by Yuri N. Maltsev
In 1918, the Soviet Union became the first country to
promise universal "cradle-to-grave" healthcare coverage, to be
accomplished through the complete socialization of medicine. The "right to
health" became a "constitutional right" of Soviet citizens.
The proclaimed advantages of this system were that it
would "reduce costs" and eliminate the "waste" that stemmed
from "unnecessary duplication and parallelism" — i.e., competition.
These goals were similar to the ones declared by Mr.
Obama and Ms. Pelosi — attractive and humane goals of universal coverage and
low costs. What's not to like?
The system had many decades to work, but widespread
apathy and low quality of work paralyzed the healthcare system. In the depths
of the socialist experiment, healthcare institutions in Russia were at least a
hundred years behind the average US level. Moreover, the filth, odors, cats
roaming the halls, drunken medical personnel, and absence of soap and cleaning
supplies added to an overall impression of hopelessness and frustration that
paralyzed the system. According to official Russian estimates, 78 percent of
all AIDS victims in Russia contracted the virus through dirty needles or
HIV-tainted blood in the state-run hospitals.
Irresponsibility, expressed by the popular Russian
saying "They pretend they are paying us and we pretend we are
working," resulted in appalling quality of service, widespread corruption,
and extensive loss of life. My friend, a famous neurosurgeon in today's Russia,
received a monthly salary of 150 rubles — one third of the average bus driver's
salary.
In order to receive minimal attention by doctors and
nursing personnel, patients had to pay bribes. I even witnessed a case of a
"nonpaying" patient who died trying to reach a lavatory at the end of
the long corridor after brain surgery. Anesthesia was usually "not
available" for abortions or minor ear, nose, throat, and skin surgeries.
This was used as a means of extortion by unscrupulous medical bureaucrats.
"Slavery certainly 'reduced costs' of labor, 'eliminated the waste' of bargaining for wages, and avoided 'unnecessary duplication and parallelism'."