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Old December 13th, 2015, 08:29 AM
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Unhappy Myth of free healthcare in Soviet Union

Myth of free healthcare in Soviet Union

FEBRUARY 16, 2011

When*ever there is a heated argu*ment whether things were bet*ter dur*ing the USSR times, this state*ment invari*ably pops up as a mighty ace: At least they had free med*ical care in the Soviet Union! This is sup*posed to bring the oppo*nent to the knees and make them beg mercy and for*give*ness for betray*ing the Great Octo*ber achievements.

Well well well. Let’s have a close look at what really was free then.


After the events of Octo*ber 1917, the Bol*she*viks chose to nation*alise all hos*pi*tals and med*ical prac*tices pre*vi*ously founded by var*i*ous state and char*i*ta*ble organ*i*sa*tions. This would have been a fea*si*ble plan, had they not cho*sen to class all doc*tors as “rot*ten bour*geois” which meant that they had to emi*grate from the “Red Ter*ror” or face death.

Even Vladimir Lenin in a let*ter dated of Nov 1918 wrote to an acquain*tance: Please go abroad to see a doc*tor – they have won*der*ful spe*cial*ists in Switzer*land and Vienna… Our so-called doc*tors are fools.


In early 1920s var*i*ous med*ical exper*i*ments became pop*u*lar and acquired great sup*port of the state: with*out much of a the*o*ret*i*cal base or sub*stan*tial research, a lot of time and money was poured into genet*i*cal exper*i*ments to breed a new type of per*son – of a Social*ist kind.

Al in all, the years in which the Bol*she*viks were start*ing off were very tough: the coun*try was in a run-down state after the WWI; there was a severe famine; pan*demics of cholera, typhoid, malaria; as well ris*ing num*bers of peo*ple dying of var*i*ous infec*tions and mal*nu*tri*tion. From a health per*spec*tive, the state of many med*ical prac*tices and hos*pi*tals was bor*der*line cat*a*strophic. The build*ings were get*ting old with*out any hopes for repair; cen*tral heat*ing often failed; med*ical sup*plies were insuf*fi*cient and irreg*u*lar. The food sup*plies were often short, and the bur*ial of the dead was an issue as well.

The state spend*ing on med*i*cine was low to start with, and it was grad*u*ally declin*ing: it was 3.9% of the total bud*get in 1927; 3.6% in 1928; 3.5% in 1929 and 3% only in 1930. The severe skill short*ages in the health indus*try were immi*nent, and there was a strong urban focus in health providers’ loca*tions – given that the sup*ply was already short, the vil*lages were even worse off.

In the late 1920s indus*tri*al*i*sa*tion, as per Stalin’s orders, aimed at devel*op*ing the heav*ier indus*trial machin*ery pro*duc*tion – so the times which what was already bad was turn*ing even more foul. Bureau*cracy was start*ing to set*tle in, while the bud*get cuts con*tin*ued (2.5% of the total bud*get in 1932, 2.7% in 1933). On paper, as often in the USSR, things looked if not rosy but at least decent: the atten*tion was drawn to pre*ven*ta*tive mea*sures and the impor*tance of the population’s health; whereas in real*ity it was very ugly.In our old post about the life in the 1920s, the images of those time were indeed scary, if you remember.

Dur*ing the Sec*ond World War, the main ben*e*fi*ciary of med*ical help was, under*stand*ably, the army – the rest of the pop*u*la*tion, fair to say, was aban*doned. Var*i*ous types of typhoid, TB, dysen*tery, malaria, cholera and even plague were not uncom*mon– the dis*eases were spread*ing very rapidly due to the poor sup*ply of drugs and increas*ing num*bers of migrants.

When the war was over, the main efforts (as well as finan*cial means) were gen*er*ated towards rebuild*ing the towns and get*ting the econ*omy back up – and as always, there was no room for med*i*cine research and devel*op*ment. The health indus*try salary bands were among the low*est in the coun*try. In 1940 the doc*tors were earn*ing 255 rou*bles per month, as com*pared with 399 rou*bles aver*age. In 1955 it was 521 rou*bles against 711 aver*age. In August 1945 a group of doc*tors sent an open let*ter to Stalin describ*ing the abhor*rent sit*u*a*tion in the health indus*try. It men*tioned the fac*tory work*ers with high-school qual*i*fi*ca*tions were earn*ing 1300 – 1400 rou*bles per month, whereas the hos*pi*tal man*ager, a doc*tor with 8 years of edu*ca*tion and years of expe*ri*ence would be for*tu*nate enough to earn 800 roubles.

