Schultz D S, Rafferty M P
Department of Pathology, MD Anderson Cancer Center, Houston, TX 77030.
Am J Public Health. 1990 Feb;80(2):193-7. doi: 10.2105/ajph.80.2.193.
Health and health care in the Soviet Union are drawing special attention during these first years of perestroika, Mikhail Gorbachev's reform of Soviet political and economic life. This report briefly describes the current state of Soviet health and medical care, Gorbachev's plans for reform, and the prospects for success. In recent years the Soviet Union has experienced a rising infant mortality rate and declining life expectancy. The health care system has been increasingly criticized for its uncaring providers, low quality of care, and unequal access. The proposed measures will increase by 50 percent the state's contribution to health care financing, encourage private medicine on a small scale, and begin experimentation with capitation financing. It seems unlikely that the government will be able to finance its share of planned health improvements, or that private medicine, constrained by the government's tight control, will contribute much in the near term. Recovery of the Soviet economy in general as well as the ability of health care institutions to gain access to Western materials will largely determine the success of reform of the Soviet health care system.
在米哈伊尔·戈尔巴乔夫对苏联政治和经济生活进行改革的“改革与新思维”的最初几年里，苏联的健康与医疗保健正受到特别关注。本报告简要描述了苏联健康与医疗保健的现状、戈尔巴乔夫的改革计划以及成功的前景。近年来，苏联婴儿死亡率不断上升，预期寿命不断下降。医疗保健系统因其冷漠的医护人员、低质量的护理以及不平等的医疗服务可及性而受到越来越多的批评。提议的措施将使国家对医疗保健融资的贡献增加50%，鼓励小规模的私人医疗，并开始试行按人头计费融资。政府似乎不太可能为计划中的健康改善承担其应有的资金份额，而且受政府严格控制限制的私人医疗在短期内也不太可能做出很大贡献。苏联经济的总体复苏以及医疗机构获取西方物资的能力将在很大程度上决定苏联医疗保健系统改革的成败。
