The author substantiates the original theoretical model for assessing the availability of medical services. This model is based on the specifics of the institutional context of modern Russian health care. A significant sign of relations between consumers and providers of medical services in Russia is the division of costs without clear regulation of its borders. The consumer of health services is in search of a reasonable balance between the two alternatives. On the one hand, the low organizational and spatial availability of medical care in public institutions and, on the other hand, the high cost of services in the commercial sector. The author offers a method of measuring the availability of medical services in a two-dimensional field of assessments, which is limited to two criterion scales – "price" and "distance". The article, based on the data of the sociological survey of the population, shows various variants of the ratio of these components of accessibility, including examples of fusion and dichotomy, which are determined by a number of socio-economic factors, including gender, age, income level, health status. The author concludes that the main problem of access to health care in Russia is the lack of development of mechanisms for leveling the information asymmetry between the supplier and the consumer of services, as well as the lack of a system of responsibility sharing between the public and private sectors of health care.