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ECONOMIC RESEARCH

TITLE

The Role of the State in Healthcare: A Comparative Study of Social Attitudes of Russians and Residents of Other Countries

Olga A. Kislitsyna

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RAR (Research Article Report)

JEL I18; I38; H51; C25

https://doi.org/10.52180/1999-9836_2026_22_1_4_60_73

AUTHOR

Olga A. Kislitsyna

Institute of Economics, Russian Academy of Sciences, Moscow, Russia

E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ORCID: http://orcid.org/0000-0002-4144-237X

SPIN-code: 7120-4122

ResearcherID: E-3767-2012

Scopus Author ID: 8852460000

FOR CITATION

Kislitsyna O.A. The Role of the State in Healthcare: A Comparative Study of Social Attitudes of Russians and Residents of Other Countries. Uroven' Zhizni Naseleniya Regionov Rossii=Living Standards of the Population in the Regions of Russia. 2026;22(1):60-73. https://doi.org/10.52180/1999-9836_2026_22_1_4_60_73 (In Russ.)

ABSTRACT

Against the backdrop of population aging and rising healthcare costs, the question of who should finance healthcare – the government or citizens themselves – is becoming increasingly relevant. Despite extensive research on social policy, healthcare as one of its domains remains relatively underexplored. The aim of the study is to investigate: 1) How do citizens in different countries perceive the government’s role in providing and financing healthcare? 2) Which factors are associated with particular attitudes toward the state’s role in healthcare? A new typology of countries based on the characteristics of health systems is used. An analysis of data from the International Social Survey Programme (ISSP) collected in 2016 reveals overwhelming support for the government’s role in healthcare across all examined countries. Higher levels of support are observed, on the one hand, in Scandinavian countries with universal coverage and public financing, as well as in countries with limited healthcare services and lower system efficiency. Conversely, the lowest levels of support are found in countries where healthcare is predominantly financed through private sources. To identify significant socio-demographic and political-ideological factors influencing attitudes toward the state’s role in healthcare, ordinal logistic regression methods were applied. The analysis demonstrates that self-interest motives have a notable impact on attitudes toward the state’s involvement in healthcare: in many countries, individuals with higher social position are more likely to oppose the expansion of public healthcare spending. Across all examined countries, moral commitment to the public good – adherence to egalitarian values – appears to be a stronger determinant of support for the government’s role in healthcare than individual self-interest.

KEYWORDS

health care, public opinion, public finance, public services, government accountability, comparative research, International Social Survey Programme (ISSP)

INFORMATION ABOUT THE AUTHOR

Olga A. Kislitsyna

Doctor of Economics, Chief Researcher, Center for Economic Theory of the Social Sector, Institute of Economics of the Russian Academy of Sciences.

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