Global Snapshots: Russia - socialism to capitalism causes problems in health care
In 1982, despite many inadequacies, the socialist healthcare system of the former Soviet Union earned recognition from the World Health Organization for promoting equity and universal access.1 Now with a capitalist economy, Russia has reformed the funding and delivery of health care to tackle the shortcomings in efficiency and quality.
Previously, health care was centrally planned and funded. But now, in line with new market based ideas, compulsory insurance allows competition between healthcare providers and between private insurance companies.2 Health indicators are not encouraging, however; average life expectancy for 1998-2000 fell for the whole population with men worst affected. Although not simply because of the reforms in health care, these statistics must be considered when assessing the reforms.3
The Russian constitution still includes the principles of equitable health care and access for all. But, arguably, funding of the insurance scheme undermines these principles because employers and municipal governments make contributions