Ailing Russian Health-Care System in Urgent Need of Reform

By Shukshin, Andrei | Bulletin of the World Health Organization, May 2004 | Go to article overview
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Ailing Russian Health-Care System in Urgent Need of Reform


Shukshin, Andrei, Bulletin of the World Health Organization


The Russian Federation needs to overhaul its corrupt and inefficient health-care system if it is to provide regular medical assistance and help the country fight an AIDS epidemic, officials have said.

"We just cannot go on like this--slowly dying--any more. We need to keep the best of what has been achieved but finally bring the system in line with market realities," said Tatyana Yakovleva, Chairwoman of the Health Protection Committee in the State Duma lower house of parliament, a body responsible for the drafting and examination of health-related bills before they are put to vote.

Although communism collapsed in the country thirteen years ago, the Soviet free-for-all health care system has survived virtually intact--a system which the government and the public agree makes bad use of limited budget resources, leaving millions of people without basic services and forcing doctors--many of whom earn under US$ 100 a month--to accept bribes.

Russians who can afford fees charged by the private sector tend to stay away from state-run facilities where patients are routinely driven to bribing personnel to obtain services which are supposed to be dispensed free of charge. Research carried out by Moscow's INDEM think-tank shows that Russians spend some US$ 600 million a year on such under-the-counter payments.

Complaints about the poor quality of medical services, crumbling infrastructure and blatant mismanagement appear almost daily in the Russian media. Many hospitals, especially in remote areas, have no hot water and some have no running water at all; even the most basic medicines are often in short supply.

The quality of medical assistance also varies considerably between Russia's 88 administrative regions depending on local economic conditions.

"The majority of the population have no access to quality health care," said Oleg Shchepin, a member of the Russian Academy of Medical Sciences and director of a research institute. "To give you one example, the number of people suffering from kidney diseases and bronchitis among Russia's have-nots is six times higher than among our better-off citizens."

Putting additional strain on the already ailing health-care system are the unhealthy lifestyles of many Russians.

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