ABSTRACT
In the traditional Soviet command economy, there were pervasive, chronic shortages and the health sector had a low priority. As a consequence, the medical system operated subject to tight budget constraints, received inadequate supplies from medical industry and import agencies, and developed on an extensive basis. On the output side, it provided the population with insufficient quantities of medical services and distributed medical care inequitably 853through a variety of rationing devices. During the period of perestroika, numerous reforms were introduced in medical institutions and attempts were made to raise the priority of the health sector. These remedial efforts were undermined, however, by the slackening of central control of economic processes after 1988 and the eventual collapse of production and exchange. Following the demise of the U.S.S.R. as a nation, the previously unified health sector was fragmented into 15 separate ones located in the successor states. They introduced a variety of medical reforms. At roughly the same time, the new governments launched radical programs of transition from command to market systems. To date, developments in the transitional economy of Russia have not been more conducive to the promotion of the health of the population than were those in the Soviet economic system. It remains to be seen whether the situation will improve in the future. 1
