This paper investigates the role of copayments in health care. We consider international experience of introducing copayments in the systems of social medical insurance. The advantages and disadvantages of instituting copayments in the Russian health care system are analyzed. Consumers of health services and the management of public medical institutions are considered as key interest groups. To identify the positions of consumers, we refer to the results of a poll of St. Petersburg citizens. We also analyze the expert opinions of the graduates of the Presidential Program "Management in Health Care" in order to determine the positions of executives of medical institutions.