400967 Health Economics And Comparative Health Systems

Question: You will prepare and present a twenty to thirty minutes oral presentation on the healthcare system of the Russia. Using best evidence related to efficiency, effectiveness, value and behaviour in the production and consumption of health and healthcare in Russia, students must address the following in their presentation: Identify three important health problems facing the Russia.Provide evidence in the form of data to support their choices of the 3 health problems Describe how healthcare is funded and delivered in the Russia Identify any areas in the country, or groups of people within the Russia, where access to healthcare is less than ideal. That is, are health resources allocated relatively equally through the Russia and to all its citizens? Explain why this has occurred. Explain if they would be happy to be a patient in this Russia’s healthcare system? Explain why or why not. Make at least four recommendations to improve this Russia’s healthcare system Answer: Healthcare System In Russia In Russia, every citizen has a right to free public healthcare through the Obligatory Medical Insurance(OMI) (Cylus & Papanicolas, 2015) . The OMI gets its funds from contributions by the employer where 2-3% of the salary of each employee is paid as social tax which is later paid to the national Russian healthcare fund. This free public healthcare was launched back in 1996. Since public healthcare is free of charge ,the majority of the citizens have access to healthcare even though they are poor(Gvosdev, 2017). Three Main Problems In Healthcare System Of Russia The Russian healthcare system has of late received a lot of criticism due to the different challenges that it has been experiencing. The three major problems of the Russian Healthcare system include: Personnel issues like lack of qualified specialists(13.0%),problems in human resources policy such salary level, working conditions (11.0%) and poor quality and degraded training of new staff(10.4%) (Medvedev, 2016). Reduced influence and control of modern politics(17.5%). Lack of adequate funding for the healthcare system(11.7%). Lack Of Adequate Funding For The Healthcare System According to the Blomberg ranking of countries by their health systems effectiveness in 2014,Russia was at position 51(Jakovljevic, 2014).One of the criteria for ranking was expenditure on the healthcare. Russia only spent $887 which is ten times lower than the USA. The effectiveness of a healthcare system is usually evaluated using health demographic indicators such as life expectancy and the crude death rates. If we use the dynamics of crude death rates ,it is clear that the introduction of national project “Health” as well as improvements in social and economic situation in 2005-2008 saw reduced crude death rates by 9% from 16.1-14.6%(Mau, 2014). This was associated with saving lives of 450 citizens. The Russian government only spends about 10% of the government expenditure to healthcare. This is a very small fraction as compared to other developed countries(Jakovljevic, Groot, & Souliotis, 2016). Despite this little expenditure, there were positive changes in population health state. The figure below shows the trends in crude mortality rates over the years Personnel issues Lack of qualified personnel is a major problem with only 580,431 physicians and 1,287,659 health workers with secondary vocational education work as of January 2015. The ratio of doctors to nurses was 1:2.3 while the provision of Russian country with doctors is at 40.3 while for the nurses is 100.0 per 10000 people(Marten et al., 2014). This is not proportional at all. Besides ,more than 90000 medical workers were dismissed. The salary and the working conditions are also not favorable in Russian Healthcare .In 2014,the salaries for all employees increased significantly with that of doctors increasing by 4000 rubles, that of medical staff increased by 2200 rubles while that of nurses increased by 1.8 thousand rubles in 2014(Jakovljevic, Potapchik, Popovich, Barik, & Getzen, 2016). Despite the increase in salaries, the medical workers endure long hours of work up to 12 hours as compared to other employees who only work for 8 hours a day. When the salary of a doctor is compared to other members in the EU, the salaries in EU members is 1.5-2.5 times higher as compared to Russia(Jakovljevic, Potapchik, Popovich, Barik, & Getzen, 