Comparison of Healthcare Systems: Russia and the US

• Joel Adewuyi
• Madalyn Arnott
• Stephanie Armstrong
• Lauren Ball

Russian federation has 17 million km2 of land surface area, making it the largest country in the world. The country has major deposits of coal, timber, oil, and assorted minerals and is thus perceived by many as a rich country who can provide universal healthcare to her citizens.

Today, the healthcare system in Russia unlike in the United States is universal but has been plagued with poor quality and deficient services and thus in the process of being reformed by the Russian government. It is a universal system only in theory but the poor quality has made many Russians result to paying under the counter-bribes in order to get their necessary treatments (Russian, 2017).

Recent government reforms, and measures to increase efficiency such as increase in funding have begun to address the ongoing problem in the healthcare sector. However, even with the new reforms in place, since the 1990’s, there has been no significant improvement in the healthcare system (Russian 2017). The biggest problem confronting this system has been attributed to lack of funding by the government.

Historical Perspectives

The end of the Soviet Union gave birth to the Russian Federation in 1991 and since then the health status of the Russian population has been on a dramatic decline. Rates of medical conditions like cancer, heart disease, and tuberculosis are the highest compared to any other industrialized country. Government spending on healthcare which was 7% of Gross National Product (GNP) in the 1960’s before Soviet Union’s breakup was reduced to 3% after the breakup (site wide, 2017). Most of the government funding started going to industrial and military developments and lesser priority given to the healthcare system and by the end of 1995 less than 1 percent of Russia’s budget was allocated to public health in comparison to more than 12 percent in the United States (site wide 2017). With this, the public health delivery system in Russia went into the crisis with poorly trained medical personnel, lack of modernized equipment, poor payments for the medical personnel, poor personal hygiene and diet, lack of exercise, virtually nonexistent preventive medicine etc.

The lack of accessibility to national health system facilities, with most patients standing in line at clinics for an entire day before receiving treatments coupled with non-affordability prescriptions drugs, has encouraged them resulting into unorthodox alternatives such as herbal medicine, mysticism, and faith healings.

Russian Healthcare System Today

There are several issues that can be observed in the modern Russian healthcare system. For example; there is limited access to healthcare facilities, and the sanitation in the facilities is below United States standards. The Healthcare system in the United States is often viewed as the best in the world, but it has several flaws as well. There is limited access for veterans and several hospitals charge as much as three times what others charge. There are also several benefits to the United States healthcare. Virtually on every corner of any town in the U.S there is access to a hospital or an emergency room. Also in the U.S., there are several payment plans individuals can use.

In the Russian healthcare system one of the main problems is limited access to healthcare facilities. Only four percent pay their doctors when they have a medical procedure (Allianz, 2009 p 5). This causes a shortage of medical professionals. The lack of medical professionals causes individuals to rely on themselves for medical treatment. Several problems arise when individuals rely on their own knowledge. Another major issue with this system is the unsanitary working conditions of medical practices and medical professionals themselves. The lack of sanitation in facilities causes individuals to be more susceptible to diseases and other types of infections (Antonova, 2016 p3). The Russian healthcare system has several flaws that we do not have in the United States healthcare system.

In the United States, there are hospitals around every corner. This allows individuals to have access to healthcare no matter where they live, but this can have some repercussions. Although hospitals are easy to find some individuals cannot afford this care. In 2010 the Affordable Care Act was signed so everyone has access to healthcare, but individuals need to have insurance for this Act to apply to them. This although seems beneficial to all, some individuals feel that they are forced to buy insurance. One positive aspect of the United States healthcare system is the amount of insurance options available. Most individuals use insurance through their employer, and some have medical cards. One negative aspect of the healthcare system is there is little to no coverage to for veterans. Tricare only covers veterans when they are in active duty, once they retire the insurance no longer covers them.

Future of Healthcare System in Russia

The Russian healthcare system for sure needs improvements due to many problems. Russia’s population is more than 6 million lower than it was nearly two decades ago (public health, 2015). Sadly, birth rates are lower and mortality rates are higher. Over half of the deaths are due to cardiovascular disease. Other problems include cancer and external causes such as accidents and traumas. However, since 2005 the Russian healthcare system have been trying to turn things around positively.

