As for all health systems, in Russia, the demand for medical care is greater than its health system is able to guarantee the supply of. In this context, removing services from the state guaranteed package is an option that is receiving serious consideration. In this paper, we examine the attitudes of the Russian population to such a reform. Exploiting a widely-used methodology, we explore the population’s willingness to pay for cooperative health insurance. Distinguishing between socioeconomic and demographic factors, health-related indicators and risk aversion we find, consistent with other literature, positive income and risk aversion effects. We interpret the former as evidence that the Russian population is not opposed to the idea of progressive redistribution, to pool the costs of health-related risks; and the latter as evidence that risk-averse individuals demand more insurance coverage. In exploring these results further, we show that cognitive bias is important: overestimating the benefits leads to the purchase of additional insurance, while underestimating lowers demand for insurance. Our overall conclusion is that the introduction of a supplementary cooperative health insurance scheme in Russia could increase the accessibility of healthcare, lower the tendency for informal payments, incentivize the personal maintenance of good health and create a new source of funding for public healthcare.

中文翻译：

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改革的态度：合作医疗保险计划在俄罗斯能否奏效？

对于所有卫生系统，在俄罗斯，对医疗的需求大于其卫生系统能够保证提供的医疗需求。在这种情况下，从状态保证包中删除服务是一种正在受到认真考虑的选项。在本文中，我们考察了俄罗斯人口对这种改革的态度。利用一种广泛使用的方法，我们探索了人们支付合作医疗保险的意愿。我们发现，社会经济和人口因素，与健康相关的指标和风险规避之间存在区别，与其他文献一致，收入和风险规避产生了积极影响。我们将前者解释为证据，表明俄罗斯人口不反对逐步再分配的思想，以分担与健康有关的风险的费用；后者证明了规避风险的个人需要更多的保险。在进一步探讨这些结果时，我们表明认知偏见很重要：高估收益会导致购买额外的保险，而低估了对保险需求的降低。我们的总体结论是，在俄罗斯引入补充合作医疗保险计划可以增加医疗保健的可及性，降低非正式支付的趋势，鼓励个人保持良好的健康状况，并为公共医疗保健创造新的资金来源。