Article 25 of the Universal Declaration of Human Rights specifies that everyone has a right to adequate medical care. Yet what constitutes adequate medical care and how to deliver it is a problem states across the world confront as they face similar problems of rising costs, access, quality of service, and technological development. This article compares health care reform in the United States and the Russian Federation since 1990. Despite differences these two countries and their health care systems have, they show interesting parallels, convergences, and lessons in terms of how reform occurs.