Russian health care

[Hari Kumar <hari.kumar@xxxxxxxxxxxx>]

Chris Doss:
"Male life expectancy has dropped 10 years; female life expectancy by about 2 years.
That should tell you off the bat that it has little to do with the state of the healthcare system, and a lot to do with a giant increase in
alcoholism and stress among Russian men and a greatly increased availability of alcohol in post-Soviet Russia. The majority of the excess deaths
are middle-aged men dying from cardio-vascular diseases (not from "hunger-related diseases" either, another frequent, and strange, canard.
There is not much "hunger" in a country in which most people grow their own vegetables.)
Alcohol was expensive in the Soviet Union and very cheap today.
In fact, Russian healthcare is about the same as it was in the Soviet era: free and bad, although you are expected to
give the doctor a gratuity. For instance, I had an operation on my lower gum in a state clinic in Kaluga. I gave the
doctor $3. For treatment of frostbite in my fingers, I gave about $1.50 to the woman who lanced the blisters.
A friend of mine just had work done on her ear, and she bought the doctor a bottle of cognac.
In fact the majority of the income of Russian healthcare workers is probably in the form of such gratuities from patients."

Reply:
Chris - I am not disputing your main thrust in your attack on NYT versions of Russian doom.
However, your note above bears some additional remarks:
i) There is rather a lot of abundant epidemiological data re the drift down in longevity from the change-over from socialism to restored-capitalism.
Yeah I know, having said the abundant bit - someone might belikely to say where?
I will dig it out if anyone wants. WHO is the best source.
On the USSR health care system previously, Henry Sigerist is worth examining.

ii) "The majority of the excess deaths are middle-aged men dying from cardio-vascular diseases (not from "hunger-related diseases"
I cannot cite to you data re diet in the USSR today.
But your dissociation of diet from CVS deaths - is misleading.

iii) No doubt 'blat' -'gratuity'-'payment' - operates reasonably well. But there is undoubtedly a difficulty with getting admissions for emergencies.
As for ICU circumstances - I am informed by colleagues in the former USSR that there are serious problems.
One is person-power.
I have a lot of friends here in Canuckia that are ex-USSR docs working as lab techs & whatever they can find.
I admittedly have not seen whether the younger generations have filled that older emigre-left 'technogap'.

Hari Kumar