2016). There is also poor quality and degraded training of health workers in Russia with most of the current workers still using the ancient skills. This is often expressed in negative indicators of quality of care such as increased mortality rates due to breast cancer. Despite the increase in salaries, the medical workers endure long hours of work up to 12 hours as compared to other employees who only work for 8 hours a day. When the salary of a doctor is compared to other members in the EU, the salaries in EU members is 1.5-2.5 times higher as compared to Russia(Jakovljevic, Potapchik, Popovich, Barik, & Getzen, 2016). There is also poor quality and degraded training of health workers in Russia with most of the current workers still using the ancient skills. This is often expressed in negative indicators of quality of care such as increased mortality rates due to breast cancer. Affected Population The highest population affected by the health problems in Russia are maternity and infants .The lack of medicines more so in the rural areas lower the infants survival chances. Studies indicate that 40-50% infant mortality is due to respiratory failure, infectious and parasitic diseases. When compared to other developed countries, the values range between 4-17% (Chubarova, 2010). The Russian Government slashed expenditure on maternal and child health care in 2013-2020 whereby only2.1 billion was allocated. According to statistics, the most affected areas that should get focus when planning implementation are shown in the table below: As a patient in Russia, I would not be happy. This is because the free healthcare service is generally full of problems and I will likely get low quality services. Recommendations: There are several recommendations that have been proposed to improve healthcare In Russia and they include: Development of spa treatment systems including one for children since they are the ones most affected(Kalmikov & Rekhtina, 2016) . There should also be an evidence based method of evaluating the expenditure effectiveness. The Government should consider setting up independent experts to draft the budget expenditure and this will minimize wastage and corruption. There should be improved training facilities for medical workers as this will sharpen their skills References Chubarova, T. (2010). The Health-Care System in Russia. Problems of Economic Transition, 52(11), 24-42. doi:10.2753/pet1061-1991521102 Cylus, J., & Papanicolas, I. (2015). An analysis of perceived access to health care in Europe: How universal is universal coverage? Health Policy, 119(9), 1133-1144. doi:10.1016/j.healthpol.2015.07.004 Gvosdev, N. K. (2017). RUSSIA in The National Interest. doi:10.4324/9781315128870 Jakovljevic, M. (2014). The key role of the leading emerging BRIC markets in the future of global health care. Serbian Journal of Experimental and Clinical Research, 15(3), 139-143.doi:10.5937/sjecr1403139j Jakovljevic, M., Groot, W., & Souliotis, K. (2016). Editorial: Health Care Financing and Affordability in the Emerging Global Markets. Frontiers in Public Health, 4. doi:10.3389/fpubh.2016.00002 Jakovljevic, M. M. (2015). Comparison of historical medical spending patterns among the BRICS and G7. Journal of Medical Economics, 19(1), 70-76. doi:10.3111/13696998.2015.1093493 Jakovljevic, M., Potapchik, E., Popovich, L., Barik, D., & Getzen, T. E. (2016). Evolving Health Expenditure Landscape of the BRICS Nations and Projections to 2025. Health Economics, 26(7), 844-852. doi:10.1002/hec.3406 Kalmikov, N. N., & Rekhtina, N. V. (2016). The Health-Care System Issues and Prospects in the Russian Federation. Biology and Medicine, 08(04). doi:10.4172/0974-8369.1000301 Marten, R., McIntyre, D., Travassos, C., Shishkin, S., Longde, W., Reddy, S., & Vega, J. (2014). An assessment of progress towards universal health coverage in Brazil, Russia, India, China, and South Africa (BRICS). The Lancet, 384(9960), 2164-2171. doi:10.1016/s0140-6736(14)60075-1 Mau, V. (2014). Human Capital: Challenges for Russia. SSRN Electronic Journal. doi:10.2139/ssrn.2659132 Medvedev, D. (2015). A new reality: Russia and global challenges. Russian Journal of Economics, 1(2), 109-129. doi:10.1016/j.ruje.2015.11.004 Medvedev, D. (2016). Social and economic development of Russia: Finding new dynamics. Russian Journal of Economics, 2(4), 327-348. doi:10.1016/j.ruje.2016.11.001

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