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Poll of Moscow: Free Healthcare Taxes Muscovites

by Shelley Mika and Neli Esipova

More than a third say healthcare access is bad

The Russian Federation's constitution guarantees citizens the right to free healthcare, which probably sounds like a good deal to Americans who face high premiums, deductibles, and co-payments -- or have no insurance at all. But on closer inspection, the grass may not be greener on the Russian side of the hospital lawn.

According to a recent Gallup Poll of Moscow residents*, about one in five (22%) Muscovites feel the availability and accessibility of healthcare in Moscow is good. More than a third (37%) feel it is bad; 39% are neutral.

Before the Soviet Union collapsed in 1991, healthcare was free for all citizens. But since then, government funding has declined dramatically -- leaving patients to absorb costs not covered by government rubles.

It may come as no surprise, then, that Muscovites' ratings of the accessibility of healthcare have declined since 2003. Two years ago, nearly one in three Muscovites (31%) felt the availability and accessibility of healthcare was good -- nine percentage points higher than in 2005.

Quality of Care

When it comes to healthcare and medical facilities, Muscovites are slightly more positive. Of the two-thirds (67%) of residents who say they have used medical or healthcare facilities in Moscow in the past 12 months, half (51%) were satisfied with the quality of care and treatment they received in their last visit. Twenty-three percent were dissatisfied, and a quarter (25%) were neutral.

In one regard, these ratings have actually improved since 2003, in that just 42% of Muscovites who sought medical care were satisfied with the quality of care and treatment on their last visit. Since 2003, the number of Muscovites reporting they are dissatisfied has stayed the same.

Bottom Line

The decline in government healthcare funding in Russia has serious implications for its citizens. Medical staffs are underpaid, equipment is outdated. What's more, the long-term reduction of healthcare budgets is a likely contributor to Russia's rising mortality rate. According to an article in the Wall Street Journal, between 1989 and 2005, Russia's population dropped from 147 million to 143 million, and some demographers predict that number could plummet to 100 million by 2050. Life expectancy, according to the CIA World Factbook, for Russian men is 60.55 years -- quite low for a developed country. Life expectancy for men in the United States is 74.89 years.

But the convalescence of Russian healthcare may be on the horizon. In early September, The Moscow Times reported that President Vladimir Putin had earmarked an extra 115 billion rubles to raise doctors' salaries, update hospital equipment, and improve healthcare services in general. Shortly thereafter, Health and Social Development Minister Mikhail Zurabov reported healthcare spending in 2006 is forecasted to double from 53.5 billion rubles to 101.1 billion rubles.

Will those budget increases for healthcare benefit Russian citizens? The short-term answer will unfold as changes occur in 2006. Far more important however, are the long-term effects of the healthcare system on the citizenry, and whether Russia's population will continue to dwindle or recover and thrive.

*Results based on interviews with 1,008 Moscow residents, aged 18 and older, conducted in January and February 2005. For results based on this sample, one can say with 95% confidence that the margin of sampling error is ±3 percentage points.


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