The numbers of the World Bank, even though considered by the key note as “educated guesses” are still the best available data. The main message of the discussions was that the next few years for Russia look grim and one aspect that was discussed was that this already strongly impacts the social situation of Russian citizens.
The healthcare aspect was not touched upon specifically during this debate, but one of the Eucomed working groups is looking at the impact of the financial crisis on the Eastern European countries including Russia. At present, the group is working on a workshop which will take place on October 6th in Brussels at the MedTech Forum to discuss growth and opportunities in those countries with regional experts (more details available soon).
The group was interested in the fact that in 2006, the Russian government decided to reform its healthcare system with a shift towards quality through the revenues coming from the oil business. On the other hand, out-of-pocket expenses and under the table bribes have increased dramatically over the past few years and with the crisis increasing the vulnerability to poverty of Russian households, it can be expected that the inability of less healthy people to pay unofficially for care will increase.
From a healthcare system point of view, if we assume that co-payments can be used as an index of countries’ underdevelopment, the structural reforms recommended by the World Bank in the above mentioned report to modernise the country, will therefore also have to think about the financing of the healthcare system. This system today is un-competitive and made up of very fragmented payment systems with sparse and irregular coverage for certain regions. Reforms are needed, but these should not only focus on the quality of the care but also equity of the access of care. Should Russia implement essential structural changes in other sectors, one point should be the introduction of a system whereby financial resources would be pooled differently to ensure an equitable and efficient re-distribution, which would finance quality healthcare for the good of the general Russian population. This might take longer than expected.
As the European Commission was commenting during the debate: fundamental human rights are on the top of the list for the EC as far as Russia is concerned.
– Aline Lautenberg , Legal Counsel Eucomed