Balancing the state and the market: Russia's adoption of obligatory medical insurance

Twigg, Judyth L.

doi:10.1080/09668139808412555

Cited by 47 publications

(21 citation statements)

References 8 publications

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“…The fundamental nature of central 10 planning hampered the effectiveness of the health care system in many areas. The development of the health care system reflected the overall growth strategy of the country, emphasizing quantity of care -growth in indicators such as doctors and hospital beds per capita -rather than quality of care; central planners also set quantitative targets for the number of beds occupied and the number of procedures performed in hospitals (Twigg 1998). Further, there were waits for medical care, as for everything else in the Soviet Union.…”

Section: Suspect 1: the Acute Medical Care Systemmentioning

confidence: 99%

Autopsy on an Empire: Understanding Mortality in Russia and the Former Soviet Union

Brainerd¹,

Cutler²

2004

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T he 199()s were a decade oi ttinnoil fttr the fi)nnerly soeudist countries. Besides the political, econoinir and social upheavals endured by Lhese poptilatioiis, many of the.se countries experienced a demographic disa.ster in the form ot sharply rising death rates. In Ru.ssia, male lile expectiincy at birth fell from 64.2 years in 1989 to 57.6 years in 1994, a decline of 6.6 years in just half a decade. Female life expectancy at birth fell by 3.3 years over the same period. To put tbis decline in perspective, it took the past 30 years Ibr ihe United States to increase life expectancy by this much. Rtissia's liie expectancy today ranks 122'"* in the world, at the .same level as Nortb Korea and Guyana.The mortality crisis is not limited to Russia. Across tbe western countries of the former So\'iet Union-the countries that we term "the mortality belt" and thai range from Estonia in tbe nortb to Ukraine in tbe soutb-tbere bave been significant declines in male iife expecumcy at birth, ranging iVoin 3.3 years (Belarus) to nearly 5 years in Estonia aiid Latvia. Life expectancy foi women fell substantially as well.But not all countries fared this poorly. The countries that diret tly border tbis "mortality belt" and tbat also experienced a severe economic shock in Uie 199()sPoland, the C;/ech and Slovak Republics, Htingarv and Romania-recorded

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Section: Suspect 1: the Acute Medical Care Systemmentioning

confidence: 99%

Autopsy on an Empire: Understanding Mortality in Russia and the Former Soviet Union

Brainerd¹,

Cutler²

2004

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“…At the same time, they wished to augment the role of market forces. Hence, a system of universal compulsory medical insurance was signed into law in 1993 (Twigg, 1998) with the intention that it should contribute 30 percent of the total health care budget (Sheiman, 1997). While the payroll tax did cover 35 percent of the health budget by 1997, financing of health care in real terms declined by more than 30 percent between 1991 and 1998 (OECD, 2001; see Table 1).…”

Section: Health Care In Transition: the Rural Russian Settingmentioning

confidence: 99%

Rural Russia in Transition: What Determines Access to Health-Care Services?

Lohlein

Jütting

Wehrheim

2003

Post-Soviet Affairs

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Three German economists analyze the determinants of access to health care in rural Russia and ask whether income and ability-to-pay, emerging as the major determinants of access in urban areas, have begun to govern rural populations' access to health-care services. Using household data from a survey conducted in the year 2000 (N=321 households) in two regions of Russia-Oryol and Leningrad Oblasts-the authors examine how the reduced role of the state and the concomitant decentralization of policy-making have affected access of the rural populace to health services. Broader policy implications and suggestions for ensuring future access to services in rural areas are offered.

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“…The implementation of the OMS had a positive stabilizing influence during financial crises and helped maintain the sustainability of the system financing [22][23][24]. Nevertheless, the OMS funds remain insufficient to cover the necessary system costs [21,[25][26][27]. This indicates that shifting solely to single-channel financing (i.e.…”

Section: Effects On Financial Sustainability (System Funding)mentioning

confidence: 99%

Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector

2011

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Balancing the state and the market: Russia's adoption of obligatory medical insurance

Cited by 47 publications

References 8 publications

Autopsy on an Empire: Understanding Mortality in Russia and the Former Soviet Union

Autopsy on an Empire: Understanding Mortality in Russia and the Former Soviet Union

Rural Russia in Transition: What Determines Access to Health-Care Services?

Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector

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