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News and Observer column overlooks big problems in Russian healthcare system

After experiencing frustrating problems with two doctors at a Cary, N.C. medical practice, Oksana Zhirnov decided to take some radical steps to get medical care.

Instead of finding a new local doctor, Zhirnov packed her bags and flew off to Russia to see a physician, she writes in an opinion column in today’s (Raleigh) News & Observer.

Apparently, Zhirnov had a very positive experience in the private Russian medical system—and paid only $250 (plus airfare) for several diagnostics, a diet consultation, and even French herb-based gall bladder tablets.

She believes that her private Russian doctors were so good because they face competition from Russia’s government-run universal health care system.

Based on this conjecture—and the fact that her mother, living in Russia, pays $1,200 a year for medical care—Zhirnov concludes:

My experience with these two health care systems leads me to believe that the American health care system is not as patient-focused as the private Russian system. Maybe a two-tiered system for medical coverage would improve the quality of health care offered to all Americans, like me.

There are excellent arguments being made for the creation of some kind of universal health care coverage in the United States. But Zhirnov’s column is not among them.

While Russia’s private health care system—where doctors are paid in cash by patients—may, in fact, be quite good, Russia’s public system is a corruption-filled mess.

As Alex Rodriguez writes in the Chicago Tribune, “Russia is an unhealthy nation, and its health-care system is just as sick. Its hospitals are understaffed, poorly equipped and rife with corruption.”

Rodriguez goes on to describe how bribery often greases the wheels of remarkably poor medical care, and cites an Open Health Institute statistic that 35 percent of money spent on health care goes to corruption.

A 2007 article from a Moscow Times correspondent published in the New York Times lays out how this corruption affects ordinary patients:

When Karen Papiyants lost his leg in a road accident last year, his medical nightmare was only beginning.

Although like any Russian he was entitled to free treatment, he says the doctors strongly suggested he pay $4,500 into their St. Petersburg hospital’s bank account, or be deprived proper care – and perhaps not even survive.

Faced with that choice, relatives of the 37-year-old truck driver scrambled to scrape together the money. But Papiyants said that did not stop the nursing staff from leaving him unattended for most of the night and giving him painkillers only after he screamed in agony.

“It’s nothing but blackmail and extortion on the part of doctors,” Papiyants said.

Beyond corruption, the Chicago Tribune article notes that in 2006, the state-run system ran low on prescription drugs due to bureaucratic problems. Only those with money to buy drugs elsewhere could afford to stay healthy. In 2007, a state hospital in Eastern Russia ran out of syringes. Again, only those with money to buy their own could be treated.

Given the dismal state of Russia’s public health care system, it’s shocking to see a call for universal health care based on this nation. A two-tiered system of the Russian sort might be good for those in the top tier, but relegating everyone else to bribery and poor care is not something any government program should ever do.

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Kronstadt Naval Cathedral

I went to Kronstadt, an island city with a long history, yesterday. I have a lot of photos to go through, but I’m posting a quick taste of what’s to come.

The Kronstadt Naval Cathedral stands behind a monument to Kronstadt's role in the uprisings of 1905-06 and 1917, and in the Russian Civil War.

The Kronstadt Naval Cathedral stands behind a monument to Kronstadt's roles in the uprisings of 1905-06 and 1917, and in the Russian Civil War.

The Naval Cathedral rises high above the rest of Kronstadt, distinctly visible from the long dam and bridge that connects the island to the mainland. Completed in 1913, the cathedral saw only 16 years of use before being closed in 1929. It was ransacked and defaced the next year, before being converted to a movie theater and later, a community center. In 2002, the Russian government placed a new cross atop the cathedral, and in 2005, the cathedral was reopened for services. However, the cathedral is now closed for extensive renovations.

The Grand Choral Synagogue

The Grand Choral Synagogue

The Grand Choral Synagogue

The St. Petersburg Grand Choral Synagogue, at 2 Lermontovsky Prospekt, is one of the largest in Europe. It serves a shrinking and aging Jewish population, in a city and country that have a history of anti-Jewish sentiment.

For about the first hundred years of St. Petersburg’s existence, Jews were officially forbidden from living in the city. Nevertheless, some lived in the city in order to serve Russian leaders, primarily as merchants or doctors.

Toward the beginning of the 19th century, restrictions on Jews were relaxed, though many were still required to live within the Pale of Settlement in Russia’s western region.

Throughout the 19th century, St. Petersburg’s Jewish population grew, and Tsar Alexander II granted the community permission to build a synagogue. However, construction did not begin until 1883, following Alexander II’s assasination, which triggered anti-Semitism and pogroms in the Pales of Settlement, though not in St. Petersburg.

Completed in 1893, the synagogue has witnessed wars and revolutions, but still tenaciously stands today. Having been neglected and looted during the early Communist period, the synagogue was restored between 2001-2003. According to the synagogue’s official history, on which much of this post is based, the synagogue’s various schools currently serve about 500 Jewish children, the future of St. Petersburg’s Jewish community.

