The growth of insurance coverage in Russia slowed toward the end of the 1990s, and gaps remain. Achievement of universal coverage will require new, targeted policies.
There has been growing concern over the consequences for public expenditure of an increasing number of elderly people dependent on a relatively diminishing working population. This concern stems largely from demographically determined dependency ratios and it is not necessarily the case that a change in the age profile of the population will lead to a greater burden of dependency. The 'engine of dependency' is shown to have at least two other cylinders-patterns of labour-force participation across age and gender, and levels of unemployment. Policy to date has had a surprisingly narrow focus in view of the dual role of economic and demographic forces in influencing the ratio of dependency. The economic and political feasibility of alternative policy options is discussed.
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