| Titre : | Obligatory medical insurance in Russia : the participants'perspective. (1999) |
| Auteurs : | J.L. TWIGG |
| Type de document : | Article |
| Dans : | Social science and medicine (vol. 49, n° 3, 1999) |
| Pagination : | 371-382 |
| Langues: | Anglais |
| Mots-clés : | Russie ; Evaluation ; Système santé ; Economie santé ; Assurance maladie ; Financement |
| Résumé : | [BDSP. Notice produite par INIST jR0xvvIu. Diffusion soumise à autorisation]. 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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