Abstract The Soviet Union is undergoing a peaceful—but massive—revolution. Everywhere, old institutions are being challenged, and old beliefs are being rejected. Soviet society is beginning to ferment with entrepreneurial zeal, a thrust toward decentralization and democratization of decision making, and a blossoming of interest in competition and free enterprise as a way of reviving the stagnant economy. The health care sector is no exception.1 Although the Soviet Union was the first country in the world to guarantee free medical care as a constitutional right to all its citizens,2 the quality and accessibility of that care are now in question. In the face of deteriorating health status indicators and dissatisfaction among Soviet citizens, restructuring the health care system has been joined to the economic reform. The major goal is to infuse new resources into the system and make it part of the self-supporting economy. This reform initiative has been References 1. Schultz DS, Rafferty MP. Soviet health care and perestroika . Am J Public Health . 1990;80:193-197.Crossref 2. USSR '90 Yearbook . Moscow, USSR: Novosti Press Agency Publishing House; 1990:271. 3. Telyukov AV, Sheiman IM. Soviet Health Care: Time of Economic Reforms and Decision-making . Working paper prepared for the Task Force on the Preparation of a Draft Law on Development of Medical Insurance ; Moscow, USSR; (May) 1990. 4. Health for All Database. Copenhagen, Denmark: World Health Organization, European Office; 1989. 5. Zelkovich RM, Isakova LE, Tsarik GN. Economic approaches to health care planning at the regional level . Santé Publique (Bucharest) . 1989;32:243-246. 6. Concluding Memorandum of the International Conference on Sociological Research in Medicine . Kobuleti, Georgia SSR: Soyuzmedinform, USSR Ministry of Health; (April 24) , 1990.
JAMA – American Medical Association
Published: Sep 5, 1990