Health care


Health care
   Since 1991, the health care system in the Russian Federation has been in transition from a hierarchal, centrally controlled system of medical provision, wholly financed from Soviet government revenues, to a more decentralized, diverse, and insurance-based system. It has also been a shift away from a two-tier Soviet medical system, which had separate health care services for ordinary citizens and the nomenklatura>, to a more market-based system that, on the one hand, provides free medical care and, on the other, does not prevent citizens from purchasing health care services from private medical establishments. The process of transformation began in the early 1990s but was abandoned under Boris Yeltsin due to the lack of funds and Yeltsin’s disinterest in the nation’s health problems, which partially accounts for the demographic problems Russia is facing today. Health care policies were reintroduced under Vladimir Putin; however, the process of transition has not been completed.
   The largely dysfunctional health care system accounts for many health-related demographic challenges, including a high mortality rate. These are caused by a number of factors, including alcoholism, malnutrition, and high levels of stress. Economic growth under Putin had little impact on the main indicators of human welfare; however, there are signs of improvement both in terms of the quality of medical care and life expectancy among average Russian citizens. Still, the number of deaths caused by malnutrition and infectious diseases, linked to poverty-related problems, remains very high. At the same time, the average life expectancy remains quite low for a country of Russia’s level of economic and social development.
   The Soviet health care system was an extension of the Stalinist industrialization project, favoring large centralized medical institutions, normally established in areas with high concentrations of Soviet factory workers. There was little emphasis on primary care, and quite often people were admitted to specialist and hospital care, putting unnecessary strain on the system. In post-Soviet Russia, general practioners have replaced terapevts (physicians), doctors with similar qualifications and focus on primary care; the name change, however, did not have any structural impact. Low prestige and poor payments of doctors and health workers encourage many doctors to join private hospitals and medical centers. Many health services are available only in private hospitals, resulting in the de facto privatization of health care. Russian health care carries the social burdens of the Soviet system, whereby access to certain medical services was available only to nomenklatura or required an informal payment for what is meant to be a free service. There also remains a huge divide between urban centers and rural areas: while people residing in provinces by law have access to large medical centers in urban centers, the sheer remoteness of many settlements prevents patients from accessing medical institutions. Access to private health care, especially to health care abroad (Germany, the United States, and Israel are popular destinations), has become an issue of social prestige, further undermining the principles of social equality and the very reputation of Russia’s health care system. Therefore, access to the health care system in Russia is becoming significantly more unequal, irrespective of the free provisions guaranteed by the constitution. To combat corruption and increase the quality of health care, the Russian government introduced the unified social tax in 2001, which is now the main source of financing health care. In principle, patients have the right to choose their insurer and medical service provider; however, in practice it is hard for them to exercise their right because of the complex bureaucratic system. As a result there is no real competition, and hospital and medical care providers are left with conflicting incentives.
   See also HIV / AIDS.

Historical Dictionary of the Russian Federation. . 2010.

Look at other dictionaries:

  • health care — health ,care noun uncount ** the services that take care of people s health: Homeless people need better access to health care. ╾ health|care [ helθ,ker ] adjective …   Usage of the words and phrases in modern English

  • health care — n [U] the service that is responsible for looking after the health of all the people in a country or an area ▪ The government has promised wide ranging health care for all. ▪ health care workers …   Dictionary of contemporary English

  • health-care — adj, always used before a noun health care workers • • • Main Entry: ↑health care …   Useful english dictionary

  • health care — n the maintaining and restoration of health by the treatment and prevention of disease esp. by trained and licensed professionals (as in medicine, dentistry, clinical psychology, and public health) health care adj …   Medical dictionary

  • health care — health′ care or health′care n. med bus any field or enterprise concerned with supplying services, equipment, information, etc., for the maintenance or restoration of health • Etymology: 1940–45 …   From formal English to slang

  • health care — noun coverage, health coverage, health insurance, health protection, medical coverage, medical insurance, medical plan, plan Burton s Legal Thesaurus. William C. Burton. 2006 …   Law dictionary

  • Health care — For The Office television show episode, see Health Care (The Office). Health care (or healthcare) is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is… …   Wikipedia

  • health care —    Spain has had a comprehensive health service only since 1986, when the PSOE government introduced the General Health Law. Previously, cover was provided under a compulsory health insurance introduced by the Franco regime in 1942, which by 1975 …   Encyclopedia of contemporary Spanish culture

  • health care — noun 1. social insurance for the ill and injured • Hypernyms: ↑social insurance • Hyponyms: ↑Medicare, ↑Medicaid, ↑primary health care 2. the preservation of mental and physical health by preventing or treating illness through services offered by …   Useful english dictionary

  • health care */*/ — UK / US noun [uncountable] the services that look after people s health Homeless people need better access to health care. Derived word: healthcare UK [ˈhelθˌkeə(r)] / US [ˈhelθˌker] adjective …   English dictionary