Priorities, shortages, and rationing in the UK and Russia national health services during 2000–2019: initial conditions for responses to Covid-19

Throughout the world in 2020 the Covid-19 pandemic caused wide-spread infections, realignments of medical priorities, pervasive shortages and rationing of medical care, increases in the hidden components of morbidity icebergs, and substantial mortality. It also caused two types of international disequilibrium: ‘excess supply’ in the macroeconomic sphere generated by lockdowns and ‘excess demand (shortage)’ in critical product markets (e.g., personal protective equipment). Although the simultaneous and global nature of these phenomena and problems in 2020 were unusual, many of them have been evident in national medical systems over the past decade. The key questions addressed in this article are: (1) What are the relationships between economic systems, government priorities, shortages in health services, and compensatory policies? and (2) How did resource constraints, priority shifts, shortages, bottlenecks in production, and rationing during 2000–2019 influence the initial conditions of medical systems in the UK and Russia in 2020 when confronting Covid-19 epidemics?