Healthcare is free and is available to all citizens and registered long-term residents in Russia. The Russian Federation adopted a nation-wide system of obligatory medical insurance (OMS), in 1993 through which the constitution confirms a citizen's right to healthcare and medical assistance free of charge. The medical services are provided to Russian citizens at the expense of the state and local budgets. Employees and employers pay around 2 to 3 percent of wages to a social tax and then a small percentage of that money goes into the healthcare fund. Dependant family members are covered by the contributions paid by employed family members. The unemployed, old age pensioners and people on long-term sickness benefit are also entitled to free health, with the state covering their contribution.
However owing to a number of well-known social problems, the state financing of medicine in Russia is insufficient and the health insurance system is not yet fully developed. Additional drugs have to be bought in many cases. Also, some special diagnostic and auxiliary procedures at Russian hospitals are also done only or mostly for money. In reality only unnecessary procedures are left free. Anything that concerns life-threatening conditions costs a fee. Besides, years of underfunding has left the healthcare system in a precarious state with decrepit hospitals staffed by demoralized and woefully underpaid staff, many of whom encourage patients to make ad-hoc payments. Russians are just used to the idea that paying under the counter bribes will help them get necessary treatment. Which is more, they are made to do it once they enter the clinic.
In many regions, crumbling hospitals rely on Soviet-era equipment. Even in Moscow, many hospitals don’t even have air conditioners to stave off the summer heat. Russia has twice the number of hospitals than the European Union. (the healthcare providers include rural health posts, health centers, urban polyclinics, special focus polyclinics). However, about 50% of these cannot provide patients with modern, quality treatment.
Therefore those who have at least a a small opportunity use private health centers or/and get a private insurance that may include treatment by specialists, hospitalization, prescriptions, pregnancy and childbirth and rehabilitation. The system itself is not efficient. Overspecialization, a legacy of the Soviet era, is a big problem because patients are shuttled from one narrowly focused specialist to another. Meanwhile, no physician generally takes responsibility for their state of health. There are usually long lines at local polyclinics where patients wait in long lines for care they have to beg for. Most working people who can afford it end up paying for their own private care anyway. Wealthy Russians only get medical care abroad.
No wonder Russians are increasingly unhappy about the situation. Now the World Health Organization (WHO) ranks Russia's medical care 130th in the world. This is the alarmingly bad index for the country that has a low birth rate, a high death rate and a life expectancy of 63.03 years for males and 74.87 years for females (2010 data). The major factors of a high mortality rate of the nation’s males are heart diseases that claim proportionately more lives than in most of the rest of the world. (In 2008, 57% of all deaths in Russia were caused by cardiovascular disease.) Other factors are death rates from homicide, suicide, auto accidents and cancer.
The situation is compounded by alcohol poisoning, stress, smoking, traffic accidents, and violent crimes. Besides the HIV and TB epidemic in Russia continues to grow. To make matters worth, cancer and its complications increased dramatically. The statistics show that about 50 percent of all cancer-related illnesses can be attributed to environmental factors. However the fact is that cancer is still often diagnosed when the disease has spread to a late stage. Thus in many cases it is left incurable, which appears the main reason why cancer mortality is high in Russia. In fact cancer is number two cause of mortality in Russia, with the majority of male cancer patients dying from lung cancer directly associated with smoking. Among Russian women breast cancer is still the leading type of cancer.
The general attitude of Russians to the state medical range from negativity to suspicion. In addition, medical care is not always easy to access. And thus it makes people treat them on their own. It does not usually apply to serious cases or when the lab analyses or diagnostic equipment is necessary. But an ordinary cold, cough of different nature, food poisoning, closed wounds, headaches or stomach aches and even more serious illnesses like flue or chest infection are often not a case to apply to a doctor and are treated at home. Different drugs commercials are numerous on Russian TV channels and in magazines. Aggressive advertisement has dramatically increased the number of Russians that do self-treatment as opposed to going to a physician or emergency room doctors say. A lot more drugs that are normally prescription-only in the West are over-the-counter in Russia despite the usual “prescription- only” mark on the packings. The choice is wide and the pharmacists are often ready to provide free advice on what drug a shopper needs. Besides, Russians often feel the experts in health care and medical treatment. People in Russia generally prefer to buy herbal pills and tinctures then prescription drugs. 68% of Russians usually buy drugs without seeing a doctor; 22% follow a friend’s advice and more than a half Russian customer just compare their symptoms with the ones shown in the drug adds when make a choice.
