Overview of Healthcare in Russia
There are three types of healthcare institutions operating in Russia: municipal clinics, federal clinics and private clinics. Most commonly used facilities are polyclinics which house out-patient clinic, pharmacy and a laboratory under one roof.
Pharmacies are easy to find in Russia. In Moscow you may find one at every metro station as well as several in every district. The regulations around the sales of pharmaceuticals are not rigorous and very often one is able to buy prescription medicine over the counter. Be sure to know the generic name of the medication you use back home as the exact products might not be available in Russia.
Statistically speaking life expectancy and overall level of health in Russia currently resembles that of a developing African nation. For those relocating to Russia in the near future this fact might seem alarming to say the least. Combination of endless bureaucracy and red tape, severely underpaid medical personnel and shortage of necessary medication and equipment all contribute to the overall dreadful state of Russia's healthcare services.
Great economic divide has brought about an unspoken law where one's life and well-being may depend on the ability to agree with the doctor on an unofficial monetary sum for the treatment (in other words a bribe). On the other hand there are plenty of high-standard international hospitals and clinic where a routine consultation fee equals to the monthly salary of a state hospital doctor. Such inconsistencies in the system leave many people vulnerable to the constant social and economic shakeups.
Healthcare Legislation in Russia
Russian Federation inherited its healthcare system form the Soviet Union. Constitutionally Russian citizens and permanent residents are entitled to free medical care. Structurally this is carried out through government organized health insurance system referred to as obligatory medical insurance scheme. The funds come from healthcare tax imposed on all registered employers, who contribute the equivalent of little over 3% of each employee's income towards the healthcare fund. The remaining portion of the overall healthcare budget is provided by the government.
While the structure appears promising and impelling the overall healthcare budget accounts for less than 4% of the country's GDP. Comparatively that is extremely low, as an average industrial nation allocates between 8-11% of its GDP for healthcare.
There has been great effort in recent years to boost government allocation for the country's health care needs, however it will take a considerable amount of time before any significant results will start appearing.
Healthcare Concerns in Russia
One of the most acute problems facing Russia today is what some call “silent suicide of the nation”. Decreasing level of life expectancy, low birthrate and aging population are major contributing factors to population shrinkage amounting to one million people annually.
Long cues in polyclinics, shortage of qualified medical staff as well as often disrespectful attitude towards patients discourages many people from seeking professional attention until it is too late. This phenomena has been dubbed as “industry of nations handicapping”.
According to the recent study that was set out to assess the overall confidence in the country's medical system revealed that half of the respondents did not see a doctor or sought qualified medical help in 2010 when ill. Moreover close to 90% of those who sought medical attention reported paying for the services, whether as a legitimate fee at private hospitals or in a form of a bribe directly to the doctor. Over 60% of respondents stated that they found the level of healthcare in the country as unsatisfactory and in great need of a major reform.
Mindless bureaucracy and accompanying it corruptions have become chronic condition of Russia's way of life, seeming impossible to eradicate. One of the founding fathers of the Soviet healthcare system N.A. Semashko famously said that “good doctors will be fed by the people, and bad doctors are just not needed.” While seemingly unimportant remark dating back almost hundred years, this attitude has prevailed until this day. The governmental law is overlaid by the unwritten rule of the social exchange that is deeply ingrained in the modern day thinking and outlook of Russians particularly when it comes to healthcare.
History and Development of Healthcare in Russia and Soviet Union
Russia's current healthcare system structure was put in place in the early days of the Soviet Union and did not significantly change over the years. The only advancement was made in the 1980's that saw the system being decentralized, dividing it into municipal, regional and federal administrative levels.
In the early 20th century plagues and infectious diseases presented the main concern to public health and well-being. Big emphasis was placed on immunization and prevention on mass-killer contagious diseases. Enormous amount of funds were poured into construction of new facilities enabling easy access to medical care. The system was highly centralized and despite major drawbacks proved to be extremely successful. By 1960's Soviet healthcare was on par with that of North American and European country's.
Starting from the 1970's the medical and healthcare system as well as the overall economy of Soviet Union began a steady decline that culminated in its collapse in the early 1990's.
One of the more significant factors contributing to the decline of the healthcare sector was and still remains a low socioeconomic status of the medical workers. Salaries are fixed according to a unified tariff scale and fall significantly short of national average.
After the collapse of the soviet union a lot of state secrets came to light, exposing the negative impact of the arms race on the overall health of the population. Systematic destruction of ecosystems in the name of economic and military advancement resulted in almost half of the country's territory categorized as under moderate to severe ecological stress. During Gorbachev's era the restrictions on communication and information distribution were lifted and for the first time the connection between evident deterioration of human health and environmental factors was openly made.
Take the case of “Mayak” an atomic weapon complex that was built in early 1940's in the province of Chelyabinsk. Over 45 years the radioactive waste was systematically dumped into Techa River, the only source of water for almost 30 villages in the region. In 1957 due to the cooling system malfunction resulting in an explosion quarter of a million people were exposed to the same level of radiation as the Chernobyl victims. The event was not reported or acknowledged by the government, people living in the area were not informed nor evacuated. In total it is estimated that over several decades close to half a million people have been exposed to extremely high levels of radiation in Chelyabinks. Doctors working in the area were not allowed to state cancer as the diagnosis in order not to draw any attention to masses of people dying prematurely. Russian government acknowledged the existence of Mayak only in the mid 1990's.
This is by far not the sole example of environmental atrocities of such scale having dreadful impact on human health in Russia. While severe air and water pollution, radioactive waste, deforestation and land erosions are primarily ecological and environmental concerns, the true impact on health and well-being of the people living in the country is still not entirely clear.