The change was brought upon by Nikita Khrushchev, who was slowly set*ting new goals and get*ting his gov*ern*ment to rede*velop many facets of Soviet life. But the late fifties were also the times when the famous free Soviet med*ical care sys*tem stopped being free. The doc*tors became less covert in tak*ing cash from patients in exchange for med*ical ser*vices, for med*ical sup*plies, for drugs. The less-qualified med*ical staff (nurses and care*givers) were mak*ing some extra cash by pro*vid*ing extra-nice ser*vices to patients – for 10 rou*bles per night you could have a nurse by your bed tak*ing care of you – obvi*ously, all other patients would have been neglected. Mid*wives in birth*care insti*tu*tions were brib*ing the fathers – one would pay a one off 25 rou*bles for the girl and twice as much for the boy as to “take them home”.

Among the key prob*lems were:

Alco*holism and drug use – extremely widespread.
Bad ecol*ogy – due to heav*ily exploited plants and fac*to*ries, many towns were below par – the South*ern republics, Mol*davia, some parts of Ukraine, indus*trial cen*tral Rus*sia and Siberia.
Food short*ages – espe*cially in the rural areas and small towns with the pop*u*la*tion of less than 100,000 peo*ple; as well as the appalling qual*ity of food.
Extremely high rates of abor*tions (100 for every 1000 women in the age of 15 – 49; or 200 abor*tions for every 100 of births). Also, the actual pro*ce*dure was a very prim*i*tive one which lead to the death of a woman in almost 25 – 30% of cases.
Health and Safety in employ*ment – extremely high indus*trial acci*dent rates
Road death tolls
Also, in early 1980s the wide*spread of sex*u*ally trans*mit*ted dis*eases started to take its toll. In 1970 more than 12% of women of repro*duc*tive age were diag*nosed and treated from STD, many of whom suf*fered from syphilis. In 1987 the first case of HIV was reg*is*tered, after which the dis*ease had esca*lated to the point of peo*ple panicking.

The Soviet doc*tors had all the pres*sure to catch up with their West*ern coun*ter*parts, and they did their best, given the cir*cum*stances. The first suc*cess*ful heart trans*plant attempt did not hap*pen until March 1987, which was almost 20 years after the Amer*i*can debut. Such a sig*nif*i*cant delay was not just due to the bud*get cuts and low financ*ing – the appro*pri*ate leg*isla*tive frame*work was miss*ing, and so was the con*cept of organ donors.

This is how the free Soviet med*i*cine had met the death of the Soviet state. It almost seems like the 70 years of the 20th cen*tury did not pro*vide any move for*ward – despite the antibi*otics, vac*ci*na*tion and hun*dreds of thou*sands of grad*u*ate doc*tors, the over*all state of the health indus*try was just ever so slightly bet*ter than at the end of the Tsar times. And then, of course, the typ*i*cally Soviet traits of doing things: bureau*cracy, cor*rup*tion, the noto*ri*ously abhor*rent lev*els of cus*tomer ser*vice and the low pri*or*ity that the state would give the health industry.

This does not deny the Soviet doc*tors their achieve*ments – over the course of 70 years, there would have been plenty – but noth*ing was easy and noth*ing was cer*tainly free.

http://www.realussr.com/ussr/myth-bu...icine-you-say/
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  #2  
Old December 14th, 2015, 11:14 AM
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Re: Myth of free healthcare in Soviet Union

Lets make this a bit more readable

Quote:
Whenever there is a heated argument whether things were better during the USSR times, this statement invariably pops up as a mighty ace: At least they had free medical care in the Soviet Union! This is supposed to bring the opponent to the knees and make them beg mercy and forgiveness for betraying the Great October achievements.

Well well well. Let’s have a close look at what really was free then.


After the events of October 1917, the Bolsheviks chose to nationalise all hospitals and medical practices previously founded by various state and charitable organisations. This would have been a feasible plan, had they not chosen to class all doctors as “rotten bourgeois” which meant that they had to emigrate from the “Red Terror” or face death.

Even Vladimir Lenin in a letter dated of Nov 1918 wrote to an acquaintance: Please go abroad to see a doctor – they have wonderful specialists in Switzerland and Vienna… Our so-called doctors are fools.


In early 1920s various medical experiments became popular and acquired great support of the state: without much of a theoretical base or substantial research, a lot of time and money was poured into genetical experiments to breed a new type of person – of a Socialist kind.

Al in all, the years in which the Bolsheviks were starting off were very tough: the country was in a run-down state after the WWI; there was a severe famine; pandemics of cholera, typhoid, malaria; as well rising numbers of people dying of various infections and malnutrition. From a health perspective, the state of many medical practices and hospitals was borderline catastrophic. The buildings were getting old without any hopes for repair; central heating often failed; medical supplies were insufficient and irregular. The food supplies were often short, and the burial of the dead was an issue as well.

