Abstract
This chapter travels to the early Soviet era and investigates private provision of health care in the 1920s. After the Revolution of 1917, health-care provision was reorganised to reflect aspirations to excluding market forces, establishing efficient central planning, and making medicine universally available and free. It was under these circumstances that private medicine emerged for a time. The chapter traces the evolution of government policy towards private provision of health care and conditions that enabled the development of this innovation under the communist rule, as well as the decline of this market innovation. By examining under-researched local archival materials, this chapter investigates how health professionals eager to provide private health-care services struggled to do so amidst conflicting decisions and signals by the new government bodies and the multiplicity of unsatisfied health needs.
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Notes
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St. Petersburg was renamed as the more Russian-sounding Petrograd in 1914, soon after the outbreak of the First World War with the Germans. In 1924, the city was renamed once again, this time after the recently deceased Bolshevik leader Vladimir Lenin (Leningrad).
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Among many other things, Russian orthography, too, was reformed in 1917–1918. The new orthography was considered by its critics to be an unjustified over-simplification, and the reform was thus widely perceived as a controversial move on the part of the Bolsheviks. Some prominent Russian intellectuals openly refused to follow the new rules in their writing.
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Popular reception of this view can be traced in the patients’ files, such as a thank-you letter that a former patient, Yurii Safronov, wrote to the staff of Bekhterev State Psychoneurological Research Institute. In the letter, he warmly thanked his doctors and expressed the view that ‘a Soviet physician … will achieve a lot, because he doesn’t worship dollars’ (Tsentral’nyi gosudarstvennyi arkhiv nauchno-tekhnicheskoi dokumentatsii Sankt-Peterburga [Central State Archive of Scientific and Technical Documentation of St. Petersburg, TsGA NTD SPb], fond 313).
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‘Socialism in one country’ was Stalin’s theory that it is possible to build a socialist state within a single country. It is thus opposed to classical Marxism and to Trotsky’s idea of ‘permanent revolution’, which is global in its scope. In his 1936 book, Predannaia revoliutsiia [The Revolution Betrayed], Leon Trotsky famously dismissed the Stalinist state as an aberration of the revolution and the triumph of the bureaucracy over the proletariat.
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Vasilyev, P. (2018). Flirting with the Market: The Early Soviet Government and the Private Provision of Health Care, 1917–1932. In: Zvonareva, O., Popova, E., Horstman, K. (eds) Health, Technologies, and Politics in Post-Soviet Settings. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-64149-2_2
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