Features
In most countries around the world, access to health care is taken as a right of the citizen. In the communist and socialist countries, the emphasis of this right was demonstrated even more with healthcare being the sole responsibility of the government. Though the Soviet Union era has ended, Russia continues to follow this principle in the rights of its citizens by being prominent in the delivery of healthcare to its citizens. The United States of America’s approach to healthcare is unique in the world, as it does not accept healthcare as a right of its citizens, and hence there is a low priority in government participation in healthcare. Being a stalwart in promoting private enterprise, the healthcare system witnesses a reflection of this with the private sector dominating the healthcare system and market forces being the driving factor. (1).
Delivery of Healthcare
The emphasis on healthcare being a right of the citizen in Russia has resulted in healthcare being predominantly run by the state. Delivery of healthcare as a state-run enterprise means that the citizens receive healthcare free of costs and personnel in the healthcare are paid by the state. Self-purchased healthcare is minimal, as the practice was discouraged in the erstwhile Soviet Union era. (2). The delivery of healthcare in the United States of America is a complex multilayered system. The elderly, the disabled, and the low-income groups are considered citizens that require some assistance in their healthcare needs and this support for their healthcare needs from the government comes in the form of Medicare and Medicaid. The healthcare needs of the majority of the working people are expected to be covered through health care schemes subsidized to them through their employers. In case the coverage is insufficient they have to have self-purchased health insurance schemes to cover their healthcare costs. A small minority of the wealthy can afford to and essential purchase their healthcare coverage. (3).
Costs of Healthcare
The population of Russia is approximately 146 million spread over a federation of 89 states. It is the government that largely meets the healthcare needs of the population by providing all the health care needs. Yet it spends a mere 5.4% of the GDP, which works out to roughly $251 per individual on such a vital need of the people. It spends even less than the erstwhile satellite nation of the Soviet Union in the form of Poland and considerably less than the European nations of the United Kingdom and the Netherlands. (4). On the other hand in America, 17% of its GDP is spent on the healthcare needs of the people, which is an expenditure of $4,700 per individual. This per capita expenditure on health care needs is the highest in the world. (5).
Efficiency
The low budgetary support that is provided for the health care sector in Russia is a key factor in the poor efficiency of the healthcare system. Even the limited budgetary allocations are mismanaged reducing the efficiency of utilization of the funds allocated for healthcare. The health care service personnel are dissatisfied with their salaries and conditions of work. Some of them take home a salary as low as $100 per month. The low budgetary allocations and mismanagement of these resources combined with health care personnel dissatisfaction leave the people bereft of access to health care services for their basic health care needs. (2). In America, on the contrary, the costs of health care services are high and the coverage is poor, with many outreach areas unable to access health care services, because of the lack of facilities in their vicinity. The multi-layered health care coverage system is insufficient as some segments of the population are without any form of coverage and many others find the coverage insufficient to meet all their health care needs. The disparity is witnessed in the satisfaction levels of the different professionals in the health care sector. For example, the medical professionals are satisfied, as they can charge fees or obtain fees that provide them a sizable income. On the other hand, nursing professionals receive low salaries and a heavy workload. The combination of high costs and insufficient coverage leaves many sections of the population without access to health care services or insufficient to access health care services for all their needs. (3).
Issues
The insufficient budgetary allocation in Russia leaves the health care services with old and poor infrastructure that does not offer credible health care. Poor coverage leaves many of the people in the rural areas without adequate health care support. The low salaries received by the health care personnel have resulted in the seeking of bribes for the services offered by them. Health care is not received or not accessible, making health care as a right a mockery. (4). In America, the high costs of health care are draining the resources of both its people and its government, which has serious implications for its economy. These high costs are the result of high profiteering by the private sector. The combination of high costs and poor coverage combine to deny access to health care to all sections of the population, resulting in the health care for all being an illusion. (3).
Conclusion
The comparison of the health care system of Russia, which is state-run and the health care system in America, which has a high private content show that neither system meets the health care needs of its populations. Reforms are required in both these systems for them to meet the health care needs of all their citizens.
References
- Shi, Leiyu & Singh, A. Douglas. Delivering health care in America: a systems approach. Sudbury: Jones & Bartlett Publishers, 2003.
- Shuksin, Andrei. “Ailing Russian health-care system in urgent need of reform”. Bulletin of the World Health Organization 8.5 (2004)
- McPhee, M. Debra. “Healthcare in the United States: The Battle of Reform”. In Health and poverty. Eds. Michael, J. Holoska & Marvin, D. Feit. New York: The Haworth Press Inc., 1998, pp.2-17.
- Vienonen, A, Mikko & Vohlonen, J. Ikka. “Integrated health care in Russia: to be or not to be?” International Journal of Integrated Care 1 (2001): 38-41.
- “Health Insurance Costs”.2009. National Coalition on Health Care.