The healthcare system in Russia including health care practices, beliefs and reform Russia being one of the largest countries in the world with a population of about one hundred and forty four million by March 2016 has the most challenged form of health sector. With its high population, the importance of a well-furnished health sector offering the best services should be among the top priorities of any governance in Russia. This would help in reducing the birth mortality rate and increase the life expectancy among the citizens of Russia. The negligence has been fueled by economic, lifestyle and social drastic changes over the past years. With too many changes in reforming the sector from since time in memorial, this paper aims at looking at the steps Russia has taken in achieving its current health sector.
Origins
Moscow, the capital city of Russia, is marked as an important city since this is where the establishment of the first medical division took place in 1775. Since during this time physicians did not have the freedom to exercise their professions thereby serving as state servants, the medical services were only offered to prosperous and loyal class of people only. This alienated majority of its citizens thus spearheading for reforms and an enhanced focus on the sector. It’s during the reign of Alexander II that great reforms were witnessed in Russia. This included the embracement of Zemstvo movement though politically influenced that advocated for use of Zemstvo medicine for preventive measures mostly in rural areas of Russia.
The movement primarily composed of primary medical care physicians in the rural areas. Bearing positive results the movement was further endorsed by Alexander III gaining popularity thus shifting to more of a political movement. Maneuvering through various historical medical reforms during the Soviet and Tsarist period, for example introduction of compulsory vaccination of children against small pox and increase funding to the health sector though the many achievements could not hold the increasing population of Russia, Russia witnessed one of the major reforms whose success is felt even on the present day.
The semashko system of health care which saw a centralized system of health care where all the health employees were under the supervision of the government was a major contributor to the health sector of Russia. The system provided care to all the Russian citizens. It also gave a well-coordinated flow from the primary physicians to the secondary physicians providing with medical services through a district physician. The district physician treated mostly communicable diseases for example typhoid and tuberculosis. The semashko system seemed to thriving and yielding recommendable results until 1970s where the congested public health sector started receiving abandonment with people seeking for better private health services (W.H.O, 320).
Failure of the semashko system led to other health reforms witnessed in 1990s. These reforms were not well implemented due to the inevitable economic evolution. The reforms from semashko system included the compulsory insurance on health and freedom to access private specialists without considering the district physician first. With poor health facilities offered in public health sector and money-driven private health sectors, Russians faced a critical confusing moment leading a reduction in life-span in the 1990s (W.H.O, 320).
Health care Practices and Beliefs in Present Day Russia Since 1996, every Russian citizen has a right to free medical care. The medical care is funded by the government through the obligatory medical insurance via the health ministry. With the high population the ratio of doctor per patient attendance is unevenly distributed leading to high number of patients accorded to a single nurse or a doctor. Despite the improvement in allocation of funds to the health sector by the government, Russia faced financial constraint in 2014 leading to poor provision of health services to the citizens. This led to closure of some health facilities since the funds were not available.
Affecting the employment sector of the medical practitioners where many lost their jobs, the patients had to look for better services that needed extra finances. Attaching itself to the communist ideology, Russia suffers a great deal in shifting to a better radical way of improving their health. Pulled back by the ego of being a developed country, Russia citizens accord their health status to the government which does not pay much attention since the decline of the health sector in the 1960s. With a decline of 148 million to 145 million in population within 1992 up to 2002, the population is predicted to worsen in terms of decline to about 100 million by 2050.
The decline caused by the increase in child and maternal death rates, reduction in life-span and fertility and spread of contagious illnesses. Accumulating about 100% and 60% of communicable illnesses and alcohol-induced deaths respectively, the life-span of male citizens in Russia declined by seven years from sixty four in between 1990-1994. With the legalization of abortion in Russia, decreased fertility continues to contribute highly to population decline. Being an industrialized country, the expectations would be that they will be need to continually increase the population due to the availability of resources which is not the case in Russia. With a decline of seven children to an average of 2.1 children per woman as from 2000 to now, the country continues to feel the effects of neglected health care with an average ratio of 2 225 000 to 1 266 000 births and deaths respectively in 2000.
