Russia’s Healthcare Reform Problems

As U.S. President Barack Obama looks to bet his presidency by actually doing something about the deplorable, non-functioning healthcare market, he’s facing an angry and implacable opposition from the Republicans, who are even fond of sending guys carrying assault rifles to the protest rallies.  Whatever the result of this Herculean effort is, one should hope to avoid the reform missteps which Russia experienced, when Vladimir Putin saw $3.2 billion from the state purse disappear into thin air.  Here Foreign Policy compiles a number of the worst attempted healthcare reforms – and the U.S. has nothing to brag about among this crowd.  (Sidenote:  IMHO, I think John McCain really hit the nail on the head when he suggested that we first have to figure out how to reduce the ridiculous medical costs – too bad his party didn’t let him keep that line.)

Before it collapsed, the Soviet Union had an enormous socialized medical system, with millions of hospital beds and hundreds of thousands of healthcare workers. The transition from that system to a public-private model, between 1989 and 1993, went, in a word, horribly.

Ninetypercent of Russians are technically covered. But, doctors and hospitalsextract “donations” for free care. Anyone who can afford it paysout-of-pocket for private hospitals and doctors. In theory, consumerscan pick their own insurance plan. In reality, their employersgenerally do it for them, bought-off by the insurers.

In 2006,Vladimir Putin’s government approved a $3.2 billion health care reformplan that failed to improve the system. The reform contained ahodgepodge of policy priorities, such as paying doctors to performprimary care, but did not address any of the healthcare system’sstructural defects.

Even with the $3.2 billion infusion, Russiastill allocates only 3.4 percent of government spending to healthcare,whereas the World Health Organization (WHO) recommends 5 percent.