Communism Effect on Russian Medicine
Throughout history, the culture has had far-reaching intricate effects on the attitudes, lives and health of a society. Russia has not been an exception in these realities. Today, Russians still experience and contend with the effects of communism. Differences between a communistic and capitalistic society are paramount in order to understand the effect of communism on the modern medical field in Russia. Capitalism gives people freedom, encourages completion and appreciates people of different classes. Government interference with the economy and individual rights is maintained at a necessary minimum. On the other hand, communism has a totalitarian system of government, where state owns the properties, free enterprise is hindered and the society is classless. Wealth is shared equally, community progresses as a whole and health and education are provided strictly by the state.
Communism and Russia Medicine
Due to centralized government of the Soviet Union, personal liberties were severely restricted. Government promised to provide employment, personal needs and health care. A well-organized universal health care resulted in incredible coverage and functionality. In the early 1960s, the health and life expectancy in Russia came very close to that of the United States (Pipes, 2015). Government distributed dispensaries and other medical to the most remote places. Former Soviet Union performed tremendously in terms of providing access to health care. On the other hand, the communistic approach of paternalism and strict centralization of medicine created a relative dependency attitude. An average Russian individual considers the responsibility for their heath an ultimate governmental function.
Before communism, the medical field in Russia was customer oriented in nature. The income of medical practitioners depended on their reputation and professionalism. To earn a higher income they had to work hard to win the trust of a wider community. Patients had the freedom of a preference of one doctor over the other. Citizens were allowed to decide which pharmaceutical product to trust and obtain medical services from the best hospital in their perspective. Hard work was rewarded and encouraged, and many doctors engaged in charity as a strategy to build a good reputation. The poor were the main beneficiaries of the charity works. Doctors were loyal to the oath of service that required them not to turndown an individual in need of medical attention. Urban areas were characterized with outpatient care and charity hospitals, which provided medical care for the less fortunate and poor families. In rural areas, poor people used items like chicken, bread or even domestic service to pay off their medical bills. In some cases, they would as well get free medical care. This form of privatized medical system enabled doctors to earn decent money making them philanthropists (Skwire, Tupy, Volokh, Watson & Cunliffe, 2015).
In anticipation of the good income and respected medical profession, individuals did their best to earn a slot at medical schools. Only the best were admitted as students and those with exceptional performance were hired as professors. Because of a well-organized system, Russian medical services and research were internationally recognized in the early 20th century (Meded.ucsf.edu, 2015). Though the medicine field was far from perfect, it was as well far better than in other regions, more cost efficient and widely available. In a competitive environment, the profit motive combined with the philanthropic spirit stamped quality medical care throughout entire Russian Federation.
Bolsheviks, infected with a communistic disease with some socialism, brought the existing medical structure down. Many doctors interacted with poor people causing them to think that a governmental system would address their challenges better. The free market approach was abandoned in pursuit of a centralized governance system. Medical care and education were the central focus in an aspiration to establish equality. This utopian idea clouded the minds of doctors and other key contributors, and they ruined the competitive health care system. Human perception that all people could have same of everything degraded the skilled medical care and, worst of all, the morale of medical practitioners (Skwire, Tupy, Volokh, Watson & Cunliffe, 2015).
By the early 1920s, the government nationalized the medical services. Gradually, huge medical factories and clinics replaced individual medical practitioners. Government started building these facilities all over the country. The right to choose where people obtained medical services belonged to the government. All citizens were assigned to hospitals and out-patient clinics based solely on government decisions (Henderson, 2015). The Soviet government was the central planner of each individual’s health care and medical expenses.
The amount and form of medical care were also dictated by the government officers who allocated the budget. If officials felt that medical care was not a priority, they would allocate a smaller budget to it, which considerably affected the quality of service. Doctors received a small salary and the number of their patients was determined by government through the quota system. Irresponsibility was in the order of a day leading to the infamous saying, “They pretend they are paying us and we pretend we are working” (Maltsev, 2012). Unionization made it close to impossible to fire medics. Price and market no longer determined the availability and value of the medical care. Pharmaceutical items and services were placed under a rationing system, which was characterized with extensive corruption, appalling medical care and increased death rates (DaVanzo & Adamson, 2015).
