Moreover, in many places, the Audit Chamber found that there are not even standards for treating common illnesses or ensuring that those who come down with them are provided with necessary medicines. But the worst problem and one that promises to make the current situation even worse in the future is serious underfunding of health care.
And this problem is getting worse: in 2016, 52 regions were below per capita targets; a year later, 56 were. The regions have few prospects of meeting the government-established targets given that they face more than 65 billion rubles (one billion US dollars) in shortfalls in funding in the health care area.
But no one should think that spending more money on health care alone will solve the problem. Vasily Vlasov, a specialist on the economics of health care at Moscow’s Higher School of Economics, says that the shortfalls in the health care system are only compounding problems created by falling incomes.
In some parts of Russia, poverty is so dire that infant mortality rates like those in Nigeria or Lesoto are what one would expect even if the health care system were radically improved. In his opinion, in fact, the possibilities for lowering infant mortality by medical facilities alone are practically “exhausted” in Russia’s regions.
The Russian government does not want to recognize that because to do so would compel it to admit that its entire economic and social welfare program needs to be reformed for further improvements to be possible. The Accounting Chamber wasn’t called upon to make that point, Vlasov says; but its data beyond question support that conclusion.