Russian Healthcare
A Naturopathic Doctor’s Observations of Russian Sanitariums on the Black Sea
by Thomas Stearns Lee, NMD
This article describes a perspective of Russia obtained during my visit with a Russian friend during July 1993. The trip was through Moscow, by plane to Rostov, then by train to Sochi on the Black Sea. My friend and I visited sanitariums and spas and spoke with doctors and nurses about their healthcare system. My language skills were such that I was fortunate to have my Russian friend along to help interpret.
My first impression from the train ride was of a vigorous and strong people familiar with adversity and survival. Every small town was surrounded by gardens and plastic-covered hothouses. Decorative trees had edible fruit that children picked and sold in the markets. Along railroads, train employees would keep small gardens near places the train usually stopped.
In the larger hospitals and spas, they have a real Catch-22. With a developed academia and incoming Western media, they all love modern pharmaceuticals, but no one can afford them. What they are left with are some excellent natural products, often superior hospital-grown vegetables and fruits, and wonderful hydrotherapy and physical therapy techniques.
What is wrong with all that? Nothing. But it was ironic to note how embarrassed and inadequate they felt about their own medical arts. Illusions about the worth of our technology were not helping them move forward. The notion of how to profit from treating disease is confusing when mixed with healthcare concepts.
My observations were made during the dramatic breakdown of a stable, if oppressive society. For over 70 years, their healthcare system was organized and extended through institutions of education, employment, and government. The elaborate sanitariums I visited in Sochi were maintained as rewards for high officials in the party, various trade unions, and regional governments.
In groups and parks, people appeared to not be as overweight as we expect, or at least on older people it was packed pretty solid. I saw wider ranges of fashion and beauty, with some advanced wear-and-tear conditions among the elderly. Viewing from the train, I saw crowded public transport, larger numbers of pedestrians, and air pollution of a diesel flavor in larger towns.
Another notable impression was stress patterns among kids. The early teens seem to have some exhaustion and depression patterns that we dont see as much of in this country. Life is hard for many people there, and it is most visible among the young women and children.
In crowd scenes while shopping and traveling, I found a wider range of age groups and economic classes. It seemed behavior was more considerate and courteous. Despite the occasional drunk or non-functioning type, even the teens who were into makeup, smokes, and Western rock fashions were pretty sweet about their drama. Animated gossip and flock behavior were pretty familiar as standard issue school-kid. They had less gear and fashions, which wasnt too bad, and it was rare to see anyone tuned out into earphones.
While institutions of government and major employers remain in New Russia, the doctors I spoke with were bewildered as to their future functions. The doctor as a small business person, or entrepreneur is a completely alien concept. Marketing of health care to profit private business is a disturbing notion to many Russians.
For that matter, even the concept of profit from healthcare is pretty black-hearted to most adults who grew within the Communist system. Far from fueling growth and progress, as our myths would have it, profit is suspected as theft and injustice. You can imagine how welcome joint ventures and developers are.
The television shows now have ads; some are very clever and businesses also are beginning to advertise. But without the social experience of promoting individual talents or skills, transitions to free-market healthcare will be painful for everyone. And without disposable income to be spent, hustling to make profits from providing healthcare services or products will never be sensible to the Russians. Capitalism is fueled by hopes.
Healthcare is a different concept in Russia. American hospitals would have a tough sell over there. Most of their prevention and nutrition is anti-clinical or despite the clinic. Doctors are cheap or free if the care is part of an employer or the state, but they have little to offer as far as medicines or materials, and people complain that they have no interest in their work.
Most prevention is called listening to your grandparents and finding out what worked for them. Every small-town market has garden produce, including various herbs that they call “Healing Grasses.” The merchants selling these herbs have opinions to share about their use, in case the grandparents might be getting things mixed up by now.
For more serious problems, major hospitals and polyclinics are in no position to rival the resources and organization of modern American hospitals. Individual doctors, the majority being women, are very skillful and caring, but the crash of their currency and political system has affected all major institutions, including hospitals.
Ask yourself how far your modern hospital could go without supplies, services, and amenities. In Russia, problems with supply are incredible because the infrastructure of communications, transport, and even contract law have stagnated throughout the Soviet era. The impressions I got of civilian society suggest many national challenges ahead for these intelligent and compassionate people.
Wherever these sweeping changes take Russia, a huge population of educated, intelligent, and hardworking people will go with her. If transitions can happen without letting the World Bank strangle her with debt, Russia could amaze the World in the next few years.
Whenever their skilled physicians become needed and respected, whatever economy Russia develops will reward those skills and others will want to mirror that success. At present, the best physicians have been very unrewarded and their genius controlled by a bureaucratic nightmare. Morale and skills have declined as a result.
Of course, so many other problems contribute to this situation that merely rewarding some doctors wouldnt change anything. A stable currency and real opportunities to survive, based on efforts, skills, and intelligence, would start to rebuild Russia, and a rebuilt Russia would bring up the standard of living for much of our world.
Our national health-care organizers are finding their ideals very limited by reality, and they would do well to examine Russia. There, the reverse is more the case, and the consequences of over-governing are quite clear. Service from one person to another can never be forced or required for long without some exchange of value.
The Russians will come up with ways to succeed. If you get a chance, go and meet these kind people yourself. You will expand your horizons, and maybe theirs, too.