Cook provides a comprehensive overview of Russia’s post-communist health care system, including the health crisis of the 1990s, and the recovery of health care financing and health indicators for the population from 2000. The chapter recognizes the broad coverage of Russia’s health care system and focuses on obstacles to universal and effective coverage, including socioeconomic and regional inequalities as well as informal payments for health services. Cook assesses the system’s accomplishments and limitations, as well as the multiple efforts at health care reform since 1990.