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07.04.2008

Bitter pills on World Health Day

Each year on April 7, the world celebrates World Health Day, the birthday of the World Health Organization (WHO). This is a good occasion to sum up the results.

Despite certain progress in this field in the last two years, Russia has nothing to boast about. The WHO put Russia in the 127th place in terms of its population's health, and in the 130th in terms of its health care system effectiveness. We are considerably behind the majority of East European and even Latin American countries with a similar level of economic development.

Hipocrates defined health as the supreme value of a human being. In this sense, the majority of Russians are poor. The annual check-up of 13 million people shows that only every fifth person is completely healthy. A total of three million people a day take sick leave. Speaking at a recent news conference devoted to the start of spring draft, Deputy Chief of Staff of the Armed Forces Vasily Smirnov said that every third conscript is not fit for military service, and every other has health-related restrictions.

Health and death indicators have started deteriorating in this country since the middle 1960s, but now they have become truly appalling. By international ratings, Russia has long fallen into the second hundred in life expectancy. Experts have calculated that the death rate has cost Russia about 20 million lives - the people who could have lived, and the children who were not born due to the death of their potential parents.

The three year-old Health National Project was designed to improve the situation. Reporting to a Cabinet meeting in late March, Minister of Health and Social Development Tatyana Golikova said that this project helped reduce the death rate from 15.2 to 14.7 per a thousand of people in 2007. But some experts find this connection doubtful. They believe, and with good reason, that the project has been reduced to patching holes in the health system, and to thoughtless and chaotic budget spending.

But state investments have been absolutely insufficient, even if they are record high. Famous doctor Leonid Roshal is convinced that they should be at least doubled, and tripled by 2015. Speaking at a RIA Novosti conference on April 3, he said that the Public Chamber Commission on Health, which he heads, forwarded a report substantiating the need for the proposed growth of investment to Dmitry Medvedev. The report proves that life expectancy and death rate directly depend on the funding of the healthcare system.

A report by the Institute of Modern Development (IMD) notes that in per capita spending on healthcare, Russia is lagging behind not only Western countries, but also the majority of East European states, which started a new life in approximately the same conditions as we did. But what quality of medical care can we expect if an insurance company pays 23.8 rubles (approximately one dollar) for a patient's first visit to the doctor, and 300 rubles ($12.5) for one day's stay in hospital.

We are 75th in the world in terms of medical expenses - a little more than three percent of the GDP. This compares with 15.4% in the United States, and 10.7% in France. The IMD report said: "Financing its health system like Latin America, Russia is promising its citizens a West European package of services. As a result, actually nothing is guaranteed to those who have neither money, nor pull."

Leftover funding is not the only problem. Even these small sums are not put to good use but are squandered thoughtlessly. There are no clear-cut goals or prospects because the reform was drafted at the top without consultations with experts, primarily the medical community.

Now Golikova is going to correct this mistake. In February, her ministry formed a commission to draft the concept of the health system's development until 2020, which included reputable doctors, such as Roshal. This gives us hope that in the long run the reform will be successful.

Nevertheless, experts maintain that the improvement of the healthcare system will not make the nation much healthier. In the WHO estimate, health depends on the quality of medical care only by one tenth; the rest is determined by other factors, such as a healthy lifestyle.

We are not doing well here. The average Russian over 15 drinks 15.2 liters of alcohol (in the pure spirits equivalent) a year, that is, almost five times more than in 1913. We are ahead of the whole world in this respect. In some estimates, 700,000 people die every year because of excessive consumption of alcohol, including fake booze.

Russia leads the world in smoking as well, and in teenage smoking, in particular. In the last decade, tobacco consumption has increased by 50% - up to 375 billion cigarettes a year. This adds about 400,000 new names to the list of deaths. In the estimate of Rossport (Federal Agency for Physical Training and Sport), a mere 11% of Russians take care of themselves and exercise regularly.

To sum up, we do not love ourselves, do not care about our health, and, judging by all, do not value our lives too much.




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