Government could not provide specialized services like ultrasound and mammograms in every part of the country. A few selected places had such facilities. Limited medical equipment was used for both treatment and research (Hoeppler, 2011). Lengthy lines that often led to the deaths of patients became a common occurrence. To access the facilities in a timely manner one had to pay a bribe. Some people witnessed how a “nonpaying” patient died struggling to reach a lavatory located at the end of the corridor immediately after a brain surgery (Maltsev, 2012). The number of patients dying under the government-managed medical care increased exponentially. In attempts to mend the statistics, doctors sent patients out of the hospital when they knew that patients were about to die.
Unlike the times when medical care was a customer-oriented market, the system changed toward a producer orientation. Eventually, the health care industry became a dark market due to its corrupted nature. Only the rich would afford to pay the bribes in order to obtain medical services, which became more expensive compared to what existed before communism (Knobler, Mahmoud, Lemon & Pray, (2006).
By the time when government realized that the communistic approach was not working, the condition of Russian health care was at a devastating stage (Noland, 2015). The infant-mortality was 2.5 times higher than that of the United States. The figure must have been obviously higher considering that in the United States even the premature babies who die are counted, unlike in Russia. According to the State Statistics Committee, today’s life expectancy of men and women is 59 and 72 years respectively. In the United States, the life expectancy of men is 73 years while that of women is 79 years. The life expectancy of an American child at birth is 12 years higher than that of a Russian child. 57% of hospitals lack hot running water while 36% of rural Russian hospitals have neither water nor a sewage system (Skwire, Tupy, Volokh, Watson & Cunliffe, 2015). The centralized government neglected basic medical human needs in pursuit of other things like the development of weapon and space exploration.
Declining Russian population can be associated with the failure of communism in addressing medical care. Russian fertility rate is worryingly low in comparison to other nations, which adapted a capitalistic approach to health care. Current HIV/AIDs statistics list Russia as the country with the highest infection rate in the entire Europe (Knobler, Mahmoud, Lemon & Pray, 2006). Age discrimination is a common occurrence in countries where government depends heavily on the medical care systems. In Russia, little to no preference is given to people aged between 60 and 70 years because they are viewed as less productive.
Comparison of the United States Health Care System to Russia
Unlike in Russia, the United States have a different system of medical care. The central idea of the system is a financial arrangement where the government pays citizens’ medical bills from an insurance purchased by an employer of individuals. Patients enjoy the freedom of selecting their doctors and medical care units. Insurance companies are expected to pay for the medical care of their clients. Competition on the medical market is not suppressed, which encourages individual investment into the research. Nongovernmental organizations invest billions of dollars into the research because they know it will pay off with breakthrough innovations. The number of private insurance companies is rising with over 1200 being already registered (Cooper & Taylor, 2011). Market incentives promote the quality and development of high-tech medical equipment and advanced drugs.
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In contrast to a communist approach, the United States classify people into the groups. Insurance companies compete for skilled workers hence keep improving their services. Government pays for the health care of individuals with no insurance cover through classified programs like Native Americans and Medicare. The major benefits of the American health care system is the availability of very high-quality service for those with good medical cover. US is the world leader in medical research. Due to a very competitive market, major medical-tech breakthrough in the world come from the United States. The number of medical professionals is also high as doctors from other countries aspire to work in the US because the income rewards are high and based on the effort (Cooper, & Taylor, 2011).
The origins of the health care crisis in Russia go back to the time when a good system was replaced. The situation continues to worsen in the wake of poor to zero investment in medical resources. Typically, Russian government ignores to allocate more resources toward medical care or renovate the health care system. Continued ignorance of the reality will eventually lead to a catastrophic situation. The fundamental advantages listed during the introduction of the system include elimination of resource wastage because of parallelism and duplication in pursuit of competitive advantage. The system was predicted to cut down the costs of the health care sector. Amazingly, the failed goals look very similar to what the Obama Care proposed: low costs and universal coverage.