Negotiating the Post-Soviet Medical Marketplace: Growing Gaps in the Safety Net
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Soviet era constitutions proclaimed the fundamental right of their citizenry to essential medical care that would be free at the point of delivery. That commitment was renewed in the early 1990s by the new constitution of the post-Soviet Russian Federation. Among the many problems facing the Russian government since the breakup of the USSR has been figuring out how to finance and rehabilitate the troubled medical care system it inherited from the former regime. Sharply negative trends in national health statistics have served as a constant reminder of both the extent and the urgency of the problem. As other chapters in this volume amply demonstrate, those macro-level indicators present a disturbing picture of a system in deep crisis. Many commentators have questioned whether the medical care system is currently capable of providing adequate care to the Russian people. As for the extent to which medical care (irrespective of quality) can be had free of charge, that also remains open to question.
KeywordsMedical Care Poor Health Economic Deprivation National Health Statistic Medical Care System
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- 1.This comment was made repeatedly by people we interviewed in St. Petersburg, although many of them insisted that they were exceptions to that rule. In addition to the findings of our research, which are discussed later in this chapter, reports of popular opinion surveys assessing attitudes toward the medical care system are summarized in K. Muzdabaev, Dinamika urovnia zhizni v Peterburge 1992–1994 (St. Petersburg: SMART Publishers, 1995).Google Scholar
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- 18.E. K. Abel, Who Cares for the Elderly? (Philadelphia: Temple University Press, 1991) discusses the positive aspects of care giving. We are also grateful to E. S. Pushkova, head geriatric physician of St. Petersburg, for her contributions to our understanding of the difficulties for families posed by the absence of social supports and home health products.Google Scholar