What Soviet Medicine Teaches Us

[Day 5 of Robert Wenzel's 30-day reading list that will lead you to become a knowledgeable libertarian, this Mises Daily was originally published August 21, 2009.]

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'."

To improve the statistics concerning the numbers of people dying within the system, patients were routinely shoved out the door before taking their last breath.

Being a People's Deputy in the Moscow region from 1987 to 1989, I received many complaints about criminal negligence, bribes taken by medical apparatchiks, drunken ambulance crews, and food poisoning in hospitals and child-care facilities. I recall the case of a 14-year-old girl from my district who died of acute nephritis in a Moscow hospital. She died because a doctor decided that it was better to save "precious" X-ray film (imported by the Soviets for hard currency) instead of double-checking his diagnosis. These X-rays would have disproven his diagnosis of neuropathic pain.

The rest is here:
What Soviet Medicine Teaches Us

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