ABSTRACT
The largest health care system in the world has been jolted into a massive restructuring. Long-standing failures in health care are being exposed and an overhaul of the delivery system has been placed on the top of Gorbachev's domestic agenda. Health care facilities are more physically accessible in the western part of the U.S.S.R., where large populations are located in major urban centers. In contrast to the US, health care in the Soviet Union is government owned and administered; central planning sets health policy goals, priorities, and direction. The U.S.S.R. has a centrally planned economy, within which planning for the health of the population is coordinated through the Semaschko Institute on Organization of Health Care, based in Moscow. A significant difference between the Soviet and US health care delivery systems is that the former has the organizational potential to be more coordinated. Glasnost has also stimulated a nascent consumerism and free market approach to medical care delivery.
