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Economic Policy

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Vol 18, No 1 (2023)
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Healthcare Economics

8-33 630
Abstract

   The paper analyzes the transformation in Russian compulsory health insurance (CHI) over the thirty years of its existence and highlights the changes in the mechanisms of state, societal and market regulation used to perform the three main functions of the healthcare financing system: i) collection of financial resources, ii) pooling and allocation of financial resources, iii) purchasing of medical care. These changes are interpreted as institutional responses to challenges in making healthcare financing operate in a stable and efficient way. The Russian CHI system has evolved from an attempt to base it on a combination of state, societal and market regulation into almost complete dominance by the state. The initially heralded creation of a competitive CHI model succumbed to practical obstacles such as the lack of market institutions in the overall economy and the time-restricted window of opportunity for implementing market reforms. This led to modifications in the design of the CHI model and to replacement of regulation by societal and market institutions with regulation by state institutions. From that point on, the government policy toward CHI has been aimed at strengthening centralized state regulation of the CHI system. The future development of the Russian CHI system will require resolving this key institutional contradiction in its design. The choices are: a) continue replacing the remaining market and societal regulatory mechanisms with administrative regulation and using the tools of the latter to ensure more sustainability and efficiency in the CHI system; or b) try strengthening market and societal regulation of the CHI system, and especially the role of health insurers, and thereby increase their impact on the effectiveness CHI. These two alternatives point to two possible scenarios for the future implementation of CHI in Russia.

34-53 123
Abstract

   Mortality in Russia from diseases of the digestive system has grown more rapidly over the past thirty years than from other causes of death, and digestive system diseases have become an increasing factor inhibiting longer life expectancy at birth. Mortality from digestive diseases currently ranks fourth as a cause of death for men and third for women, falling behind only mortality from cardiovascular diseases and neoplasms. Interregional differences in mortality from diseases of the digestive system have been increasing over recent decades. The most pronounced interregional
differences appeared after 2005 as mortality from digestive system diseases decreased in several regions, while the trend in most other regions continued to worsen.

   This article attempts to identify the economic factors determining interregional differences in mortality from diseases of the digestive system.

   The hypothesishat  teconomic and nutritional factors are significant in explaining those interregional differences is evaluated in the article. The Federal State Statistics Service of Russia is the source of the database for the article’s econometric analysis, which uses the method of estimation by a regression panel model with fixed effects. The resulting estimates indicate that mortality from digestive diseases is positively correlated with average per capita alcohol consumption and negatively correlated with per capita milk consumption. There are also positive effects on mortality from such characteristics of general well-being as increased area of living quarters per inhabitant and a higher proportion of urban residents. These findings are pertinent for devising health policies.

Financial Markets

54-77 167
Abstract

   Because the sustainable finance market is growing rapidly all over the world, there is a need for harmonized standards to regulate it at the national and international levels. Work toward introducing a green bond mechanism in Russia is currently being carried out by VEB.RF together with the Ministry of Economic Development of Russia and the Bank of Russia. The article outlines problems arising from the lack of uniform and comprehensive international criteria for evaluating the effectiveness of green financing. Without such standards, data on the positive effects of green investment are not comparable across countries. Unless Russian green finance standards can be harmonized with international ones, it will be impossible for Russian projects to attract investment by placing financial instruments (such as bonds) on foreign exchanges. It should also be noted that the restrictions imposed by economic sanctions require Russian regulators to ensure that sustainable financing mechanisms comply with the international approaches in order to attract sustainable investment even from the countries that have not acceded to these restrictions. This is because those countries nevertheless take part in the international harmonization of national approaches to sustainable financing, including those that apply to EU countries. For example, some of the countries that have not agreed to sanctions (Argentina, China, India, Indonesia, Malaysia, etc.) are harmonizing their sustainable finance standards through the International Platform for Sustainable Finance (IPSF). This study includes a comparative analysis of the existing standards for green finance in key jurisdictions (EU, China, Russia), identifies potential barriers arising from Russia’s green finance standards that would discourage foreign green investment in instruments from Russian issuers, and finally highlights the risks incurred by failure to harmonize Russian standards with the international ones.

