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Obligatory medical insurance in Russia: the participants' perspective

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  • Twigg, Judyth L.

Abstract

The Russian Federation adopted a nation-wide system of obligatory medical insurance in 1993 in an effort to earmark a targeted source of funding for health care and to reverse a steep decline in health outcomes. The author conducted a survey in 1995-1996 of managers of two of the new institutional participants in Russia's health insurance scheme: Territorial Health Insurance Funds and private medical insurance companies. The survey results reveal deep dissatisfaction with the level of financing provided by the new system; continuing confusion and substantial regional variation in the implementation of the insurance legislation; fierce bureaucratic and institutional infighting between the major players, stemming primarily from controversy over delineation of responsibilities and ongoing battles for control over resources; promising hints of competition and other market-based incentives emerging from the current chaos; and broad agreement that further structural reform must accompany increased infusions of resources in order for significant systemic improvements to be realized.

Suggested Citation

  • Twigg, Judyth L., 1999. "Obligatory medical insurance in Russia: the participants' perspective," Social Science & Medicine, Elsevier, vol. 49(3), pages 371-382, August.
    • Handle: RePEc:eee:socmed:v:49:y:1999:i:3:p:371-382
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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. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517, May.
    3. Gordeev, Vladimir S. & Pavlova, Milena & Groot, Wim, 2011. "Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector," Health Policy, Elsevier, vol. 102(2), pages 270-277.
    4. Besstremyannaya, Galina, 2015. "Measuring the effect of health insurance companies on the quality of healthcare systems with kernel and parametric regressions," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 38(2), pages 3-20.
    5. 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).
    6. Galina Besstremyannaya, 2014. "Urban inequity in the performance of social health insurance system: evidence from Russian regions," Working Papers w0204, New Economic School (NES).
    7. 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).
    8. Artur Nagapetyan & Alexander Drozd & Dmitry Subbotovsky, 2023. "How to Determine the Optimal Number of Cardiologists in a Region?," Mathematics, MDPI, vol. 11(21), pages 1-23, October.
    9. Wagstaff, Adam & Moreno-Serra, Rodrigo, 2009. "Europe and central Asia's great post-communist social health insurance experiment: Aggregate impacts on health sector outcomes," Journal of Health Economics, Elsevier, vol. 28(2), pages 322-340, March.
    10. 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).
    11. Pragyan Monalisa Sahoo & Himanshu Sekhar Rout & Mihajlo Jakovljevic, 2023. "Dynamics of Health Financing among the BRICS: A Literature Review," Sustainability, MDPI, vol. 15(16), pages 1-21, August.
    12. Lloyd-Sherlock, Peter, 2000. "Old Age and Poverty in Developing Countries: New Policy Challenges," World Development, Elsevier, vol. 28(12), pages 2157-2168, December.

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