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Saturday, October 22, 2016

Why the Americans and the Russians is rapidly dying out: the secrets of health rankings

The Russian healthcare system pursues the blow by blow. Literally yesterday it became known that the respected medical journal The Lancet has put our medical system in place 119 out of 188 possible. Just adjacent to war-torn Syria and Ukraine.

But it turns out it’s not so bad. The Bloomberg international news Agency has identified Russia has in the last, 55th, place on the effectiveness of health care. And this happens not for the first time. Calm can only the fact that the US and the tail 50.

photo: Gennady Cherkasov

In fact, this ranking of the effectiveness of the health system in different countries (Health Care Efficiency Index, we first learned in 2014 when Russia got into it for the first time. And, with the last place (when it was 51). A year later, we went up a notch, giving “the palm” from the end of Brazil. A year passed and we are again at the bottom.

So, a bit about how reputable the Agency came to this conclusion. The main indicator, which was calculated, what country were the life expectancy of the resident. And if in any country it is less than 70 years, it simply misses. Because of that, our Russia was not there until 2014. However, this year, the life expectancy of Russians has grown to 70.5 years. And today here she fell to 70,37 of the year despite a small increase in state spending on health care.

Thus, for example, according to Bloomberg, in many countries, health spending even less than we do — and life expectancy is higher. For example, Jordanians spend on medicine is less, and live more than three years longer. Even in Kazakhstan at a lesser cost to the healthcare system, people live on average 1.5 years more than in Russia.

And here, for example, in the U.S. some of the highest costs in the world for medicine of 17.14% of GDP ($9403 per person). However, a particularly effective such spending can not be called — the United States took only 50 of the 55 seats.

Bloomberg offers as the main criterion of life expectancy in the country. And here the numbers speak for themselves. The average life expectancy in Russia in 2015, according to Rosstat, amounted to 71,39 year, which is lower than the planned state Program of health development (72,02) and 8-10 years less than in Europe, says Director Foundation of independent monitoring “Health”, member of the Public chamber of Russia Eduard Gavrilov.

According to Gavrilova, if you compare with other countries, we have a very high mortality rate from circulatory diseases: 6 times higher than in Canada, Germany, Spain, Portugal, 2 times higher than in Estonia. And even in Afghanistan and Albania the death rate from cardiovascular disease is lower than ours. In 2015, our country increased mortality from cancer. The expert reminded that for 2013-2015 in Russia reduced more than 100 thousand patients, mainly specialized in first place in district hospitals. By the end of 2015 the volume of paid services exceeded 500 billion rubles, which is almost five times higher than the 2013 level. On the background of annual increase in healthcare financing 20% in 2012, volume of medical care somehow reduced: only 2015 in the outpatient sector is fixed at 45.7 million doctor visits less 8 million less prophylactic. And admissions to hospitals decline in 2015 more than 800 thousand.

– It is unclear why in 2014 we have suddenly revised the indicators of provision of medical personnel in the state Program “Development of health care till 2020” in the direction of decreasing: from 44.2 to 40, 2 to 10 thousand of population. But in fact the number of doctors even lower by 37.1 per 10 thousand population, and the reduction of health workers is still ongoing – continued Gavrilov.

But the Director of the Institute of health Economics HSE Larisa Popovich said the “MK” that the rating is very strange, and made it not quite correct: “He very successfully appeared before the American presidential elections. I believe the main purpose of this rating is to show the ineffectiveness of Obama’s policies, but Russia just got under the hand. In one of the American articles says: that’s what brought us Obama! This internal political struggle, inter-showdown that we have no relationship. Of the 214 countries in the rankings were only 55, which ensure the life expectancy of people in more than 70 years. But life expectancy and health care costs – things not entirely related. Because mortality depends not only on the level of health, but the diet, incomes, the quality of drinking water – a lot of what. In General, this rating is methodologically not an objective assessment. Besides, some of our officials said that it used data from unofficial statistics. In short, I would seriously not treated. As for the American health care system, it has always been inefficient. It is very expensive, the most expensive in the world, but it does not give the results that are expected of her. Americans, like Russians, are contemptuous of maintaining health, they are frivolous, overeat, few take the time to physical activity. All of this contributes to improvement of the population. But in the countries caught in the first place (Hong Kong, Singapore, Spain, people not only eat right, but in General look after their health. Besides, the Asians have their own genetic characteristics. Please note — their situation worsened Sweden. There life expectancy is so high and healthcare costs are rising. But in the end it turns out that the system is less effective. But it not so!”

And yet there are other ratings that do not consider the Russian health care system efficient. “According to the who (world Health Organization), long time we did not rise above 130 positions, – says the head of the Russian League of Patients Alexander Saversky. – I believe that while the state does not determine the correct paradigm in the healthcare system, and will be destroyed. And today we have no single vector of development. According to who, in Russia, 3 Tril. rubles of health expenditure borne by the state and 3 Tril. the population — at our free health care! No one understands the system we are building, private-public, public or private? And in a situation of uncertainty all collapses. It is impossible to build a system of requirements, responsibilities and expectations. Doctors disoriented patients.

Just recently, the League of Patients published a nationwide survey which investigated the attitude of Russians to our health care system. The results were much worse than the gloomiest expectations of skeptics. For example, the question “how Often do you pay for medical care?” answers from “always” to “rarely” gave a 95% (!) respondents. “We naively thought that such 50 percent, – throws up his hands Saversky. – 36% to pay for care in public medical institutions offer “often”, 25% “sometimes”. But I was even more amazed that the prices of drugs for 80% is a barrier to their purchase. And if the person had not bought the drug and not treated, he will get treatment 10 times more expensive, and in the hospital.”

In addition, respondents were told how much they are actually waiting for doctors — despite all the electronic queue. For example, the main specialist, which is required by law to accept a patient on the day of treatment, 30% are waiting for several days waiting for a 10% week and 10% a few weeks! Overall, only 31% receive the assistance of a therapist in the same day. Welcome to the professionals 23% of the respondents wait several days a 25% for a few weeks, 7,5% – a month and 10% a few months . Research expect 24% for a few days, a 10% a week 26% several weeks, and 9% a month 15% a few months. Clinic respondents appreciated alot, emergency medical care — at the five hospitals — four. However, on a 10-point scale.

Overall, 66% of Russians believe that medical care in our country for 5 years has become less available and less quality. So surprised by the shameful places in international rankings, of course, nothing.

As for the rankings, Asian countries, Hong Kong and Singapore, for example, in last people live an average of 82,65 year, and medicine is spent not so much – 4,92% of GDP. As much as $ 8 billion is allocated to health and other benefits for the elderly. According to Bloomberg, in recent years, the aging of the working population, the Singapore government is increasing spending on health care is constantly. The government subsidizes household spending on medical care, if residents are choosing high quality medical services, using a special system of savings. “I think the Singapore system is the least imperfect in the world”, – said head of consulting firms working in the health sector in Asia and the Pacific Jeremy lim. Well — I probably am.


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