The state spending on medicine was low to start with, and it was gradually declining: it was 3.9% of the total budget in 1927; 3.6% in 1928; 3.5% in 1929 and 3% only in 1930. The severe skill shortages in the health industry were imminent, and there was a strong urban focus in health providers’ locations – given that the supply was already short, the villages were even worse off.

In the late 1920s industrialisation, as per Stalin’s orders, aimed at developing the heavier industrial machinery production – so the times which what was already bad was turning even more foul. Bureaucracy was starting to settle in, while the budget cuts continued (2.5% of the total budget in 1932, 2.7% in 1933). On paper, as often in the USSR, things looked if not rosy but at least decent: the attention was drawn to preventative measures and the importance of the population’s health; whereas in reality it was very ugly.In our old post about the life in the 1920s, the images of those time were indeed scary, if you remember.

During the Second World War, the main beneficiary of medical help was, understandably, the army – the rest of the population, fair to say, was abandoned. Various types of typhoid, TB, dysentery, malaria, cholera and even plague were not uncommon– the diseases were spreading very rapidly due to the poor supply of drugs and increasing numbers of migrants.

When the war was over, the main efforts (as well as financial means) were generated towards rebuilding the towns and getting the economy back up – and as always, there was no room for medicine research and development. The health industry salary bands were among the lowest in the country. In 1940 the doctors were earning 255 roubles per month, as compared with 399 roubles average. In 1955 it was 521 roubles against 711 average. In August 1945 a group of doctors sent an open letter to Stalin describing the abhorrent situation in the health industry. It mentioned the factory workers with high-school qualifications were earning 1300 – 1400 roubles per month, whereas the hospital manager, a doctor with 8 years of education and years of experience would be fortunate enough to earn 800 roubles.

The change was brought upon by Nikita Khrushchev, who was slowly setting new goals and getting his government to redevelop many facets of Soviet life. But the late fifties were also the times when the famous free Soviet medical care system stopped being free. The doctors became less covert in taking cash from patients in exchange for medical services, for medical supplies, for drugs. The less-qualified medical staff (nurses and caregivers) were making some extra cash by providing extra-nice services to patients – for 10 roubles per night you could have a nurse by your bed taking care of you – obviously, all other patients would have been neglected. Midwives in birthcare institutions were bribing the fathers – one would pay a one off 25 roubles for the girl and twice as much for the boy as to “take them home”.

Among the key problems were:

Alcoholism and drug use – extremely widespread.
Bad ecology – due to heavily exploited plants and factories, many towns were below par – the Southern republics, Moldavia, some parts of Ukraine, industrial central Russia and Siberia.
Food shortages – especially in the rural areas and small towns with the population of less than 100,000 people; as well as the appalling quality of food.
Extremely high rates of abortions (100 for every 1000 women in the age of 15 – 49; or 200 abortions for every 100 of births). Also, the actual procedure was a very primitive one which lead to the death of a woman in almost 25 – 30% of cases.
Health and Safety in employment – extremely high industrial accident rates
Road death tolls
Also, in early 1980s the widespread of sexually transmitted diseases started to take its toll. In 1970 more than 12% of women of reproductive age were diagnosed and treated from STD, many of whom suffered from syphilis. In 1987 the first case of HIV was registered, after which the disease had escalated to the point of people panicking.

The Soviet doctors had all the pressure to catch up with their Western counterparts, and they did their best, given the circumstances. The first successful heart transplant attempt did not happen until March 1987, which was almost 20 years after the American debut. Such a significant delay was not just due to the budget cuts and low financing – the appropriate legislative framework was missing, and so was the concept of organ donors.

This is how the free Soviet medicine had met the death of the Soviet state. It almost seems like the 70 years of the 20th century did not provide any move forward – despite the antibiotics, vaccination and hundreds of thousands of graduate doctors, the overall state of the health industry was just ever so slightly better than at the end of the Tsar times. And then, of course, the typically Soviet traits of doing things: bureaucracy, corruption, the notoriously abhorrent levels of customer service and the low priority that the state would give the health industry.

This does not deny the Soviet doctors their achievements – over the course of 70 years, there would have been plenty – but nothing was easy and nothing was certainly free.
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  #3  
Old December 14th, 2015, 11:17 AM
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Re: Myth of free healthcare in Soviet Union

Just because They couldn't apply social medicine properly, doesn't mean others also can't.
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