Click here for photos from my visit to the Grand Choral Synagogue.

US will work with Russia to investigate journalist’s Moscow murder

Following the fifth anniversary of the Moscow murder of Paul Klebnikov, a Forbes editor who started the Russian-language edition of the magazine, the Russian government has agreed to accept help from the U.S. in investigating the killing.

One can only hope that the involvement of American investigators will help catch the assasins—and that Russia’s commitment to resolving the case will give journalists who continue to work under dangerous conditions in Russia some respite from the violence and intimidation they sometimes face.

New York Times on Russian Racism

As I was writing yesterday’s post about Russian racism, I was surprised to find that the American media had ignored this issue as America’s first black president visited Moscow. But today, the New York Times addressed Russian racism in a piece on Russia’s lack of Obama-mania:

In the background is the question of race, which Russians view through a complicated prism. For decades, Soviet propaganda hammered home the idea that the United States was an irredeemably racist country, as opposed to the Communist bloc nations. But Russia in recent years has been plagued by racist violence against people from the Caucasus region and Central Asia, as well as other immigrants.

Yet many young Russians, like David Zokhrabian, 21, who recently received a graduate degree in international relations from Moscow State University, said Mr. Obama’s race cut both ways. “Students in Moscow, they are pretty positive about this,” he said. “It’s cool, modern, progressive. All the students know American history, they know about segregation, so it shows us about democracy, how it can be.”

But the same cannot be said for average Russians, he said, adding: “It looks weird to them. They just think that America has gone crazy.”

Racism in Russia

As I was hanging out by the Gulf of Finland recently, a Russian acquaintance engaged me in a conversation about U.S. politics.

“Do you think Obama can solve the U.S. economic crisis,” he asked.

“I think he’s working hard on it – I think he has a good chance,” I responded.

“But,” the Russian persisted, “Obama is black.”

This exchange wasn’t the first time I’ve heard Russians question Obama’s competence based on his ethnicity (though I have relatively few conversations with Russians, in part due to my limited Russian skills).

More broadly, it fits into a pattern of racist attitudes held by some (but certainly not all) Russians towards people who are not white Europeans.

The media has overlooked this attitude, even as newspapers and TV stations have reported on Obama’s efforts to improve relations with Russia as he visits Moscow.

But for those harmed by Russian racism, this pernicious social fact cannot be overlooked.

Visibly foreign students, particularly Africans and Asians, sometimes face harassment and even violence in Moscow, St. Petersburg, and other cities, as documented by the BBC in several 2006 articles.

A lot of the violence is perpetrated by Neo-Nazis, such as the ones described in this TIME article. But the attitude goes beyond the skinheads.

There are also the subtle looks at minorities, the passing comments made about people from “the south” (Largely Muslims from Russia’s southern regions and the bordering former Soviet republics), the police harassment (see this article, for example), the recoiling of subway passengers from dark-skinned people, the racist chants targeting black players at Zenit football matches — all of which make Russia an unfriendly place for those who are not white.

One of our Russian teachers, a middle-aged woman, began class by asking each of her students what we had done the week before.

After we finished describing the museums we had visited, she said, “It’s great that you get out. The Chinese students never go anywhere. Only to the store.”

The same teacher also told us about the “problem” Russia has. People from “the south,” she said, are moving into St. Petersburg and other major cities and giving birth to many children. She worried that these people (who are strong and able to produce lots of kids because they don’t drink, as she put it), will soon outnumber white Russians.

Understanding today’s Russia

With President Obama in Moscow, America’s attention has been focused anew on its former cold war adversary. But nearly two decades after the fall of Communism, Russia remains an enigma to many Americans.

In an excellent example of explanatory journalism, Clifford J. Levy, a Pulitzer Prize-winning New York Times journalist, offers a simple six-step guide to “decoding Russia.”

Mr. Levy’s broad ideas about modern Russia are quite perceptive and accurate (no earth-shattering revelations), and should be read by every American who wants to gain a better understanding of the new Russia.

They reflect a strong understanding of what makes Russia tick – an understanding no doubt fed by Mr. Levy’s command of Russian and his efforts to reach out to Russian readers and sources.

Through all of Mr. Levy’s points runs a common thread – to understand Russia today, one needs to have an accurate understanding of Russia’s past. As I’ve written about before, this includes an appreciation for the massive toll of World War II – the Great Patriotic War – on Russia, and Russia’s perception that it bore the brunt of the conflict.

Beyond World War II, it’s important to acknowledge that Russians have a mixed view of their past – and that for many, the Soviet system had favorable aspects, while the current capitalist system has its pluses and minuses as well.

For more on what you need to know to understand Russia, including a brief overview of Russia’s take on former president and current Prime Minister Vladimir Putin (TIME Magazine’s 2007 Person of the Year), check out Mr. Levy’s piece.

Have your own questions about Russia? Leave them in the comments or send me an email, and I’ll do my best to answer them.