The Russian Health Care Reforms and Changes of Its Administrative Systems in the Era of Post Communism

After the collapse of communism, Russia has reformed health care, pensions and social assistance systems. While the reforms of pensions and social assistance systems were stagnated by the Soviet privileges’ resistance, the health care reforms were well proceeded without troubles. The health care reforms focused on the administration systems. The main changes are as follows; First is administrative decentralization. It was changed from the centralization system which central government controlled all aspects of health care system to the decentralization system that central government plans and guides health care system and the local health insurance funds manage the health insurances. Second is the mixed system of financing. The governmental financing system was substituted by the mixed financing system which governments (budgets), enterprises(pay-roll taxes) and citizens(cost sharing) contribute together. Third is the third-party payment system. The socialist system which government directly gave budgets to the public hospitals was transformed to the insurance system which the third-party insurer gathers the contributions of governments and enterprises, and pays medical treatment fees to hospitals. These changes mean the rigid state monopoly system was changed to the mixed system which government and civilians co-share the responsibility of health care system. Under liberal society, it was a inevitable transformation.