The article examines the principles underlying health service planning in the USSR, emphasizing the unitary plan for health services as part of the state's economic and social development. It highlights the ideological foundations of this planning, which are rooted in the principles developed by V.I. Lenin. However, the article also identifies institutional factors that may hinder equality in health service provision, particularly through "democratic centralism," which allows local units to deviate from all-union guidelines. The interaction between sector and territorial plans, reflecting economic development levels, is noted, but the article does not address measures to reduce geographical disparities in access to medical care. Statistical data suggests that without addressing territorial justice, spatial inequalities in the Soviet health service will persist.The article examines the principles underlying health service planning in the USSR, emphasizing the unitary plan for health services as part of the state's economic and social development. It highlights the ideological foundations of this planning, which are rooted in the principles developed by V.I. Lenin. However, the article also identifies institutional factors that may hinder equality in health service provision, particularly through "democratic centralism," which allows local units to deviate from all-union guidelines. The interaction between sector and territorial plans, reflecting economic development levels, is noted, but the article does not address measures to reduce geographical disparities in access to medical care. Statistical data suggests that without addressing territorial justice, spatial inequalities in the Soviet health service will persist.