Soviet health care and perestroika

'Perestroika' is the term used to describe Mikhail Gorbachev's programs to restructure those aspects of Soviet economic and political policy that have proved inadequate. One of the areas targeted for reform is the Soviet health care system. Despite early successes, the Soviet system of universally available, socialized health care has deteriorated since the 1970s. Infant mortality has risen significantly and cardiovascular disease and alcoholism have reached epidemic proportions. Inequities exist in the delivery of services, with one standard of care available for certain elite groups and a lower standard provided to the general population. Corruption and 'under the table' payments to providers are common. Soviet medicine has also lagged behind other countries technologically. Only 50 CT (computerized tomographic) scanners are available in the entire Soviet Union. Other types of equipment, both permanent and disposable (such as syringes) are in short supply or nonexistent. Hospital care is inadequate and AIDS (acquired immunodeficiency syndrome) continues to spread, with no realistic hope that it will be contained. In order to deal with these inadequacies, it has been proposed that the health care system be made less centralized, and more decisions be made on a local level. Further, a greater share of the gross national product will be devoted to health care. To some extent, there will be privatization of health care services in the form of health care 'cooperatives' owned by their staff members. Essentially these will be fee-for-service operations. However, the success of these ventures will depend on the willingness of the people to risk the insecurities of unemployment and inflation in return for the promise of increased material wealth. Success in the reform of health care will depend in large part on the future improvements in the Soviet economy in general. (Consumer Summary produced by Reliance Medical Information, Inc.)