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Medical technology and pharmaceutical trade exhibitions were sponsored in Russia by the U.S. Department of Commerce, and cross-cultural health systems analyses by GOSPLAN reformers were published in the American public health literature (Rowland and Telyukov 1991). Critiques from health economists (Chernichovsky 1992b) were actively sought from the World Bank. Russian deputies visited Japan and the United States to assess the experience of existing health care systems, and examined the health legislation of other developed nations in preparation for drafting a final bill. The political crisis in August 1991 established the national sovereignty of the Republics and accelerated the progress towards health reform.