In the Russian Federation, provision for healthcare is one of the primary social functions of the state; covering delivery of medical care, prevention of disease, and improvement of the population's health. After the February and October revolutions of 1917, the main feature of Russian healthcare was the creation of a single state medical treatment and prevention system.
By the mid-1960s, the country's health indicators had improved considerably. However, the deterioration of public health, which started in the 1970s, was a clear sign of the need for healthcare reform. The reform program developed in 1990/1991 laid the foundations for a transition to a mandatory health insurance system. At the end of the 20th century, the collapse of the Soviet Union and ensuing radical changes in the country's social and economic policy engendered healthcare problems and systemic challenges, many of which are yet to be addressed. Starting in 1998, the Russian Federation Government has been implementing an annual program that provides guaranteed free medical care to Russian citizens, funded by the state budget. Since 2005, hospitals, 7,951 health centers, 2,330 outpatient/polyclinic institutions, and 827 dental clinics. Despite a developed network of outpatient/polyclinic institutions, the current system for the provision of primary medical assistance is not capable of meeting the needs of the country's population and modern society. Poor organization of the work of district-level doctors and current pay arrangements prevent primary healthcare providers from doing their main job: preventing disease. Despite the introduction of financial rewards for increases in the provision of medical care to the population by primary healthcare providers, there has not been a material redistribution of the healthcare burden from specialists to primary healthcare providers. The lack of a social care system, combined with ineffective monitoring of patients with chronic problems, has created a situation where emergency medical care is a widespread method of providing outpatient medical care to the population.
