This article analyses the interrelation between human resource policies and educational policies in the system of healthcare provision to solve the problem of the structural imbalance in the supply of physicians. International experience reveals a growing emphasis on policies which help maintain the optimal structure of medical workers, i.e. the structure that corresponds to the needs of the healthcare system and society as a whole. Such policies include new regulatory and planning mechanisms for medical schools, the regulation of admission plans and the specialization structure in postgraduate medical education, specific post-education employment practices, and measures to overcome the shortage of supply of some categories of physicians and their geographic misbalance. In Russia, the structural component of human resource policies and educational policies has clearly weakened. The current regulatory and planning methods tend to reproduce the accumulated structural imbalances. Regulatory measures to improve the quality of the training of physicians are still ineffective. No prospective planning exists. Postgraduate training is poorly oriented towards the specializations currently in short supply. Medical schools are interested in training physicians capable of paying for their education and the government does not have the instruments to manipulate the structure of the student body. Recent attempts to improve the situation have not resulted in any positive outcomes yet. The decision to accredit graduates for practicing in primary care without postgraduate training will most likely deteriorate the quality of healthcare. Based on international experience, the authors suggest new regulatory mechanisms.
Institutional approach to the analysis of the development of Russian medieval civilization is impossible without recourse to the theory of "Asiatic mode of production." In terms of this approach, the Russian civilization is a "double periphery" - while the periphery of the Western way of development based on private property, and the Eastern way of development based on the power of ownership. Mobilization and communal environment of Russian civilization and the strong influence of the Oriental Institute have created the preconditions for the development of the dominant institutions of "Asiatic mode of production", but retains the possibility for the development of feudal institutions. Over the XIII-XVII centuries. was an active confrontation between the four models of the Russian state - Moscow, Lithuania, Novgorod and Cossack. The final victory of the Moscow model based on the dominance of the "Asian" institutions, has been subject to a number of both objective and subjective circumstances. Institutional competition of different patterns of development of Russian civilization continues to this day - for example, in the form of competitive models of develop-ment of Russia, Ukraine and Belarus.
Douglass North, John Wallis and Barry Weingast in their book 'Violence and Social Orders' have proposed a new conceptual approach to analysis of social development. They divide all societies into those with orders of limited and open access, and consider the development as the process of opening access to economic and political activity for non-elite social groups. However, according to North, Wallis and Weingast the presence of common beliefs in society is crucial for the transition from limited to open access. From this point of view, the historical experience of the Soviet Union is extremely important because it represents a unique case of a new social order based on a specific ideology. We argue in this paper that one of the key factors of the USSR's success between the 1920s and the 1960s was connected with opening access to education, the development of healthcare system, and the opportunity for social mobility for non-elite members. These elements of open access could be implemented in reality because social equality and social activity of masses were important parts of the dominant communist ideology and were considered as an advantage in the competition with the capitalist world. These open access elements could be successfully implemented because they were supported by common beliefs in social equality, which were widely shared throughout society. However, these common beliefs were of artificial ideological origin and during this time they came into deep conflict with the personal (private) interests of the new Soviet elite. As a consequence common beliefs, which were not supported by direct experience, started to erode, and this process finally predetermined the collapse of the Soviet Union - because this social order was driven not by the private interests of economic agents and political actors but by ideological incentives. Thus, the Soviet experiment helps us to understand that sustainable social development can rely only on common beliefs and values growing from the interactions of private interests.
A routine analysis of the demographic situation is usually based on indicators calculated for calendar periods. Using cumulative indicators such as total fertility rate and life expectancy, it is possible to characterize the general trends of these demographic processes. However, such an approach does not properly reveal the changes in the number of children a woman has during the course of her life or the real life expectancy of a given generation. In other words, a proper assessment of the effects of demographic policies must rely on information about real (rather than hypothetical) cohorts. Such an assessment is only possible 20–30 years after the implementation of policies, because it takes time to collect the necessary data. Therefore it is only now that we can finally assess the effects the demographic policies of the 1980s. The analysis presented in this article utilizes official statistics on births and deaths from 1946 to 2013 and official estimates of the population age-sex composition between 1959 and 2014. For the period 1946–1958 we use unofficial estimates of the age-sex composition. Using this data for different real generations we calculate age-specific fertility rates, age-sex-specific mortality rates from all causes combined and from some causes of deaths. By exploring these indicators we find that the immediate effect of demographic policies of the 1980s was quite impressive: in 1987 the total fertility rate was at its highest and life expectancy at birth improved to the level of the mid-1960s. Additional positive consequences are found in changes in mortality and the fertility of several real generations. Nevertheless, long-term effects are less visible, bordering on negligible. These findings are discussed in the context of current demographic policies and conclude with tentative predictions regarding their long-term effects.