The oil crisis is smashing up public sector healthcare in Russia and many private operators are strangling on dollar-denominated debt. A third could disappear. Many cash-strapped consumers are turning to the grey market of gifts and bribes, rather than paying private operators. The next few years should bring a wave of consolidation as the strong in the private sector, which still enjoys huge tax breaks and strong demand, take control. We name the top 20 players and look at market forces.