Tuesday, May 30, 2006

Law, Legislation, and Lunacy

For your reading pleasure, today's installment will be a brief recount of my experience with the Russian healthcare system. FYI, I'll be writing up a few words on immigration, borders, and more such things by tomorrow.

I know. You're probably snickering at the compound: "Russian healthcare" seemed to me too little more than an oxymoron, even for much of the time when I've been living here. But then, as are so many of our preconceptions and prejudices, they're laid bare for their inadequacy in the face of their subject. I went to the pharmacy to buy medicine, and to the hospital for my wife's sonogram (yes, she's pregnant! Very.), and in both cases, I saw something very different than what I expected to find.

While the characterization of Russia as a backwards country is in many ways accurate with regards to its economic development, the medical system seems to be flourishing. Despite a free alternative being offered by the government, nobody that can afford private medical care makes use of it. The consequence is that there are a number of private clinics offering service and medication for next to nothing, even by Russian standards.

Examples: I pay a $20 co-pay plus insurance and doctor's fees every month for ONE of my medications in the US. Here, I pay about $10 for the exact same product with a Russian-language lable, no insurance fees, no perscription, no overhead, no doctor's fees, nothing. Straight, honest, easy. For another, I paid about the same $10 dollars, even a bit less, for my wife's sonogram. No appointment, no hassle, we just walked in, saw our little baby, got our paperwork, then left.

Why are things like this? For starters, the Russian government realized that they weren't able to take care of people after the USSR let its outer territories go. Consequently, the medical regulations they have are much less prohibitive, and the legal climate much less prone to lawsuit-frenzy. Don't get me wrong, the Russians would love to regulate things more, and the Russian lawyers would wet their pants to have the kinds of opportunities offered in the American system, but for now, things are basically OK - quality medical care is available and relatively inexpensive (even free, if you don't mind standing in lines for hours).

All this just makes me wonder: how much does my medication actually cost in the US, AFTER counting doctor's visits, co-pays, the litigi-mania insurance (for the PRODUCERS), medical insurance costs (for me, the CONSUMER), etc.? I figure that on my insurance rate and number of perscriptions, about 80 dollars a month, give or take. I'm horrified, and I hope lots of other people are too. These kinds of imbalances speak volumes about the ways costs rise when price discrimination become possible.

It's nice to have medical coverage of the quality in the US, but big numbers tend to help people remember the kind of helpful aid drug companies and medical professionals have in the form of government regulations, not to mention the harm done them by insane awards in lawsuits. Allowing people to buy their medicine wherever they want is a great start, and dropping the perscription requirement would be a wonder as well.

But ah, it's very hard to be angry about it when you're not stuck with the costs involved :-P But heck, I'll be back state-side soon enough; and while my return to the "land of the free" will find it anything but free, I'd like to think that filling it back up with people like me helps make it more so.

3 comments:

Tim said...

I'm going to have to ask for forgiveness if my English and writing has gotten less coherent - It's been a while.

Robert Nanders said...

Easily affordable? If normal medications in Russia cost $10 dollars a month, that might be more than the equivalent of $100 dollars a month. Nevertheless, it's impressive insofar as it reflects the costs of production more accurately than US prices.

Daniel Haszard said...

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