One of the central processes in Russian healthcare since 2000 has been the so-called “optimization”, the main instrument of which is to liquidate and reorganize the institutions recognized as “ineffective”. This policy has led to an unprecedented reduction in the number of hospitals and polyclinics in the country: in 2000–2015 the number of Russian hospitals has decreased almost twofold – from 10.7 to 5.4 thousand. At this rate of hospital cuts, Russia is at the risk of degrading itself to a pre-revolutionary Russian Empire of 1913 in just 5–6 years. The number of hospital beds per 10 thousand people has decreased over 15 years from 115 to 83.4, i.e. by 27.5 %. There is an on-going massive liquidation of outpatient clinics and polyclinics: their number has decreased from 21.3 to 18.6 thousand.
The share of health care expenditures on GDP in Russia is 3.6 %; this indicator is 2–2.5 times inferior to its counterpart in Western European countries. Persistent underfinancing of medicine under the health insurance model, which is known to be ineffective in Russia, inevitably worsens the quality of medical services.
The government reports on “an increase in incomes” of medical workers, while in fact it is practically impossible for a doctor to earn the income promised by the government, unless they do three full-time shifts, i.e. work day and night and without days off. The actual hourly rate of a qualified doctor with higher education in the Russian province is comparable, for example, with the hourly rate of an ordinary employee of McDonald’s. Because of this the medical specialists give up on their profession and massively “escape” into paid medicine.
Such reasons as overcrowded hospitals and polyclinics, patients queuing up for weeks and months, an ever increasing shortage of equipment and medicines force citizens to resort to paid medical services, the number of which is constantly growing.
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