how to overcome it. The international developments are discussed but the focus is on the health sector in the Russian Federation. The major objective of the paper is to evaluate the level of fragmentation/integration in the delivery of care, as well as to suggest organizational and economic mechanisms of strengthening integration. The conceptual model of integration is suggested with the focus on three characteristics – teamwork, coordination and continuity of care. They are affected by the instruments of integration – joint clinical guidelines, information exchange, and integrated methods of payment. A set of indicators is developed to evaluate each integration characteristic (around 50 in sum). The empirical data is collected based on the survey of 1500 physicians in three regions of Russia. The survey indicates that outpatient physicians don’t contact much with hospitals doctors before in the process and after hospital admission; joint work of curative and diagnostic services providers is at its initial stage; the readiness of patients for admission is very low as a result of poor teamwork. The continuity of care indicators shows low frequency of easy transfers of patients from an acute care stage to long term and rehabilitative stages. Policy implications are discussed with the focus on economic incentives. It is argued that more integrated units of health care payment should be used –those which cover both outpatient and inpatient care. In the context of the Russian Federation the most promising instrument is "policlinic as a fundholder" (fundholding) which creates strong incentives for outpatient care to plan inpatient care and work closer with hospitals and other providers. It also encourages the role of district physician as a gatekeeper and coordinator. We conclude with the point that strengthening integration should become an independent area of health policy.

Program budgeting is directed at the increase of efficiency of the public sector. Development of state programs unites all instruments to achieve the objectives of the state policy. Thus, it is not in all realized programs that target indicators are carried out and the planned results are reached, at the same time in the conditions of restriction of budgetary appropriations the problem of assessment of their efficiency becomes very important.

In the article features of state programs are analyzed, approaches to the assessment of the efficiency of state programs are considered. Structural units and elements of the efficiency of state programs are allocated, the efficiency condition – existence of a direct interrelation between actions and the assessment indicators which is shown on the example of the program in the field of health care is formulated.

The authors specify and define the concept of efficiency in relation to the results of the programs implementation and investigate aspects of efficiency.

Approaches to the assessment of the efficiency of the budget programs are described. The important issue of the program efficiency evaluation still remains unresolved despite the fact that many evaluation methods and techniques can be used. Therefore questions of reliability and relevance of indicators continue to remain as most important ones.

The principles of the assessment of the efficiency and the criteria of the efficiency of budgetary expenses are found during the realization of state programs. Examples of the indicators are given and the algorithm which can be used to assess the efficiency of ecological programs is offered.

The article analyzes methods of monitoring and the assessment of programs. It proves that a complex assessment of efficiency allows to estimate objectively the effect of the financial resources invested by the state and to define the efficiency of the realization of the state policy in priority spheres.

This article was prepared on the basis of the proposals of its author, included in the report of the expert group, set up under the instruction of the President of the Russian Federation dated 12 February 2013 to identify measures of the efficiency improving of the budget spending. The author's proposals address two tasks of improving the organizational and financial mechanisms for public and municipal services: 1) the implementation of the public sector and local government agencies reform; 2) the creation of an "open" area of public and municipal services. Openness is understood in the sense that in this area state and local government agencies, as well as private, primarily non-profit organizations are functioning in competition with each other.

The proposed measures are aimed at the adjustment of existing normative legal acts, as well as developing new ones. They are divided into short-term (implementation until 2016) and medium term (implementation in 2017, 2018).

Analysis of the progress of the reform of institutions leads to a conclusion that today, much of it has deviated from its original purpose and is on the verge of collapse on a number of its key parameters. In this context, there are proposed measures related to: a significant increase of economic self-reliance of autonomous and budget funded institutions in the areas of planning, accounting, money management, and the transition to normative financing of the provision of the public and municipal services, ensuring greater structure conformity, content and quality of these services to the guarantees and obligations of the state, the priorities of socio-economic policy.

The second task deals with the problems and measures aimed at: improving the legal regulation of the provision of public and municipal services (today in the definition of such services there is already a discrimination against private organizations as their potential suppliers); implementation of an institutional conversion of public and local government agencies (it is proposed to begin to work on the development of nonprofit organizations on the basis of state and municipal property that may be jointly established by federal and regional authorities, local authorities, as well as individuals); improvement of the mechanisms of the budget financing of public and municipal services (also it is proposed to establish a common legal framework for the provision of state and municipal grants by adopting a special federal law).

Bureaucracy is apt to grow extensively, which manifests itself in its unreasonably broadened powers, staff increase and hence more expenses on their provision in agencies. These regularities are described by V. Niskanen in the model of "a maximizing bureaucrat." Though, this model can be changed by reforms in the public administration through central government decisions on freezing/reducing budget financing, finding and cutting down on excessive bureaucratic functions, introducing mechanisms to stimulate performance.

The change of the model is especially relevant in the conditions when extra budget financing is obviously necessary to keep up with the competitive level of salaries in Civil service. It is the situation in the Russian Federation that has been lately, when decisions to increase salaries in the military and law-enforcement services have been realized, and a big salary increase in public administration for the nearest years is being planned. So, it is quite natural for the problem of saving reserves and reducing the number of employees in the public administration apparatus to arise.

After analyzing the dynamics of the number of bureaucrats as such over the last years, and the number of people employed in the economy, the authors came to the conclusion that the quantity of the civil servants does not depend only on the number of the population, but also on the volume and the order of carrying out administration functions.

The article indicates two main directions of making expenditures on public officers more effective: (1) by extra public administration functions and services reduction; (2) by improving the inner organization of performance, making the processes and procedures simpler, by controlling and stimulating economical spending of the means/money. The authors suggest a set of measures in the frame of these directions that can secure saving the budget money.

The purpose of this study is to provide economic analysis of penalties through the lens of Russian tendencies to increase the absolute values of fines. The work is based on the methodological approach of the new institutional economics theory and economic analysis of law. The study reveals the conceptual framework of economic analysis of penalties, analyzes the mechanisms of influence of various factors on the performance of penalties, describes various aspects of the deterrence of rules violation taking into account type II errors, investigates complex issues of the relationship between deterrence and the risk attitude of the objects of sanctions application and factors affecting the likelihood of a violation being identified. The deterrent effect of sanctions is analyzed in view of the existence of type I and type II errors. All these factors must be considered when establishing a system of penalties for a short and long term. Besides, discussion on issues of fines performance demonstrates that there are no simple solutions. In other words there is “no free lunch” in the area of enforcement mechanisms. It means that any discussion of the state of affairs or possible changes have to be accompanied by defining what is appropriated and what is lost. In particular, it is related  to correlation of types I and II errors, deterring and fiscal functions of fines. Issues of fines implementation in case of unintended damages are also discussed. The results can be used to develop policy evaluation programs for establishing and applying penalties in different areas.