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The author wrote the following article after returning from a visit to the Soviet Union as a member of an HEW delegation. It identifies some of the underlying political and economic considerations that influenced health policy in the Soviet Union and comments on how the health system underpins the political system. The author also identifies some of the challenges being faced by the Soviet health system as consumer expectations increase, and how those challenges are causing the Soviets to ask many of the same questions currently being asked in the U.S. health system.