Equity in the provision of medical care

50% (16% less than in 2011) of Russians consider it unfair that rich people can provide their children with better medical care compared to poor ones. The share of respondents who completely disagree with the fact that the state should provide a set of only basic medical services has increased by 8% – up to 36%. 53% (an increase of 6%) of respondents are absolutely not ready to pay higher taxes to improve medical care for the entire population of Russia.


The Levada Center presents the results of the annual ISSP monitoring study on issues important for the social sciences. This is an initiative research program that brings together teams of scientists from more than 40 countries. Every year, surveys are conducted on one of 10 topics (national identity, labor relations, social networks, ecology, religiosity, etc.) based on comparable questionnaires and representative national samples. The study allows us to track changes in public opinion over a 10-year period and reflect socio-cultural differences on the most significant topics. The Levada Center team has been a regular participant of the program from Russia since 1991. 

The topic of the current wave of research is health and healthcare. Data for international comparisons will be available at the end of 2022.


Half of the respondents consider it unfair that people with high incomes can provide their children with better medical care compared to people with low incomes: rather, unfair – 22%, completely unfair – 28%. At the same time, a quarter (26%) of respondents assess this situation as fair: rather fair – 15%, completely unfair – 11%. In 2011, this situation was considered unfair by 66% of respondents – 16 percentage points more than in 2022, fair – 15% (11% less than in 2022).

The results of the survey show that the idea that inequality of access to social services is a consequence of their economic situation is entrenched in society. This opinion is increasingly becoming part of the social norm.

A quarter (26%) of Russians agree that people use medical services more than necessary: 10% fully agree with this point of view, 16% rather agree; about half (49%) disagree with this statement: 25% rather disagree, 24% completely disagree. People are more likely to adhere to this opinion than 10 years ago. In 2011, the share of those who agreed with this statement was 15% (11% less than in 2022), those who disagree – 61% (12% more than in 2022).

A comparison of the results obtained with 2011 may indicate both an increase in the availability of various medical services and the emergence of new consumer behavior practices related to medicine: wellness programs, check-ups, etc. At the same time, it is necessary to take into account the possible impact of the epidemic on changing attitudes to medicine.

27% of respondents agree (fully agree – 13%, rather agree – 14%) that the state should provide only a set of basic medical services, 61% disagree (completely disagree – 36%, rather disagree – 25%). Compared to 2011, the share of those who agree with this statement increased by 7%, while the share of those who disagree also increased by 5 percentage points, which, in particular, is explained by a decrease in the group of “I find it difficult to answer” and those who “partially agree, partially disagree”.

A decrease in the proportion of neutral responses (and in fact avoiding a direct answer) indicates an increase in the polarization of opinions on the social function of the state. On the one hand, supporters of the limited role of the state in providing medical services may be associated with the growing popularity of private medicine. On the other hand, the coronavirus epidemic has jeopardized the provision of even basic medical services to the population, and an increase in the proportion of respondents who advocate the provision of a basic set of medical services by the state may mean the lack of proper assistance.

70% of Russians are not ready (53% are not ready, 17% are rather not ready) to pay higher taxes to improve medical care for the entire population of Russia, 18% are ready to pay. Compared to 2011, the share of those willing to pay higher taxes for this purpose was practically unchanged, the share of those not ready increased by 6 percentage points.

68% of respondents agree that people without Russian citizenship should have access to state medical care, 18% disagree. Compared to 2011, the share of those who agree with the need to provide access to state medical care to people without Russian citizenship decreased by 7%, the share of those who disagree increased by 10%.

A quarter (25%) of respondents do not agree that people who harm their health by their behavior should have access to state medical care. 56% of respondents agree with this statement. In 2011, 13% of respondents held the first position (an increase of 12%). The share of those who agree with this statement decreased by 9% – in 2011 there were 65% of such people.

A more “market-based” approach to the provision of medical services by the state is also reflected in the willingness to refuse to provide basic medical services to those who, in their opinion, lead the “wrong” lifestyle.

More than half (52%) of respondents agree that people suffer from serious health problems because of their harmful behavior. 22% of Russians disagree with this position. Compared to 2011, the latter indicator increased by 12%. At the same time, the share of consonants decreased by 11%.

A decrease in the proportion of those who blame the diseases on the patients themselves may indicate an increase in medical literacy and greater awareness of the origin of diseases

87% of Russians believe that it is easier for rich people to get medical care compared to poor people: 77% believe that it is much easier to get help if you’re rich, 10% – a little easier.

42% believe that it is more difficult for the elderly than for young people to get medical care (19% – much more difficult, 23% – somewhat more difficult). 37% believe that older people and young people have the same access to medical care.

The absolute majority (82%) of respondents believe that women and men have equal access to medical care.

About half (46%) believe that it is easier for Russian citizens to get medical care compared to persons without Russian citizenship (26% – much easier, 20% – somewhat easier).


The survey by the Levada Center was conducted January 27 – February 02, among a representative sample of all Russian urban and rural residents. The sample was comprised of 1626 people aged 18 or older in 137 municipalities of 50 regions of the Russian Federation. The survey was conducted as a personal interview in respondents’ homes. The answer distribution is presented as percentages of the total number of participants along with data from previous surveys.

The statistical error of these studies for a sample of 1600 people (with a probability of 0.95) does not exceed:

3.4% for indicators around 50%

2.9% for indicators around 25%/75%

2.0% for indicators around 10%/90%

1.5% for indicators around 5%/95%

The ANO Levada Center is included in the registry of non-commercial organizations acting as foreign agents.


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