The condition has been worsened by the high mortality rate among its citizens thereby reduction in life expectancy. The most hit by this are the male citizens in Russia. With an average of 1 in 2 likelihoods of hitting 60 years, the male gender in Russia has thirteen years lesser than that of a female’s life-span. Alcohol consumption leading to death has mainly contributed to the male misfortunes in Russia.With theoretical laws governing the health sector in Russia having been penned down on paper, the implementation of these laws is questionable. The health care being free but the citizens required to pay a must insurance fee which cannot be well accounted for leaves one in a confusion of how the health sector in Russia is run.
The citizens pay for the scrambled state of health sector dearly with their lives as the prominent and wealthy men who ought to guard their rights seeks proper medical services abroad for their families and relatives (Bennetts, 1). Hanna Run an Iceland woman who happened to visit Russia paid the consequences of a corrupt medical sector during her stay in Russia. Suffering only from a mere heart burn, Hanna was to undergo an operation which she declined. The doctors who cared less about her condition administered drip on arrival without proper examining. The conditions of where she was having her medical attention services were not conducive to any patient or any human kind for that matter. The less concerned medical authority later denied the truth on the ground after Hanna posted her ordeal on a blog in which they considered her not fully adapting to the Russia’s system. This clearly surfaced the realism of the matter in the health sector in Russia.
Not mentioning many of the victims in the health facilities of Russia was Yelena, a Siberian woman who met her death during child birth. The negligence of patients by doctors continues to be witnessed here where the doctors failed to perform blood transfusion in due time thus leading to her death. Drunken doctors, unhealthy status of the medical facilities, less medicines, poorly paid medical practitioners and the corrupt authority has overtaken the decaying state of health sector in Russia (Bennetts, 2).
The Need for Health care Reform With the overwhelming challenges in the health facilities in Russia, there is a need to make changes in the system so as to meet the needs of its citizens. Lack of enough finances in the sector is the root problem of this sector. Due to poor federal and local funding systems, the health sector faces the challenge in providing with the proper services. This leads to low motivation of medical practitioners leading to negligence of their duties where the patients suffer the effect. The financial constraints also leads to poor services and facilities offered in many health facilities where patients are required to look for better services at an expensive rate (Rozenfeld, 1).
The poor free services provided by the state leaves the citizens with no option than looking for better services which one would learn later are federal facilities with the best services. The poor and corrupt organization of the health sector leads to mistrust among the primary physicians with many opting to directly seek services from a private medical practitioner thus no proper and clear medical history is followed leading mostly to incorrect diagnosis.The shift from federal funding to local funding has primarily contributed to the failure of the heath sector in Russia. The citizens though entitled to free medical care they are also subjected to a compulsory insurance that they have to pay.
This creates the start of corruption where the federal state only funds certain medical facilities creating them as the only option remaining in Russia for proper medical services thus becoming a great beneficiary. This money-oriented provision of proper medical services only leaves a nation more collapse adding a heavy burden to its citizens who hardly can sustain their living with the instable economy. To regain its right and proper shape, the health sector in Russia should pay importance in acknowledging the primary physician.
This would be done by motivating them by increasing their salaries and equipping the facilities with the right and proper facilities. The primary physician would be able to put the preventive measures on the lives of the patients before handing them over to secondary physicians in case of such. This would also bring back the broken trust in them in providing with proper medical services to the patients. All this cannot be achieved by avoiding reforms in the funding of the health sector (Rozenfeld, 2).
Lastly the government needs to keenly work on the freedom of access to private medical coverage of health care. This should be reformed since the citizens have to pay the mandatory insurance in which they don’t see the fruits since the healthcare system is free. The private medical facilities would help the citizens in accessing the proper services or in case of a referral from the primary physicians. This would also help in reducing the corruption in the medical sector in Russia since now the citizens would account for the finances they put in the insurance policy (Rozenfeld, 2).
Work cited
1. Bennetts, M. The horror of Russian healthcare. The Independent, Independent Digital News and Media, 2 Dec. 2016
2. Health and Health Care in Russia and the Former Soviet Union. Health and HealthCare in Russia and the Former Soviet Union | UCSF Medical Education | Global Health, University of California San Francisco
3. Healthcare in Russia. Wikipedia, Wikimedia Foundation, 11 Aug. 2017
4. Rocky road from the Semashko to a new health model.Bulletin of the World Health Organization, vol. 91, no. 5, May 2013, pp. 320 321
5. Rozenfeld, B. A. The Crisis of Russian Health Care and Attempts atReform.RAND Corporation