Economic History

78-105 136
Abstract

   The common view that Peter the Great’s administrative reforms were largely borrowed from primarily Swedish European practices and resembled the seventeenth-century kinds of governance associated with cameralism provides this study’s starting point. The article describes how the reform process that introduced the collegia unfolded and amounted to a true bureaucratic revolution with fully elaborated paperwork and regulations. Reconstructing the legislative processes of these reforms helps in understanding the extent to which they were borrowed and the way they differed from European prototypes.

   The article’s main objective is to show the variety of methods employed to argue for cameralist features in Peter’s administrative reforms, as well as to identify the advantages and disadvantages of a broad and narrow way of interpreting them.

   The broad interpretation of cameralism offers discourse about its striking resemblance to the spirit and tone of modernization but does not invoke any specific influences. This logic of historical elective affinity between phenomena is in the end too simplistic and may result in invalid conclusions. The paper maintains that it is more valuable to identify causal relationships and direct paths of influence. An example of this approach can be seen in Claes Peterson’s historical reconstruction, which clearly demonstrates how the ideas of the seventeenth-century cameralists Schroeder and Seckendorff were applied in Sweden’s regulations. This is the kind of diligent work that can firmly establish a connection between cameralism and the reforms. Broad generalizations capture only the most general features of the era and render the content of the term “cameralism” meaningless.

106-135 155
Abstract

   The Admiralty Regulations of 1722 reformed the administration of the Russian naval fleet and laid the foundation for the system of state accounting. Tsar Peter the Great initiated those reforms in order to create a modern fleet and in so doing developed a new accounting system.

   The aim of this study is to evaluate the success of the reforms from the viewpoint of finance and accounting.

   This article’s analysis of the financial and accounting system of the navy indicates that Peter’s economic policy required the state to intervene directly in economic life and use redundant, granular controls for regulating all economic activities. The accounting model introduced by the Regulations is examined in reference to primary sources in order to determine to what extent the economic doctrine of cameralism was incorporated into the practice of public administration. The study also maintains that, within the context of cameralism, Peter’s reforms of public administration and finance were quite rational from an accounting standpoint. The study delves into the emergence and theoretical foundations of what is termed cameralistic accounting, one of the most widespread and influential accounting concepts of its era. Although this concept (also referred to as a model, theory or paradigm) was widely used toward the end of the eighteenth century and even now persists in the public sector, its development and theoretical basis remain poorly understood. The study shows how effective the budgeting efforts inherent in cameralism were in the Russian state administration of the Petrine era and describes the role accounting played in this process.

136-175 128
Abstract

   The last decade of Peter the Great’s forty-three-year reign (1682–1725) was marked by a series of attempts to introduce fundamental reforms in Russian public administration. The old administrative system, hampered by extreme fragmentation, was dismantled to be replaced by a rational and unitary administration characterized by a systematic, institutionalized division of responsibilities and an internal division of labor based on a standardized procedure. These administrative reforms undertaken to centralize power were an expression of the monarchy’s absolutist effort to completely unify political and military power. Administration in general and fiscal administration in particular were given a much more important role than they previously had in Russia. State policies of taxation and administration derived theoretical support from mercantilism and cameralism. In order to meet rising government expenditures, it was necessary to mobilize all of the state’s potential economic resources by means of stringent taxation and regulation. According to the Cameralists, uniform and regular fiscal management was of paramount importance for efficient fiscal policy. This excerpt explores the preparation for collegial reform in Russia, gathers information on the Swedish administrative system, on the process of setting up collegia in Saint Petersburg, and on the instructions for their administration. The main thesis is that these Russian administrative reforms were less the result of Western intellectual influence than they were due to socio-economic and political changes in Russia.



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ISSN 1994-5124 (Print)
ISSN 2411-2658 (Online)