Private healthcare expenditure in Russia has been constantly increasing, resulting primarily from insufficient quality of services provided by the public sector.
Increasing affluence of the Russian society, its gradual ageing, combined with growing health awareness, help trigger the demand for private healthcare services. This has been encouraging investment from private sector over the recent years.
According to Frost & Sullivan, the Russian private healthcare market was worth about $8.3 billion in 2009 and is expected to reach almost $20 billion in 2016. This includes private healthcare insurance and direct out-of pocket payments for all healthcare services that have been provisioned privately.
The Russian private health care market is driven by obsolete equipment and inefficiency in large public hospitals. Recent trends indicate a rapid decline in the number of public hospitals in Russia and this is expected to continue.
The public healthcare system also faces difficulties of over-staffing and doctors are usually hired at below-average salaries.This is the reason why patients, who can afford treatment in private facilities, tend to avoid the troubled public sector.
The recently introduced 2020 Healthcare Development Program set ambitious goals to increase quality and affordability of healthcare and improve the overall health status of the Russian society. According to WHO, the ratio between the public and private healthcare expenditure stands at approximately 65 per cent against 35 per cent presently.
Because of the obligatory health insurance (OMS) covering 100 per cent of the Russian population, the public healthcare expenditure is much higher than the private healthcare expenditure. However, there is an existence of a gray zone, because of which citizens end up paying much more.
These payments are made even for staying at public clinics. As a result, approximately 42 per cent of the Russian citizens pay for medical services on an out-of-pocket basis. Such a situation further discourages patients from using public healthcare services and is likely to continue over the years.
In terms of private healthcare insurance about 90 per cent of revenues is generated by corporate contracts. The remaining 10 per cent is generated by individual customers, including foreigners coming to Russia” says Frost & Sullivan Consulting Analyst Dominika Grzywinska. “It is estimated that 8-10 per cent of Russia’s total population is covered by private health insurance obtained by the employer. Only about one per cent of the population purchases private health insurance individually.
” The high average annual cost of individually purchased insurance estimated at $450-$500, is considered to be the main reason for the low preference from individuals. It is expected that the market for individual private health insurance will stagnate in the next years, whereas the corporate segment in private healthcare insurance will grow steadily.
Even though a small fraction of Russia’s population (especially living in large cities) is becoming increasingly affluent, the majority still cannot afford private healthcare services. This restrains the growth of the Russian private healthcare market and has also resulted in large regional discrepancies with regard to the demand for private healthcare.
Another factor limiting the growth potential is the lack of social acceptance for paid healthcare. “Healthcare in Russia is considered a socially vital service that should be provided free of charge, as it is guaranteed in the Russian constitution, or at least be strongly subsidized by the state,” argues Grzywinska.
However, the demand for private healthcare in Russia is on the increase, in spite of the factors hampering its growth. In the short and medium term, the largest demand is likely to be revealed in areas such as dentistry, gynecology, diagnostics and cosmetology.
Moreover, there are still significant shortages of independent expert centers, family medical centers, as well as medical tourism organizations. These areas are considered highly favorable for investments and are expected to attract foreign investors to enter the Russian private healthcare market.