The issue of grey and black markets often arose as a result of the shortages of experienced health care personnel. The system could not adapt to a flexible environment as it was led by rigid official procedures and the mentality of the people who controlled it was commanding, their vision short-sighted and hardly beneficial in such a situation (Barr and Mark, 1996).
The breaking up of Soviet Union which brought crippling economic and political problems to the countries also aggravated the health care situation making it reach an all-time low. The collapse of the health care system ran by the government led to the belief that turning towards a market economy or more capitalistic notions and perceptions would have been a better idea. The competition in the private sector would have had improved efficiency and averted an inevitable collapse of the health care system in the Soviet Union. This transformation, often advocated by the Western economies could have been inappropriate for the Soviet Union as it would have been impossible to solve the health care problem individually without keeping in mind the other social, political and economics problems gripping the country (Barr and Mark, 1996).
The Health Status of the Former Soviet Republics during the 1990's
When western scholars attempted to discern the health care situation in Russia, it was reported that it had a falling life expectancy rate while a rising infant mortality which depicted that it was still clouded with serious health concerns. In 1990, infant mortality in eight former Soviet Union countries was reported as 17.4 per 1000 live births and it was 18.8 for the first half of 1993. These states, however, calculated the infant mortality rate differently from the international computation laid down by World Health Organization (WHO). In 1994, when WHO standards were considered and applied, the infant mortality rate in Russia increased by 20% to reach a level of 24-25 per 1000 live births (Barr and Mark, 1996).
Even now, fifty percent of all the infant deaths in these countries are caused by respiratory and contagious diseases which when compared to its United States counterpart it forms only a meager 10%. Western countries are afflicted from contagious diseases 10% lower than in former Soviet states. Infections, hemorrhage and hepatitis are some of the reasons for increasing maternal deaths. Simple needs of vaccines and vitamins are not fulfilled even in the well to do Baltic States. Increasing pollution and environmental concerns have also adversely affected the health of the citizens who can hardly hope to be provided with free and quality health and care services (Barr and Mark, 1996).
Traumatic stress, poisoning, lung illnesses, complications in pregnancy and childbirth are causing most of the early deaths. Emphasis was laid by the WHO on improved conditions of sanitation and care provided to infants and mothers. It was stated that the improvement of these conditions should be preferred of developing medical technology and care systems. The remedy of the socioeconomic and environmental causes of the spreading diseases was emphasized (Barr and Mark, 1996).
The independent states received a very chaotic and problematic health care system after the collapse of the Soviet Union. The last years of the existence of the Soviet Union were characterized by low budget spending being done on the health care system. Of the very small percentage of the funds provided, only the high-ranking people could have availed the health care benefits while the common citizens continued to face hardships (Barr and Mark, 1996).
The conditions prevailing in hospitals and clinics were dismal because some of them often lacked basic plumbing facilities and they continued to exist in an alarming state of disrepair. When the Soviet Union was on the verge of disintegration, the health care needs had been only scarcely met due to the shortages of syringes, basic medicines, surgical instruments, intravenous tubing, gloves, sterile needles and other dressing supplies. The shortages continued to occur even when the supplies had been improved (Barr and Mark, 1996).
The awful health conditions in these former Soviet Union States can be judged from the fact that abortion was the only option available to control births which was made more painful as basic medications such as anesthetics was not available. The birth control pills did not appear even after being ordered while the number of abortions underwent in the country rose to an alarming 3 million. The abolishment of physician's association made sure that the quality of the health care personnel was not maintained and the wide number of doctors available at that time were considered inexperienced according to Western standards (Barr and Mark, 1996).
The Health Status of the Former Soviet Republics in the 21ST Century
The conditions in the 21ST century have not changed at all. The funding of the healthcare is still extremely low. The poor and underprivileged class still finds it difficult to gain access to quality healthcare facilities and treatment. The rich continue to reap the benefits of a highly impartial healthcare system. The conditions of the doctors and physicians (though, has improved slightly) is still not up to the international standards. Similarly, the shortage of syringes, basic medicines, surgical instruments, intravenous tubing, gloves, sterile needles and other dressing supplies still continues to exist in most of these former Soviet Republics resulting in higher healthcare expenditures by individuals. While birth control now is being done through pills, many women still consider abortion as an option as it has become a norm in these states (Balabanova, Haerpfer, McKee, Pomerleau and Rose 2004).
The Former Soviet Republics in the 21st Century are no longer under communist rule and so have been driven away from the older centralized models of healthcare systems. These former Soviet Union states believe in adhering to strict rules and defined ways of pursuing their goal of providing free health care services of an unvarying nature to every citizen. However, this inflexibility coupled with the administrative problems of centralization has not made them successful in achieving their highly ambitious goals, even if it drastically increases the number of doctors and health care personnel available. Also, there has been a difference in the provision of health care facilities depending upon the organizations it is providing service for. The elite industrial class of people has been given the option of taking advantage of high-quality services while the common men, women and children have been left unattended (Balabanova, Haerpfer, McKee, Pomerleau and Rose 2004).
In addition, there are several healthcare issues emerging out of the rural areas. These people cannot gain assess to these health care facilities because of a lack of communication and/or transportation barriers. The need for changing the Soviet system of healthcare is clear, as the communist system of providing goods and services has been criticized by many countries and the political, economic and social damage the country received is enough to ensure that funding to the health care system will unlikely increase (Balabanova, Haerpfer, McKee, Pomerleau and Rose 2004).
The changes that have occurred include the decentralization of both funding and delivery of medical services. There have been shifts to decentralization in the over all organization and funding from health insurance. In many countries, the rigid system of providing health care has disintegrated and there have been an increase in informal payments (Lewis 2002). However, there is no confirmed way of research to gauge how the anti-Soviet system had changed the health care system for the people and additional research needs to be carried out in order to fully comprehend the current status of healthcare in these former Soviet Union republics (Balabanova, Haerpfer, McKee, Pomerleau and Rose 2004).
The establishment of democratic institutions while also enhancing the general health level of society at large is no easy task to accomplish. According to the World Bank's World Development Report (1993) the achievement of health care aims is an ongoing struggle which neither the government nor the free market alone can achieve efficiently. It is the responsibility of the policy makers of health reforms to consider alternative use of natural resources to decide upon the most efficient one and to ensure that none of the resources go to waste so that society can benefit most effectively.
Balabanova, D., Haerpfer, C., McKee, M., Pomerleau, J., Rose, R. (2004). Health service utilization in the former Soviet Union: evidence from eight countries. Health Services Research
Barr, D.A. And Mark G. (1996). The Current State of Health Care in the Former Soviet Union: Implications for Health Care Policy and Reform. American Journal of Public Health. 86, 3.
Lewis, M. (2002). Informal Health Payments in Central and Eastern Europe and the Former Soviet Union: Issues, Trends and Policy Implications. In Funding Health Care, European Observatory on Health Care Systems Series, edited by E. Mossialos, a. Dixon, J. Figueras, and J. Kutzin, pp. 184-205. Buckingham: Open University Press.