Healthcare in Russia

The Constitution of the Russian Federation has provided all citizens the right to free healthcare under Mandatory Medical Insurance since 1996. In 2008, 621,000 doctors and 1.3 million nurses were employed in Russian healthcare. The number of doctors per 10,000 people was 43.8, but only 12.1 in rural areas. The number of general practitioners as a share of the total number of doctors was 1.26 percent. There are about 9.3 beds per thousand population—nearly double the OECD average.

Expenditure on healthcare was 6.5% of Gross Domestic Product, US$957 per person in 2013. About 48% comes from government sources. About 5% of the population, mostly in major cities, have health insurance.

Pre-1990s Soviet Russia had a totally socialist health care model—the Semashko system with a centralized, integrated, hierarchically organised with the government providing state-funded health care to all citizens. All health personnel were state employees. Control of communicable diseases had priority over non-communicable ones. On the whole, the Soviet system tended to primary care, and placed much emphasis on specialist and hospital care.

The integrated model achieved considerable success in dealing with infectious diseases such as tuberculosis, typhoid fever and typhus. The effectiveness of the model declined with underinvestment, with the quality of care beginning to decline by the early 1980s, though in 1985 the Soviet Union had four times the number of doctors and hospital beds per head compared with the USA. Overall, the quality of Soviet medical care was low by developed world standards. Many medical treatments and diagnoses were unsophisticated and substandard (with doctors often making diagnoses by interviewing patients without conducting any medical tests), the standard of care provided by healthcare providers was poor, and there was a high risk of infection from surgery. The Soviet healthcare system was plagued by shortages of medical equipment, drugs, and diagnostic chemicals, and lacked many medications and medical technologies available in the Western world. Its facilities had low technical standards, and medical personnel underwent mediocre training and had no financial incentives to improve performance. Soviet hospitals also offered poor hotel amenities such as food and linen. Special hospitals and clinics existed for the nomenklatura which offered a higher standard of care, but which was still often below Western standards.

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Wikipedia