Modernization of the Russian health care: challenges, expectations and reality

The article reviews the challenges of updating the Russian healthcare system. We determine the key directions of such an update, means of interacting with the public, social and cultural innovation mechanisms in the area, as well as the Russian public’s responses. We also analyze the modern trends in healthcare funding, which helps us reveal that the share of healthcare in Russia’s social spending has been dropping for many decades, starting from the USSR. Today’s healthcare systems in different countries all face the same challenges: making healthcare services accessible to as many people as possible and ensuring proper quality control. Accessibility is generally achieved by providing the financially vulnerable population groups with a guaranteed set of free services. Furthermore, this article analyzes the healthcare overhaul under the Zdorovye (Health) national project. As the chief goal of this overhaul, the Russian government has declared it necessary to create a model that would prioritize basic healthcare and well-developed disease prevention services. Most of the funding is to be allocated to outpatient clinics. The studies carried out during the past few decades continue to highlight such clinics’ low status in public opinion. Russians are not satisfied with the quality of healthcare services and the way they are provided, as well as with the doctors’ professionalism and doctor-patient interactions. The doctor and clinic competition system, offered by the reform initiators as an incentive for increasing service quality and qualifications, does not work in reality. And as the reform is incomplete, there is no legal regulation of doctor-patient interactions. The public’s dissatisfaction with healthcare, especially basic healthcare services, breeds deviant behavior strategies, such as seeking medical aid at the latter stages of disease; refusing aid when the disease is deemed “trivial”; and attempting self-therapy at home. This allows us to conclude that it is necessary to develop and introduce the concept of valuing health on the public and individual level, as well as promote disease prevention.

technological and socio-cultural modernization, primary health care, self-preservation behavior, ways of access to medical care