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KMID : 1124020100260010091
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Korean Social Security Studies
2010 Volume.26 No. 1 p.91 ~ p.119
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Transition to Market Economy and Health Care Reform in Russian Federation
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Moon Kyung-Tae
Lee Sang-Eun
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Abstract
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The Break-up of USSR and the transition to market economy in Russian Federation led to a health care reform. Under the planned economy, the USSR had nationalized all of health resources including physicians, polyclinics, and hospitals in the 1920s, as a way of establishing a comprehensive free health care system for all people. After transition to market economy, Russia adopted in 1993 a mandatory social health insurance system as an alternative of financial resources, while keeping the principle of providing comprehensive free health care services to the general public. On the contrary to the original plan expecting that health care insurance fund shall be responsible for 2/3 of total health care expenditure, it turned out that the insurance fund took care of 25% of total expenditure ever since the year 2000. The decentralization of Russian Federation transferred financial burden to local governments, and made them responsible of their resident’s health care. But, financial subsidy from the local governments has been also dwindled. Neoliberal market economists insisted a shock approach, including pluralizing of health finanace, giving up free heath care, and privatizing medical resources. However, the decision makers of the health care system have kept the free and state owned health care system. The reform of health care system in Russia was a mixed one. As the result, the reform itself was limited. Patients have to shoulder a substantial amount of financial burden, either formally or informally, by paying most of the prescription drug cost. And the life expectancy has been seriously deteriorating since the 1990s. The health care reform in Russia is
limited in its effectiveness as well as reform itself.
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KEYWORD
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transition to market economy, socialist health care services, social health care insurance, Russia
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