Aspects of Political and Economic Development in Eastern and South-Eastern Europe from 2000-2005
Edited By Josette Bär
III. Economic Developments in Russia
180 181 Maxim Ryabkov1 The Rationality of Paying for Healthcare Russian citizens pay for healthcare that is, by law, granted free of charge by the national healthcare system. It is not immediately clear why they pay. A simplistic explanation based on professionals’ official salary being below the efficiency wage provides no satisfactory ans- wer. A matching of expectations of the doctor and the patient is required, so that both parties could find reasons to engage in a trans- action. Introduction If one demands an explanation of a socio-economic pattern, it ap- pears legitimate to reformulate the question as one of rationalisa- tion: What beliefs and expectations can support the observed pat- tern? If we have to choose among several candidates, we choose those beliefs and expectations that are most likely to be upheld by the agent in the circumstances. This is the explanatory approach that I shall apply to the socio-economic pattern of paying for healthcare that is free by law in contemporary Russia. A few explanatory paragraphs are required first. Euler said: “Since the fabric of the world is the most perfect and was estab- lished by the wisest Creator, nothing happens in this world in which some reason of maximum or minimum would not come to light”.2 1 Resident International Scholar, Academic Fellowship Program, Open Society Institute and International and Comparative Politics Department, American University in Central Asia. I would like to thank AFP for the research grant that made possible the research for this paper. 2...
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