Abstract

In the course of the present transition in Russian society, a new system of social security has been developed. The previous Soviet system has been replaced by a system of four more or less independent social funds, covering the main branches of social security. These funds are supposed to be run according to insurance principles and to be financed by contributions, mainly from employers. Given the difficult economic and social situation of the country, there have been increasing demands for effectiveness in the management of the different funds and also in the management of the whole social security system. The results of this study show that the social funds have developed different organizational structures with different degrees of centralization and decentralization. Only one of the funds seems to be relatively well‐functioning and effective, while the others have experienced more or less serious problems in fulfilling their main tasks and functions. The most serious problems, however, seem to stem from the structure of the social security system as a whole, which is perceived as fragmented and badly coordinated. In order to improve the coordination of the system, there have been proposals to merge two or more funds into a unified social security organization. This strategy is open to question, however, since it would increase the bureaucracy of the system. There are other ways in which the structure of the social security system might be advanced. Such developments should be based on an analysis of the system from the perspective of the individual client or patient.

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