Top popular drugs among Russians are pain-killers, antibiotics (both over the counter ), vitamins, cold medicines, anti-inflammatory, anti-hypertensives and immune stimulants. The popularity of antiviral medicine, probiotics and liver medicine is booming. Cholesterol drugs use are quite rare though. Whereas the situation in the USA and other Western countries is a bit different. Most Popular prescription drugs in the US include pain killers, high blood pressure drugs, high cholesterol drugs, and antibiotics. Thyroid disorders and diabetes drugs are on the top list as well. Americans were registered to be consuming more antidepressants than ever before. Russians seem to have different methods.
The Russian government is embarking on a huge reform which will see an influx of cash, over $28 billion, to outfit the country’s hospitals with new high-tech equipment, better salaries and, it is hoped, improved care by 2013. The spending boost should see Russia increase its healthcare spending from 3.9% to 5% to approach EU levels. The government is building a series of health centers around the country with a focus on cardiovascular disease and cancer. One of the programs in the new reforms will set up nine high-tech prenatal centers around the country. The use of neonatal surgery will be expanded and is expected to save the lives of 1,000 children each year. Also the obligatory medical insurance tax paid by companies for compulsory medical insurance will increase from current 3.1% to 5.1% starting from 2011. However even those at power admit that the entire very system needs to be reformed. Corruption inside the health-care system is a threat to Russia's national security.
The reforms are expected to reduce the number of medical officials in health care that expanded enormously over the last years. It is planned to introduce electronic databases to eliminate the huge amount of paperwork doctors have to do which delays medical aid and makes it less efficient On November 1 2011 Russia State Duma approved a much debated health care law. The bill legalizes the commercial basis of surrogate motherhood, it regulates the legal aspects of donorship and the transplantation of organs, allows conducting drug tests for school children, deals with internship and a number of other issues of the national health care. The euthanasia and human cloning is still forbidden.
Russians are often stereotyped as the nation of people with bad teeth. It seems to be a kind of next myth nowadays. The domestic dental care market has exploded in recent years. Municipal clinics still exist in all Russian cities, yet private dental centers with new equipment and modern dental technologies and materials are in abundance and their number is growing. The promotion of the importance of good oral hygiene is talking place. And it has always been. Do not believe a fairy tale about one toothbrush for the whole family in Russia. It has never been a reality even for the period of goods shortage in the Soviet times. Every school in the city had a dental office that days and all school children underwent checkups twice a year. If necessary the treatment was made immediately. The checkups exist now, the free clinics are limited though.
The majority of senior people lack teeth or have grave problems indeed. Remember the life they lived: many of today 65-year-olds were born right after WWII and experienced hardship and underfeeding. The quality dental care is expensive. However the state clinics exist and emergency help, some basic care can be provided. Besides, the possibilities to obtain free dentures in Russia are much more limited unlike European countries. Therefore Russian elderly seldom boast nice smiles.
Good teeth are appreciated a lot and people do take care of them whatever the cost is involved. Most people have their old fillings or crowns replaced with new, better-quality ones. You can hardly ever see people with gold teeth - Soviet time reality. In wealthy Russian cities they view dental care as the part of their image and invests in it heavily. Good teeth is the equivalent to success. It makes the citizens of especially wealthy Russian cities view dental care as the part of their image and invests in it heavily.
Novelty dental hygiene products, teeth straightening and other orthodontic care is available almost everywhere in Russia. Children are drilled to take care of teeth from the very early age. Besides, some municipalities start fluoridation campaign as lack of fluoride in water and products is often cited as the reasons Russians have bad teeth. Russians cannot boast really white teeth, that is true. This is because they are not obsessed with whitening as much as Americans do and there is no regular supply of fluoridated water. The access to tooth whitening as well as modern dentistry technologies is still much cheaper than in the States and Eastern Europe. The quality is the same though. This generated dental tours to post Soviet countries among the foreigners seeking affordable dental care.
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