Russia’s Healthcare System
Dr. Boris
Rozenfeld shares the current status of Russia’s healthcare system in this 2010
Rand report: The Crisis of Russian Health Care and Attempts at Reform. Dr.
Rozenfeld is a lead researcher at the Center for Demography and Human Ecology,
Institute for Economic Forecasting, Russian
Academy of Sciences. The
healthcare system in Russia
has not developed well, has faced huge financial issues, and is not delivering
effective healthcare to the population. The reason? Rozenfeld states, “This is
mainly due to a continued lack of funds, medical and technical equipment and
supplies, and, finally, to the ineffective organization of health care delivery
services. “
The problems
with the healthcare system in Russia
have developed over many years. Although
the recent economic downturn in the Russian economy has not helped the issues
impacting healthcare, Rozenfeld makes it clear that it did not create the
problem. Instead he believes the
political model of “state-paternalistic social system development” is the
cause. This model was known for priding itself on the idea that the state would
provide for its citizens’ entire healthcare as part of national pride, but when
it came time for healthcare delivery to rely on the state, the state fell flat,
delivering more propaganda than actual health care. This was all in spite of a
huge number of doctors and an adequate number of hospitals.
There also was
an apparent lack of attention not only to the quality of care, but also to the
effectiveness of the care. Also,
Rozenfeld describes a “complete absence of incentives for improvement of
services in all kinds of medical institutions.”
On the part of the Russian population, their attitudes combined
disastrously with the government’s ineffectiveness and inefficiency. The Russian people were known to have an
irresponsible attitude about their health, yet they wanted to be major
consumers of what the government was offering.
The three
biggest issues confronting Russia’s
healthcare system are: 1) continued economic instability, 2) ongoing
operational difficulties in healthcare delivery, and 3) low prioritization of
healthcare system funding. With inadequate funding, the construction,
remodeling, and maintenance of health care facilities have come to a
standstill. Most healthcare facilities
are in disrepair or dilapidated. To deal with the inefficiencies in delivery of
health care, the government has attempted to introduce some free market principles,
but this has backfired. Citizens who once had the state provide for their
health care needs cannot afford to now pay for that care, so they defer seeking
care. Only the wealthy citizens – a
small percentage of the population - can afford this approach, so the best
available healthcare is delivered to a fraction of the people, and everyone
else waits as their health deteriorates. According to Rozenfeld, state funding
for healthcare allows the system to be maintained at “survival level only”.
In 1993, Russia
instituted Obligatory Medical Insurance (OMI) to help fund its healthcare
system. If all citizens were required to obtain insurance, it was hoped that
many of the funding problems would be eliminated. In the two decades since the
policy was put in place, it is apparent it has failed. Employers making minimal
profits are refusing to provide the insurance for their workers, and employees
need their full paychecks to provide housing, food, and clothes for their
families. In 2010, the amount of money collected through OMI is, according to
Rozenfeld’s assessment, “too little to finance larger goals and is sufficient
only for supporting the most basic set of health needs.”
Russia’s
healthcare system is in a downward spiral. Consistent and adequate funding must
be found to improve the management of the system, upgrade facilities, and increase
the population’s access. While there are an adequate number of physicians in Russia, they
and all healthcare workers need to be paid a better wage. The annual earnings
of all healthcare workers – including doctors – is 20% less than others with an
equal number of years of education.
Emily Crigger
4-3-13
1:05 PM
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