The Mayor of Moscow recently stated that the current system providing mandatory health insurance (MHI) to both employed and unemployed citizens under identical conditions is inequitable. This article explores experts` opinions on this matter.
Moscow Mayor Sergey Sobyanin has highlighted concerns regarding health insurance contributions for non-working individuals. According to his data, Moscow contributes 180 billion rubles annually to the federal MHI fund for this demographic, while Russian regions collectively spend approximately one trillion rubles. Sobyanin argues that offering identical MHI coverage to both diligently working citizens and those who are idle, even those who haven`t sought social assistance, undermines the principle of fairness in taxation. He emphasized the need to address this issue but affirmed that coverage for people with disabilities, pensioners, mothers with many children, and students should remain unchanged.
Experts were asked whether it is fair to provide mandatory health insurance to unemployed Russians.
Georgy Soldatov
CEO of Aditim Holding (an engineering company specializing in polymer processing)“As a working individual, I understand that a portion of my earnings, figuratively speaking, goes towards those who are idle. If we are a welfare state, and these individuals are citizens, then they are entitled to this coverage. While any discussion on this topic is welcome, it must be supported by data, concrete proposals, and a clear strategy outlining our goals and direction. Social insurance is a very sensitive area.”
Vladimir Elishev
General Director and Chief Physician of Clinic K+31 Zapad, Candidate of Medical Sciences“The Russian Federation is arguably unique globally in guaranteeing and providing such an extensive range of medical assistance under MHI. In most developed nations, this minimum is restricted to urgent or emergency care. I fully agree that socially vulnerable groups, who require support funded by the working population as primary taxpayers, should receive quality care. However, those who do not demonstrate social engagement should not necessarily be covered by such broad state guarantees. The scope and categories of medical assistance provided should likely be differentiated.”
Alexey Odinets
Chief Physician of Moscow clinic Algomed, Candidate of Biological Sciences, biotechnologist“In my view, the benefits and payments we currently receive are far from ideal. This reduction in social support… What if someone with appendicitis ends up in the hospital? Will they not receive surgery? Our good medical care is increasingly becoming paid. Moreover, people are diverse; there have been instances where bribes were demanded to obtain disability status. Further reducing the social burden does not seem to be the right approach.”
Interviewer: If this measure were implemented, could it stimulate healthy competition in the voluntary health insurance (VHI) market?
Odinets: “If a person is unemployed, they are unlikely to have money for it.”
Interviewer: It`s quite likely they have `grey` incomes. Authorities emphasize this point.
Odinets: “If they are not integrated into society, they are unlikely to purchase VHI either. In a force majeure situation, if they genuinely fall ill, they will likely resolve the issue by paying out of pocket.”
In a poll conducted among subscribers of a business publication`s Telegram channel, 60% believed it is fair to provide MHI to unemployed Russians. A third of respondents considered it unfair, while 11% stated they do not use MHI and were indifferent.
Rupert Blackwood 
Clement Ashworth