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Russian Healthcare Declines

In the winter of 2013-14, residents of Russia’s Pskov region were left waiting in the cold at their train stations due to alleged obstructions on the tracks. Oddly, neither snow nor ice had blocked paths of the trains; rather along the tracks lay the shivering bodies of numerous Russians in need of medical attention.

A lack of accessible health service or transportation options had compelled these ill residents to prostrate themselves on the cold steel in hopes of hitching a ride to metropolitan centers with hospitals.

Even in city centers like Moscow and St. Petersburg, the situation has become dire. Hunger strikes aimed at preventing the healthcare cuts have occurred in the past two years in both of these major metropolises.

Stories like these call attention to the increasingly desperate state of Russia’s healthcare system, which has experienced significant consolidation and downgrading. In response, many Russians, as these incidents indicate, are quite literally willing to die for better healthcare.

The fierce will for state-sponsored, universal healthcare coverage has persisted since the Soviet era, while the quality of Russian healthcare has not. According to The Moscow Times, “from 2005 to 2013 the number of health facilities in rural areas fell by 75 percent, from 8,249 to 2,085. That number includes a 95 percent drop in the number of district hospitals, from 2,631 to only 124, and a 65 percent decline in the number of local health clinics, from 7,404 to 2,561.” In March of 2015 leaked government reports claimed that over 10,000 medical professionals in the capital had been laid off after the closure of 28 clinics and hospitals. The reports outlined 14,000 further firings leading up to 2017.

Between the years of 2013-14, 90,000 medical workers lost their jobs despite reports of significant shortages of personnel across the country. That same year, The Audit Chamber, a government agency, had attributed the 3.7 percent spike in hospital deaths to spending cuts. In total, 18,000 Russians needlessly lost their lives.

This is all a part of the Russian Government’s recent ‘optimization’ which aims to eliminate inefficiency by consolidating healthcare resources in larger hospitals. Consequentially, it entails the closure of smaller more local treatment centers.

Putin and his administration are determined in their efforts. They seem to have ignored funding and personnel issues and have instead lauded the healthcare system during a meeting in April 2015. Contrary to their own government reports, they claimed an alleged increase in rural medical coverage and a $4 billion expansion of healthcare funding.

For the doctors that have survived ‘optimization’, life in the workplace has become chaotic. Bloomberg News reported on a female family doctor who had to increase her workday from eight hours to 12 hours. On top of this, she admitted to working three weekend shifts per month for the past year.

One clinic has restricted the average appointment time between the doctor and patient to a mere 12 minutes. This gives the doctor just enough time to fill out paperwork.

Those unwilling to compromise effective treatment will defy these strict time limits. This comes at a cost, however, as many doctors have been forced to regularly work overtime in order to provide adequate care.

For patients, this entails excessive waiting times for treatment. With so few staff, they can expect to wait hours just to meet with a specialist. Those in need of ultrasounds often get put on a six week waiting list. Last year one could expect an ultrasound in a matter of days.

Tired of waiting, many Russians have sought better medical care by taking to the streets in protest. Several demonstrations challenging recent healthcare developments took place in Moscow during the fall and winter of last year.

With approval ratings for the country’s healthcare system under 20 percent according to a recent poll, Putin has also displayed some hesitation. During a conference in the fall of last year, he admitted that his administration had not yet considered everything. If protests continue it is perhaps possible even the notoriously headstrong Putin will alter the course of Russia’s healthcare.

Andrew Logan

Sources: Bloomberg, The Moscow Times, Radio Free Europe/ Radio Liberty, The Washington Post

Photo: Bloomberg Business