In 2006, the Russian government launched the National Priority Project (NPP) to try and change the system for the better (public health 2015). The budget for this project was over than 400 billion rubles (Russian dollars) which was granted between 2006 to 2009 (public health 2015). Many activities have been planned and accomplished through the NPP. The NPP has increased salaries of primary and emergency care physicians, purchased more primary care equipment, provided more vaccination programs, providing free medical examinations to the public, increased the promotion of fertility, and made more high-tech centers for tertiary care. These activities have increased the quality of the system and bettered it for the citizens of Russia.

There have recently been very bad financial troubles in Russia yet the NPP has managed to improve the system through these ways. Fertility rates are higher, mortality rates are lower, and life expectancy for both women and men have risen. However, not all the healthcare problems have been addressed. Basic healthcare is still unfunded, there are many problems with Russia’s healthcare insurance, and there is little effort to face and fix the population health behavior. Until the Russian citizens take these problems into their own hands the future of

Russia’s health will be a problem. The citizens need to stop smoking, binge drinking, and bad habits in order to enjoy better health. The Russian public needs to be able to provide healthy air, water, better food quality, safer roads, and safer work environments. Until these problems are addressed, the health challenges that Russia faces will not be fixed and will follow to the years ahead.

Russia’s health care system has taken a turn for the worst. Consequences of a failing healthcare system have fed to declining health among the Russian population. Inefficient funds have led to cost cuts, this already damaging a weak system. Numerous medical staff had to be laid off because of this, when healthcare workers were already at a minimal amount. At this point in time Russia suffers from a high death rate, low birth rate, and low life expectancy. The total population is decreasing by 700,000 people each year (Aarva 2009). The average life span for a male is statistically shown to only reach 59 years old (Aarva, 2009). Compared to the United States, a typical average life span for men is 78 years old (Aarva, 2009). Women in Russia overall only average to 72 years old (Aarva, 2009). The fertility rates in Russia cannot meet the declining rate of population. The decline in health statistically shows to only get worse within the next 50 years, declining by 30 percent (Aarva 2009).

In Russia, the number one leading cause of death is cardiovascular disease, this is followed by alcoholism and tobacco use. The World Health Organization accounts for more than 1.2 million deaths per year from these. A growing health issue in Russia is disease, such as HIV/AIDS, a little over 1 percent of Russia’s population test positive (Aarva, 2009). Lancet 2012 study showed that 57 percent of those affected acquired this from drug use (Aarva, 2009). Although over looked, Russia’s health care system has led them to have a lot in common with 3rd world countries.

Numerous factors have led to Russia’s health care decline; however, many believe lack of education is the number one reason for the decline. Public health policies and information is less easy to access in Russia then the United States. Russia is also lacking in resources such as a lack in medication. Russia’s health care doesn’t have the ability to give the citizens proper health care, if this situation continues their population will significantly continue to decline.

In conclusion and in fairness to the Russia federation, the truth is that despite the relatively poor health statistics and healthcare situations, Russia is not dependent on any international assistance for her healthcare funding and is nondependent on any of the developed countries. Even though, they are independent, the government’s duty of a guaranteed full range of free healthcare services to her citizens has not experienced any setback, but rather has been confirmed through the newly implemented Russian constitution and the new healthcare financing laws.

References

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Landed, S. J. (2014, May 04). Overview. Retrieved February 22, 2017.

Allianz. (2017). Healthcare in Russia – support. Retrieved February 23, 2017.

Aarva, P., Ilchenko, I., Gorobets, P., & Rogacheva, A. (2009). Formal and informal payments in health care facilities in two Russian cities, Tyumen and Lipetsk. Health Policy and Planning, 24(5), 395-405. doi:10.1093/heapol/czp029

Antonova, N. (2016). Access to Healthcare in Russia: A Pilot Study in Ekaterinburg. Central European Journal of Public Health, 24(2), 152-155. doi:10.21101/cejph.a3942

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