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Forming the system of health insurance in the Russian Federation

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  • Sheiman, Igor

Abstract

A radical reform is being prepared in the Russian Federation health care. Its major point is a transition from tax-financed national health system to social health insurance. The paper highlights the issues of forming the system of health insurance. First, the arguments for a transition to a new model of finance are discussed. Secondly, the concept of the new model and its implementation in the context of the regional experiment are addressed. A discussion of current and expected developments focuses on two major issues: monopsony or pluralistic model of third-party purchasing? What is important for forming the market of health care provision? The major argument is that a transition from a highly integrated to a contractual model may start with regional monopsony or some version of it. A pluralistic model of third-party purchasing needs a refined regulation and may not meet health policy objectives. It is also argued that on the first stage of reform implementation forming the market of health care provision is more dependent on its regulation and management than on the market structure of health care purchasing.

Suggested Citation

  • Sheiman, Igor, 1994. "Forming the system of health insurance in the Russian Federation," Social Science & Medicine, Elsevier, vol. 39(10), pages 1425-1432, November.
    • Handle: RePEc:eee:socmed:v:39:y:1994:i:10:p:1425-1432
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    Citations

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    Cited by:

    1. Galina Besstremyannaya & Jaak Simm, 2014. "Multi-payer health insurance systems in Central and Eastern Europe: lessons from the Czech Republic, Slovakia, and Russia," Working Papers w0203, Center for Economic and Financial Research (CEFIR).
    2. Sheaff, Rod, 2005. "Governance in gridlock in the Russian health system; the case of Sverdlovsk oblast," Social Science & Medicine, Elsevier, vol. 60(10), pages 2359-2369, May.
    3. Galina Besstremyannaya & Jaak Simm, 2014. "Multi-payer health insurance systems in Central and Eastern Europe: lessons from the Czech Republic, Slovakia, and Russia," Working Papers w0203, New Economic School (NES).
    4. Galina Besstremyannaya, 2014. "Urban inequity in the performance of social health insurance system: evidence from Russian regions," Working Papers w0204, New Economic School (NES).
    5. Galina Besstremyannaya & Jaak Simm, 2012. "The impact of private health insurers on the quality of Russian regional health systems," Working Papers w0177, New Economic School (NES).
    6. Sheiman, Igor, 1995. "New methods of financing and managing health care in the Russian Federation," Health Policy, Elsevier, vol. 32(1-3), pages 167-180.
    7. Galina Besstremyannaya, 2014. "Urban inequity in the performance of social health insurance system: evidence from Russian regions," Working Papers w0204, Center for Economic and Financial Research (CEFIR).
    8. Pavlova, Milena & Groot, Wim & van Merode, Frits, 2000. "Appraising the financial reform in Bulgarian public health care sector: the health insurance act of 1998," Health Policy, Elsevier, vol. 53(3), pages 185-199, October.

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