The article presents main prospects of academe discussions on health care for the elderly and the data of sociological research based on an expert survey and mass questionnaire in two Russian regions: Republic of Tatarstan and Republic of Mari El. Health care in Russia contains both the features of political heritage incorporated into ideological attitudes of the elderly population and the institutional specificity of «hybrid» changes, when neo-liberal health care reforms are accompanied by increasing in state regulation. The perception of social justice by social groups affects the degree of satisfaction with health, the indicators of which are used not only for system operation assessment, but also for evaluation of activities of central and regional authorities. Experts indicate positive processes of increasing access to high-tech care and healthcare efficiency, and negative ones related to decline in medication accessibility and division of health by territorial entities. The survey data also indicate a decrease of accessibility. About half of the surveyed elderly people consider current health care system in Russia fair, the other half – unfair. Dividing distribution mindset into equal allocation of medical care among citizens (80%), elderly people nevertheless more often argue for the need of inequality than the representatives of other age groups by means of special health support for low-resource population groups as against those who are solvent, and for limiting medical services citizens with shady employment.