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Soviet healthcare

August 21, 2009 – Comments (7)

This was going to be a reply to the "Socialist Medicine" post by whereaminow, but for some reason that post got deleted. The original article referred to by the poster is here: "http://mises.org/story/3650". 

"I know that the views I express will be unpopular, but having some (thankfully, limited) first-hand experience of the two systems, I hope my observations might complement the grim picture painted by Maltsev.

Where I agree with Maltsev 100% is about special hospitals for the "nomenclatura". It was one of the ugliest features of the regime, and it was a major reason for the regime's stagnation and subsequent collapse.

Next, I want to make an observation about Maltsev. Quite frankly, I don't trust this character at all. And  I will never believe in his competence as an economist even if you tell me that holds ten Harvard diplomas. "An ecomonist working in Gorbachev's reform team" is a complete personal charasteristic. To give you a cross-cultural reference, this job description raises the same flag as "accountant working for Enron" or "Undersecretary of Emergency Preparedness woking for the Bush Administration". As someone directly responsible for the mess he created, he is now simply trying to cover his arse by blaming his predecessors. Besides, he knows that if he gives some credit to the old system, his current employer won't appreciate it. So he has every incentive to paint the picture in the darkest colors.

My opinion is that socialized medicine is the better way to run healthcare, but both systems had their strong and weak points. Also, both systems have room for improvement, and I mean those improvements that don't change the nature of the system.

With regard to general medicine, the Soviet system beats its American counterpart hands down. For simple tasks, routine check-ups, preventive care, dentistry, psychological counseling, diagnostics, and small surgeries done manually, this system proved very efficient; moreover, it consumed very little money. So strong were the fundamentals of socialized healthcare that even today, after 20 years of efforts by Maltsev and his collegues to destroy it, it is still functioning better than the HMO system.

High mortality rates in the USSR (and even higher in today's Russia) are mainly caused by alcohol. For those Russians who don't smoke, drink, or do drugs, life expectancy is not that much lower than for those Americans who also stay dry and clean. 

The situation is different when it comes to complicated surgeries. American hospitals have better equipment than Soviet hospitals, and most surgeries are done here on a very professional level. Soviet surgeons were not inferior to their American colleagues, but they lacked equipment. The kinds of instruments they had were appropriate for the 1960s, but when time came to re-tool the industry, the Soviet planners failed miserably. By the mid-1980s the planning mechanism was in ruins, thanks to the efforts of Maltsev and his likes.

An apple-to-apple comparison does not do full justice to the Soviet economic system. The fact is that even before the Bolshevik revolution, Russia was a backward country, and the two world wars did little to help matters. It is easy to observe that some parts of the economy (basically, those parts that depended on technology) were below the Western standard. If you run the same comparison of Tsarist Russia and America in 1913, your results will not be any different! I encourage you to look up medical statistics, life expectancy, etc. for those years when Lenin was still drinking coffee in Zurich dreaming about a proletarian revolution, and report your findings.

Also, it is important to realize that health care was never a top priority for the Soviet regime. Healthcare spending amounted to 3-5% of GDP, and that GDP could also, quite frankly, be a little larger. The Health Ministry was doing what it could, but each time it requested additional funding, the regime had some other priority such as strengthening the organs of state security, building a new aircraft carrier, or supporting the Nigerian Communist Party. By the 1980s the economy stopped growing as a result of corruption on the top levels of government, and with 3% of a stagnant GDP the healtcare too could only stagnate.

For the ordinary citizen, socialized healthcare worked better overall than a capitalist system would. For a very modest amount of money the state created a functioning healthcare system which was free to everybody. Nobody had to worry about not getting treatment due to a lack of money. There wasn't such an item in a family budget as "unforeseen medical expenses". The system would have worked much better if the Soviet government were less totalitarian and ran the country with at least some common sense and competence.  

Regards,

Z.

"