Russia's healthcare budget faces a record 370-billion-ruble hole

This piece has two parts: the news with source links, followed by the Sardaana News editorial position.

What happened

Russia’s state healthcare system faces a record funding shortfall over the next three years, The Moscow Times reports, citing the draft budget law of the Compulsory Medical Insurance Fund (FOMS), approved by the State Duma in first reading last week.

The numbers

• In 2027 FOMS will spend 5.205 trillion rubles against revenue of 5.037 trillion (mostly contributions of working citizens). The deficit: 168.48 billion rubles, double this year’s 82.1 billion and above the 2025 record of 136.6 billion.
• The gap will be 78.2 billion in 2028 and 126.6 billion in 2029, a cumulative 373.3 billion rubles over three years.
• To cover it, the fund must spend almost all its reserves: of 370 billion rubles in its accounts, only 158.7 million will remain by 2029.
• Federal transfers to FOMS will fall by 23%, from 481.3 to 372.6 billion rubles. Total federal healthcare spending will drop 3%, to 1.818 trillion.
• Spending on fighting cancer will be cut twelvefold, from 44.9 to 3.8 billion rubles; the healthcare infrastructure project (repairing clinics and hospitals) loses 30%, from 77 to 54.4 billion.

What experts say

“By the end of the three years the source will practically run dry,” says Andrei Ragozin of the Financial University under the Russian government (The Moscow Times).

Guzel Ulumbekova, head of the Higher School of Healthcare Organization and Management, estimates 2027 state health spending from all sources will grow 6% — about 2% in real terms, and nothing at all if medical inflation runs higher. Total state health spending stays at 3.6% of GDP, almost half the 5–6% recommended by the WHO.

Sardaana News editorial position

Russia is slowly moving toward the American practice — paid medicine. Under the war with Ukraine, sanctions and demographic collapse, the state cannot provide free medicine for everyone in the long term.

That is why paid medical centers are being introduced in the country “very quietly” — so there are no protests. Doctors working in state institutions often work in parallel at private clinics.

Back in 2023 Russia dropped off the list of countries that successfully treat cancer — Russians increasingly get treatment at expensive clinics in South Korea and Israel.