Friday, December 22, 2017

Putin’s Health Care ‘Optimization’ has ‘Thrown Russia Back 85 Years,’ Alikin Says



Paul Goble

            Staunton, December 22 – As a result of Vladimir Putin’s so-called health care optimization program, the number of hospitals in Russia is now back to where it was in 1932 and in five to six years, it will be back to where is was on the same territory in 1913, according to Aleksandr Alikin.

            While some of this reflects changes in transportation which allow for larger but fewer hospitals, he continues, many of the cutbacks mean that Russians have access to less health care than they did three or even four generations ago, a trend that many have failed to note because as with most things Putin, it wasn’t announced as such (russian.eurasianet.org/node/65086).

                As Allikin points out, “a single document about health care reform does not exist.” Had Putin announced what he was doing all at once, there might have been more opposition. But instead, he has taken a series of steps, all of which were euphemistically and deceptively declared to be about “raising the quality of medical care.”

            According to the Moscow Center for Economic and Political Reforms, the number of hospitals in Russia under Putin has dropped from 10,700 to 5,400, the number of hospital beds from 1.6 million to 1.2 million, the number of polyclinics from 21,300 to 19,100; and the number of rapid response centers from 3172 to 2458.

            And these declines have occurred as the number of people seeking medical care has gone up, from 3.5 million in 2000 to 3.9 million last year. The number of doctors and other medical professionals has also declined, although it rose again to the level of 2000 in 2016, Alikin acknowledges.

                Rural areas have been hit especially hard. There are now 17,000 villages without any medical care at all, and 11,000 of these are more than 20 kilometers from such facilities. And more than a third of them are not served by public transport making it difficult if not impossible for those who are ill to get to a doctor.

            But the problems arising as a result of Putin’s approach have not been limited to rural areas, Alikin says. In major cities too, there are now enormous lines for care; and St. Petersburg is among the cities that have set up call centers so that people can telephone in advance to get a spot in line.

            All of this is pushing Russians out of the public medical sphere into pay for service places. Between 2005 and 2014, the amount Russians paid out of pocket for medical care rose from 110 billion rubles to 474 billion rubles (2 billion to 8 billion US dollars) every year, imposing yet another cost on the population.

            Unless Russia changes course, the journalist says, there is every chance that Russia “will forever lose the chance to approach in quality the standards of health care in developed countries.”

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