Annotation

This scientific article provides a comprehensive analysis of the evolution and current state of the powers of state authorities in the field of health protection, covering historical, legal and contemporary aspects. The survey is based on the integration of historical-legal and comparative-legal methods, which allows for a comprehensive examination of the issue. Within the framework of a historical retrospective, the genesis and transformation of legal regulation during the imperial and Soviet periods are traced, which makes it possible to identify consistent trends and characteristic historical models of healthcare management in Russia. The main focus is on the current state of the system, including the changes introduced by the 2020 constitutional amendments and their impact on the distribution of powers between federal and regional authorities, which has exacerbated the problem of legal certainty. The author identifies key gaps and contradictions in legislative regulation, proposing possible ways to eliminate them in order to improve the effectiveness of healthcare management. Based on the analysis, proposals are formulated to improve current legislation, aimed at optimising interaction between different levels of public authority, eliminating legal conflicts and, as a result, increasing the effectiveness of state policy in the field of healthcare.