Social Representations on the Healthcare Model in Russian Society

The executive order of the President of the Russian Federation "On the Strategy for the Development of Health Care in the Russian Federation Until 2025" outlines significant challenges to national security in the field of public health along with positive indicators of the health care dynamics. These challenges include the dissatisfaction with the availability and quality of health care, the substitution of free health care by paid services, etc. Moreover, the need to activate social reserves of human capital and to ensure the conditions for the active longevity of the Russians becomes urgent in terms of the pension reform and the problem of the aging of the society. The spontaneously formed existing practices of the population's medical activity can hardly be called positive, i.e. contributing to the positive dynamics of the health status of an individual, the members of most social groups, and the society as a whole. The ideology of health and the culture of health care consumption have not yet been formed in Russian society. At least these two circumstances contribute to the intensification of social inequality among patients and potential patients ("pre-patients") in the access to health care. The relevance of the subject area of the article is determined by the need to overcome the existing differences in understanding the social connotation of medical care consumers' representations and its factors in terms of the transformation of the healthcare institution. The novelty of the research is determined by the use of the neoclassical model of scientific rationality and the methodology of sociological constructivism in the study of internal and external factors that determine the social representations on the healthcare model of the Russians. On the basis of empirical data across the South of Russia, the distinctive features of the two alternative types of social representations on the healthcare model-liberal and conservative-are identified. However, in real life, social representations acquire a hybrid nature. The number of the hybrid type supporters is significant and heterogeneous by its composition. The representatives of this type recognize the necessity and inevitability of market regulators' intervention in the health sector, but suggest that there should be a package of guaranteed free aid and that the state should also bear the burden of financial expenses and responsibility for the quality and availability of medical care. Depending on the direction of the social expectations and demands of medical care consumers, the hybrid type of social representations may manifest itself as neoconservative or neoliberal, integrating the elements of conservative and liberal representations.

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