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Obligatory medical insurance in Russia: the participants' perspective

  • Twigg, Judyth L.
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    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.

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 49 (1999)
    Issue (Month): 3 (August)
    Pages: 371-382

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    Handle: RePEc:eee:socmed:v:49:y:1999:i:3:p:371-382
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