Web-economic-crisis-health-systems-and-health-web

The Russian Federation
Elena Potapchik
Economic trends
• After high growth in 2008, The Russian Federation's real GDP per capita
contracted in 2009 but recovered in 2010 and 2011 with growth rates
above the European mean.
• The unemployment rate increased in 2009 but remains low compared
with other European countries.
• Although the size of government spending relative to GDP saw a reduction
in 2010 and 2011, health spending as a share of government expenditure
remained largely stable, although at levels below the European mean.
In 2010, as public per capita health expenditure declined by 3.3%,
OOP expenditure per capita increased by 47.6% compared with 2009
(Russian Federation: Figs 1 and 2).
Policy responses
Changes to public funding for the health system
• Public spending on health increased slightly in 2009, fell sharply in 2010 but
increased slightly in 2011 and should continue to grow in current prices from
2012 to 2014; however, federal budget expenditures are expected to fall because
of reduced spending on the National Priority Project – Health and other
programmes, while spending by the regions and SHI is expected to increase.
• SHI contributions paid by employers were increased from 3.1% of payroll in
2009–2010 to 5.1% in 2011 (2009).
• The additional revenue generated was to be spent on specific projects (e.g.
capital investment, standardization of care and development of information
technology) but from 2013 will not be assigned to specific projects.
• A new SHI law established a uniform formula for calculating budget transfers
to cover SHI contributions for non-contributing people, a move intended to
integrate revenue streams.
Changes to health coverage
Population (entitlement)
• Extended statutory coverage to resident foreigners, temporary residents and
stateless persons; previously only citizens were covered (2011), although this
was subsequently reversed (2012, 2013).