Russian Modern

The health of the Russian health system - from the patients perspective, it's not all roses !

Under the constitution of the Russian Federation, every citizen is entitled to receive free medical healthcare, the problem is that there are no defined levels of service for regional health authorities to aspire to, or targets of patient satisfaction to reach. There is no system that allows a patient to complain about the treatment he receives, and in reality patients have little or no recourse to the legal system to pursue a case of malpractice or negligence.

Where medical healthcare is concerned, Russian citizens suffer from a form of post code lottery much the same as in some European countries, regions of the country that are less prosperous have less in the budget to allow for healthcare spending, a patient will often receive care based on the prosperity of their region, not on the severity of their illness.

Russian medical healthcare is only a section of Russian life, are you curious about other aspects of Russian life ?

Since the introduction of democracy and the birth of a new country on 24th August 1991, healthcare for many Russian citizens has become less accessible than in Soviet times with approximately 42% of the entire healthcare budget being paid for by the patient in one form or another, whether it be taxpayers,employer contributions through the salaries of staff, voluntary health insurance or "invisible" ( bribes, gifts, presents, call it what you wish, it is undeclared income ) payments.

After several decades of under investment the true picture of healthcare in Russia is depressing and disturbing, if you have money and can pay, sometimes quite extortionate amounts, then you can get access to some of the best medical services in the world, with state of the art equipment, modern powerful western drugs and of course some of the best doctors that the profession has to offer....if you can pay ! The services are in the country, but they are in very short supply and available to only a minute percentage of the people.

So, what is left for the bulk of the Russian people ? The polyclinics are the first point of call for most Russian people, generally run down structures, 16% of which were built before 1940, these are public buildings and require permanent upkeep, they have fallen into disrepair. The polyclinics are symptomatic of the cycle that the medical staff are trapped in together, the doctors and support personnel, quite often older women, bark at the patients constantly, supremely oblivious to the fact that they are dealing with real people just like themselves who need help, assurance and a friendly ear. The patients in turn, bark back, becoming agitated and frustrated which inflames the doctors once more...and so the cycle continues.

Visit any state funded diagnostics clinic, polyclinic or dispenser and you'll see the mountains of paperwork that people have to endure from the support staff to the doctors and ultimately the patient, who sometimes carry their own medical history with them that closely resembles a car servicing handbook. Doctors spend, on average close to 50% of their working time writing reports in longhand, the computer system, away from the cashier desk is old, basic and under used, and the paper ( of which, compared to the West is not considered disposable, and should be treated with care ) is of extremely poor quality, grey, thin and prone to tearing. Carbon copying is still commonplace, as is threading pages of foolscap paper into a cardboard folder with a 3 inch needle and twine...yes, this is the reality of bureaucracy in Russia.

Patients must endure the most aggravating, humiliating and often traumatic process of getting one piece of paper signed , then go somewhere else, get another piece signed...and so on. You need to be healthy to be ill in Russia. The long corridors in the hospitals and clinics with seemingly endless closed doors, poorly signed, sometimes with a number, sometimes a name but usually the wrong name, have no system of entry and are rarely locked. If you're told to go to room 23, you must ask the people in the corridor if they are waiting, and if not you must knock and enter room 23, only to be barked at because there is a patient standing stark naked in front of you, how are you to know ? Systems, that's how, and this is a problem all over Russia, a simple queuing system, an engaged sign on the door, a take a ticket procedure for larger queues. There are simple, fairly inexpensive options to reduce the stress in the health system, but the actual drugs, equipment and expertise must come first for the people, and so the cycle continues, for a while at least.

The "bedside manner " has yet to reach most parts of the Russian medical system, one of the shocks to the system of any foreigner seeking medical care. In the expensive private sector, the manner is a little better but not much.

The people want help, service, drugs that the institutions just don't have, they need medical equipment that will not be in their region for 20 years or more, they want reassuring advice and a patient ear from doctors without a mindset stuck in a time warp, who themselves are struggling with the same inadequate system in different ways, but most of all they need confidence in the medical ability of the professional treating them or their relatives. The Russian Federation is a young country, with the western values, expectations and target driven economy ideals thrust upon them almost overnight, but the people must wait, or die waiting.

Ask a doctor in Russia where they go when they are ill and you'll be told either, "I'll go to a family member" or "I know who is a good doctor and who isn't"... it seems that the profession looks after their own, recommendation and contacts are everything in an introverted society such as Russia.

Unfortunately for the Russian people, when they are failed by a system that they expect to look after and decide for them, they often turn to alternative medicine, and since 1991, and the ban on practitioners of alternative medicine was lifted, there has been a considerable revival in therapies, mixtures, potions, herbal remedies and so on, joined by astrology, tarot card reading and Reiki, to mention but a few. Surprisingly, the followers of these alternative practices are not always older people living in Taiga ( moist sub-arctic forest that covers enormous swathes of Russia, consisting mainly of spruce and fir conifers ), at remote outposts and settlements across Russia, but younger people disillusioned with modern healthcare in Russia.

For the moment the problem for Russian people in terms of healthcare is the system...there is no system, but there is growing optimism and confidence that time will provide just rewards. The Russian people will wait patiently, they have little choice.

On a final note, I have used the Russian medical system many times both for routine testing required by the authorities and for fairly serious accidents and illnesses, I have been treated well and badly. I am the last person to criticize the individual when it is the system that is at fault. For a thorough understanding of Russian medical institutional practice and related Russian information, you may wish to read more .....

About the Author

When I met my wife on the internet 7 years go I didn't follow the usual path of bringing her to my European country, I wanted to understand her background, her views and lifestyle...I moved to Siberia and still live here. The experiences need to be seen to be believed but you can read about them at www.rurev.com

If you want to understand your partner, understand Russia, start by looking at some real photographs and then read all about Russia at www.rurev.com

No Russian (Modern Warfare 2 Machinima)