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Phantom pains. Why it's pointless to criticise European healthcare and yearn for the accessibility of post-Soviet healthcare


People living in Russia are usually surprised to learn that Russia has more doctors than most countries in the world. More than in America, France, or Korea. For those who doubt, I have evidence: numbers.

On average, in the world, there are sixteen doctors for every ten thousand people. In Russia, there are 37.

37 is an  approximate number, based on  data from the Russian Ministry of Health for 2018. Since 2018, the Ministry of Health has not published its data. Now, you have to go to Rosstat for the numbers, and the numbers it shows are positive. If you believe Rosstat, then the Ministry of Health was wrong and in 2018, Russia had not 37 but 48 doctors per ten thousand people. If we continue to trust Rosstat’s figures, by the end of 2022, Russia had 52 doctors per ten thousand people.

And this is after Russia shared hundreds of doctors with Kazakhstan in September of the same year!

Well, Rosstat delights us and inspires optimism.  I will continue to believe that there are 37 doctors per ten thousand people in Russia.

As for other countries, my calculations are based on WHO statistics. There are 24 doctors per ten thousand people in Canada, 23 in China. Europe varies: in Sweden, there are 70 doctors per ten thousand, 45 in Germany, 31 in the UK.

There are two doctors per ten thousand people  in Haiti, but you wouldn't want to go there. In Liberia, Togo, Niger, and Chad, there's one doctor per twenty thousand people. But if you combine Liberia, Togo, Niger, and Chad with Sweden and divide evenly, you'll get the world's average doctor-to-population ratio.

Kazakhstan, Belarus, Ukraine, Armenia, and Russia have mostly retained the Soviet healthcare system, with Soviet staffing standards. Following the example of Chad with Sweden, we'll take the average ratio of 37 doctors per ten thousand people for them.

37 is a good number. It ensures access to medical care. But then why do people go to Israel for treatment? (which has 36 doctors per ten thousand)

Yes, you probably guessed that quantity and quality are not the same. Calling a doctor to your home whenever you want, like a pizza delivery, but for free, is cool. But it's much better when your life is effectively saved.

In medicine, there is a standard indicator that allows us to assess the effectiveness of healthcare in different countries. Its name speaks for itself: "Probability of dying from cardiovascular diseases, cancer, diabetes, chronic respiratory diseases at the age of 30 to 70." Good medicine can control diseases. A forty-year-old person is unlikely to die from a heart attack if they quickly get to a good hospital.

The probability that a young thirty-year-old person living in Belarus will die from diseases before reaching the age of is 24%. But if they drive twenty kilometres from Grodno to Białystok and end up in Poland, everything in their life will be different. In Poland, the probability of dying from a disease decreases to 17%. Not bad  for a twenty kilometre journey.

The risk of dying from a curable, controllable disease by modern medicine is a clear indicator of healthcare quality.

In Israel, this risk is only 8%  and in Sweden, it's also 8%. But we remember that the doctor-to-population ratio in Israel is 36 per ten thousand, and in Sweden, it's 70 per ten thousand. How did the Israelis manage to achieve such results with fewer doctors is indeed remarkable.

Canada, France, and the UK, which don't excel in the number of doctors, boast a 10% probability of death from diseases before the age of seventy. Germany stands at 12%, which is still good. Geographically close Poland shows healthcare efficiency equal to China at 17%. However, Togo, Niger, and Chad are much worse. Their healthcare is so poor that it's almost non-existent, and the probability of death from diseases between the ages of thirty and seventy is high at 24%.

Oh, wait a minute, did you notice a little earlier that distressing number, the twenty-four percent probability of death from disease before the age of seventy, regarding Belarus?

In this astonishing fact, the main idea of the text you've read is highlighted: the probability of death from cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases between the ages of thirty and seventy in post-Soviet countries is the same as in the Republic of Chad, where there is one doctor per twenty thousand people.

Yes, in Germany, a doctor doesn't come to your home, and you may have to wait for six months to see an orthopaedic specialist. But objective indicators of healthcare quality suggest that there's no reason to miss the post-Soviet healthcare system. While you might have to wait for an orthopaedic appointment, in Germany, they won't let you die from pneumonia in three days. In Russia, it's a matter of luck, but the statistics are not reassuring.

In post-Soviet countries, there is accessible healthcare. If you want to get a check-up and receive treatment as part of self-care, the healthcare system offers you a variety of options, from genetic tests to quartz crystal treatment. Some of these are even covered by the state insurance program.

The problem is that these options don't significantly impact your health.

For treating conditions that critically affect your health, a different approach is needed. It requires an alternative to the current organisation of healthcare. It needs a filter for dangerous, disabling, and rapidly deteriorating conditions, as opposed to chronic, unpleasant conditions that don't deteriorate quickly.

An orthopaedic specialist can indeed have a six-month waiting period. A doctor may not need to visit your home. Emergency services should indeed be dispatched only to those who would die without immediate medical attention.

There's no perfect healthcare system anywhere on the planet. Modern medicine is very complex and expensive. However, a person living in Germany receives higher-quality healthcare than a person living in Russia, even if it may not seem that way initially.

I provide simple and interesting information about children's health on my YouTube channel ‘Will It Pass on Its Own?’

By: Maya Tserakulava, pediatrician


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