The article refers about the problems of Russian health care and higher and midlle medical education as integral elements of a single holistic system of the state in the conditions of their commercialization. A serious test for health care was the Covid-19 epidemic, which revealed the consequences of the so-called optimization of the medical industry: lack of an effective plan to prepare for the outbreak, lack of hospitals and beds, trained medical and nursing personnel, necessary equipment and medicines, test systems for determining coronavirus, protective suits, consumables, including masks. In order to understand modern trends, the dynamics of indicators of the state of the medical industry in Tsar 's Russia, the USSR and the Russian Federation after 1991 to the present have been traced. Modern Russia finds itself in a number of positions dropped to the indicators of 1913 (reduction of the number of hospitals and polyclinics, graduation of doctors and paramedics, in fact there is no medical industry, chemical and pharmaceutical production, etc.). The main elements of effective organization of higher medical education are identified, which presents both issues of material support of students and teachers, as well as core issues of educational process. The weaknesses of medical education have been identified, which are due both to the lack of sound State policy to support it and to its consequence - insufficient funding. The materials of the article make it possible to formulate the principles of restoration of domestic medical education as the foundation of the health care system.