- Статьи
- Society
- The rate is not zero: private clinics warned of rising prices in case of higher taxes
The rate is not zero: private clinics warned of rising prices in case of higher taxes
State Duma deputies have developed a bill that sets the income tax rate at 5% for private medical organizations. With this money, it is proposed to increase the financing of public health. The bill has so far been sent to the government. However, both private clinics and the community as a whole opposed this idea, warning that it would lead to an increase in the cost of medical services. For more information, see the Izvestia article.
Why do they want to increase the tax for private clinics
The bill was introduced by LDPR deputies led by Leonid Slutsky, the leader of the faction, and Sergey Leonov, chairman of the State Duma Committee on Health Protection. In the reference to the document, which is available to Izvestia, the introduction of a 5% income tax is explained by the fact that "simultaneously with government spending on the development of the healthcare system, the incomes of private medical organizations are also growing."
At the same time, the authors of the bill recognize that private medical organizations play an important role in the healthcare system.: They provide additional capacity, introduce innovative methods of treatment and diagnostics, and meet public demand for medical services.
At the same time, it is proposed to increase the income tax, crediting it in full to the budgets of the regions of Russia.
"At the same time, in case of violation by a private medical organization of the conditions for applying the 5% tax rate to the corporate income tax base and applying the 25% tax rate provided for in paragraph 1 of Article 284 of the Tax Code of the Russian Federation in this regard, the calculated tax will be distributed among the budgets of the budgetary system of the Russian Federation in accordance with the current legislation. regulation," the bill says.
Since 2010, the income tax rate for healthcare institutions has been 0%, subject to certain criteria prescribed in art. 284.1 of the Tax Code. To do this, the organization must have a license, income from medical activities must be at least 90% of the total income (including compulsory medical insurance services), and there must be at least 15 employees on staff and at least half of them must have a specialist certificate.
The explanatory note says that the application of the zero rate was aimed at creating favorable conditions for the development of the entire healthcare system. And this really helped in its formation, however, the "priority area of state policy" is the development of state and municipal medical organizations. And while government spending on the development of the healthcare system is growing, the incomes of private medical organizations are also increasing, the document says. In 2023, the total revenue of Russia's 20 largest medical companies increased to 208 billion rubles from 189 billion in 2022. At the same time, the cost of paid medical services is increasing: in 2025, prices in individual private organizations increased by about 30%, the document says.
"Currently, maintaining a zero income tax rate for them is not fully consistent with the priorities of government policy aimed at developing a system of affordable and high—quality free medical care," the explanatory note says.
It is in this regard that it is proposed to set the corporate income tax rate of 5% for private medical organizations. And Sergei Leonov said that the introduction of the tax would allow additional funds to be collected from 20 billion to 30 billion rubles in the budgets of the regions, which could be used to improve the infrastructure of public clinics.
How private clinics reacted
Zarema Omarova, a dermatologist, cosmetologist, and co-owner of Dr. Omarov's clinic network, stressed that private medical organizations would not support the initiative.
— Commercial clinics do not receive any subsidies or benefits from the state, such as IT companies (a 5% income tax rate has been introduced for IT companies. — P ed.), — she remarked. — We, like many others, have created our own network of clinics with our own money, annually we direct the lion's share of profits to purchase consumables, equipment, pay for licenses, rent, repairs. For us, profit is also money that allows us to develop.
Zarema Omarova noted that many people in the private sector "work with very small margins." She suggested that clinics will increase the cost of their services, look for ways to optimize costs, and some will leave the market altogether.
"In any case, there is a risk of reduced investments, purchases of modern equipment, high—quality materials and a decrease in the quality and availability of services," added Zarema Omarova.
Muslim Muslimov, Chairman of the National Association of Healthcare Managers and a member of the Civic Chamber of the Russian Federation, notes that the introduction of the new tax will deal a serious blow to private medical organizations, significantly limiting their development.
"It is important to understand that the profits of most private clinics, especially small institutions within walking distance and regional networks, are minimal," he said, also noting that even large network structures from the top hundred ratings operate with low financial performance, and the profits are reinvested in development.
Olga Shuppo, founder and scientific director of the Grand Clinic network of immunorehabilitation, adaptive and preventive medicine clinics, also points out that the initiative "will scare away investors and new players who planned to enter this market."
"Clinics will be forced to shift costs to consumers, and the availability of services to the public will decrease," she told Izvestia. — This will be especially critical in the rehabilitation segment, which has not received significant development from the state since the pandemic, in the segment of high-tech care, in preventive medicine, etc.
Zarema Omarova notes that this will particularly affect the fields of dentistry, cosmetology, and ophthalmology, where private clinics occupy the main market share.
How will the initiative affect the industry as a whole
Muslim Muslimov believes that the consequences of the initiative's implementation will affect the entire society. The diagnostic base may deteriorate, since it is small clinics and laboratories that play a key role in the initial detection of diseases, referring patients for further high-tech care in large medical centers. At the same time, many clinics carry a high debt burden due to the purchase of high-tech medical equipment.
Yan Vlasov, co-chairman of the All-Russian Union of Public Patient Associations, notes that private clinics now provide up to 25-30% of all outpatient care in the country, closing the shortage of doctors and equipment in some regions.
"Many patients are referred there by government agencies, and in this sense, the state and private medicine are not competitors, but parts of a single system," he told Izvestia. — Any decisions that weaken the private sector automatically affect the availability of medical care, especially in regions where the burden on polyclinics is already enormous.
He added that many commercial clinics operate in the compulsory health insurance system and are also very dependent on the tariffs for this type of medical insurance. Yan Vlasov agrees with the opinion that the new burden of costs will be shifted to patients.
— It is possible to say that "an additional 20-30 billion rubles" from income tax will automatically improve the situation in public clinics only if the allocation of these funds is strictly targeted and transparent, — said Yan Vlasov. — It is important to understand that tax revenues are not always "colored": if the money just ends up in the general budget of the region, there is a risk that it will not reach healthcare.
Mikhail Androchnikov, Deputy Chairman of the Central Committee of the Trade Union of Healthcare Workers of the Russian Federation, noted that another problem with the initiative is that private clinics themselves are very unevenly distributed throughout the country: half of the commercial medical organizations are located in the Central and Volga Federal Districts, as well as in large cities. Accordingly, the "colored" income tax will be applied only in selected regions.
And Muslim Muslimov adds that it is unclear what to do with government medical organizations that also provide paid services — whether they should pay income tax in this situation. If not, then this creates unequal conditions, the expert is sure.
— The division into "friend and foe" based on the principle of ownership forms is wrong, especially since many private clinics are now operating in the compulsory health insurance system, – said Larisa Popovich, Director of the Institute of Health Economics at the National Research University Higher School of Economics. — We need to involve private companies in fulfilling state tasks, and such a measure simply discriminates against them.
Is there a chance for the bill to be passed
Experts interviewed by Izvestia are inclined to believe that the initiative will not be accepted. Mikhail Androchnikov calls it not calculated and emphasizes that such decisions should be based on a very serious economic analysis.
"The parliamentarians did not provide the medical community with any specific studies, calculations, or references to the work of reputable institutions involved in public health or financial analytics,— agrees Muslim Muslimov. — Such statements cannot be the basis for serious reforms, especially when it comes to measures that directly affect the social well-being of the population and the development of the medical industry.
Sergei Leonov refrained from additional comments on the bill, Izvestia also sent a request to the Ministry of Health of the Russian Federation.
Переведено сервисом «Яндекс Переводчик»
