Access to healthcare in Russia: the role of socioeconomic factors and digital technologies

The analysis of the structural determinants of medical care availability in Russia has been carried out. The research focuses on the mutual impact of socio-economic factors (social stratification and territorial inequality), economic mechanisms (government financing and commercialization), and digitalization on forming a dualistic healthcare model. The empirical basis of the study has been made up of data from 20 semi-structured in-depth interviews with the heads of Russian pharmaceutical companies and leading healthcare professionals. The study results have revealed the persistence of key systemic challenges: regional asymmetry in the resources provision, staff shortages, and the growing burden on the compulsory health insurance system. The analysis of the experts’ discourse demonstrates its ambivalent nature: with the declared support for the policy of import substitution and economic sovereignty, respondents emphasize the issue of the technological gap and institutional barriers. The thesis has been argued on the need for a paradigm shift from extensive “disease control” to proactive “health management” with the integration of regular monitoring of public attitudes into the process of public policy formation. The effectiveness of import substitution depends not only on the amount of financing, the level of technology, and digitalization, but also on transformation of the symbolic capital of domestic medical products in the eyes of the professional community and the population.