Otto von Bismarck or Karl Marx: financing medical guarantees for the population by contributions from salaries or by turnover tax?

The article examines the circumstances that allowed the Soviet Union rapid creating the world’s first universal health coverage (UHC) system in the 1920s and 1930s, ahead of most developed OECD countries. At the same time, while OECD countries created their UHC systems in the context of rapid economic growth during the so-called “golden age of capitalism” (1945–1975), the achievement of UHC in the USSR occurred in extremely unfavourable economic conditions. Analyzing the success of healthcare in the USSR, the authors conclude the refusal to finance it from taxation of the wage fund (the so-called Bismarck system) to be in favour of the innovative Soviet tax on the turnover of enterprises, the authors found the source of ideas for which in the works of K. Marx and W. Rathenau, played an important role. The authors see prospects for using the Soviet tax innovation in the 21st century.Contribution of the authors: Ragozin A.V. — research concept, writing the text, compilation of the list of literature; Grishin V.V. — statistical data processing; Dudnik A.I. — editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Acknowledgment. The article was prepared based on the results of research carried out at the expense of budgetary funds under a state assignment for the Financial University.Conflict of interest. The authors declare no conflict of interest.Received: December 3, 2024 / Accepted: February 19, 2025 / Published: April 30, 2025

Universal health coverage, financing, taxes, insurance premiums, impact on production, Bismarck, Marx