Having taken a coupon to a therapist a week before the visit time and having stood for more than 2-3 hours further than the appointed time, I had to go to swear to the heads of the doctor. Why issue coupons if you can't get them on time? I am ready to sign up for a week and maybe a year, but does this guarantee me a visit to the doctor at the scheduled time? Yes, a dozen pensioners come and they are prescribed by the therapist preferential medicines. I am not against the admission of a formed group of pensioners by a doctor, but then why do we need time coupons? What kind of optimization and improvement of medical services, if it became more inconvenient to get a certificate? Well, any service is possible only at an age while finances are being deducted to the FMS. This state does not need pensioners.
In a good medical system, of course, there should have been an appointment via telephone. There is no problem if the health care provider would book the patient to see the doctor.
It's hard to say how in the regions, but in Moscow there has been a massive reduction in hospitals and doctors themselves. For example, two or three polyclinics were combined into one medical institution, making one of them the head and the rest branches. Doctors were laid off in branches.
In addition to this, almost all doctors are now available only through a therapist, which gives rise to additional queues, primarily just in time for therapists. And in the case of a reduction in polyclinics, this leads to the following. Now, in order to make an appointment with a doctor in another clinic, you need to stand in line first to see your therapist in your branch, and it may be possible to get to a specialized doctor in another medical institution.
Finally, the most important thing. Due to the consolidation and destruction of the institution of district doctors, there is now no opportunity as a class to call "their" supervising doctor. And you have to go to a medical facility every time, for every certificate, every sneeze, etc.
In general, the medical system today is geared towards maximum bureaucratization, inconvenience and non-transparency of medical services, so that people, in principle, never want to visit the clinic again.
I understand this is a troll question, but I'll answer anyway.
There are two levels of this problem.
Technical. Pensioners stand in line because they do not want or cannot (because they do not want) to learn how to use the electronic queue. It has been available for several years both via the Internet and through terminals in the clinic itself. Of course, there is a problem of a double queue: one is electronic, the second is live, but it exists precisely because citizens do not want to sign up properly in advance, two or three days in advance (and if it hurts today!), Creating problems for themselves. It's like drivers trying to avoid a traffic jam on the side of the road creates an even bigger traffic jam.
Ideological and economic. Our medical system is clearly ineffective. The so-called "free medicine" (which, of course, is not free, but necessarily insurance) does not suit anyone, neither doctors with their meager salaries, nor patients who have to buy syringes for their own money. But a sharp transition to the western voluntary insurance model based on the principle of "no insurance - treat yourself with tea" will lead to the fact that a large part of the population will be left without medical care at all, and this is a social catastrophe and a universal paragraph. A way out could be the development of a voluntary health insurance system to leave it mandatory for socially unprotected segments of the population, but this requires:
1) so that VHI policies are affordable;
2) so that VHI is in demand by the majority of the population;
3) that a network of clinics working with VHI ( in addition to municipal clinics!) was more developed.
Today, unfortunately, none of these conditions are met, because we have what we have, including the queues of pensioners.