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Cablegate: Private Healthcare in Russia Still in Its Infancy

VZCZCXRO5743
PP RUEHAST RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHTM
DE RUEHMO #2503 2341321
ZNR UUUUU ZZH
P 211321Z AUG 08
FM AMEMBASSY MOSCOW
TO RUEHC/SECSTATE WASHDC PRIORITY 9621
INFO RUEHYG/AMCONSUL YEKATERINBURG 3282
RUEHVK/AMCONSUL VLADIVOSTOK 2920
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHPH/CDC ATLANTA GA

UNCLAS MOSCOW 002503

SENSITIVE
SIPDIS

DEPARTMENT FOR OES/IHA
USAID FOR GH, E&E
HHS FOR OGHA

E.O. 12958: N/A
TAGS: TBIO SOCI SCUL RS
SUBJECT: PRIVATE HEALTHCARE IN RUSSIA STILL IN ITS INFANCY

SENSITIVE BUT UNCLASSIFIED, NOT FOR INTERNET DISTRIBUTION

1. (SBU) Summary: Fears of the demise of Russia's system of
state-sponsored health care are premature. The country has an
enormous potential market for private health care, but the sector is
still growing. Private care is primarily available in outpatient
fields such as cardiology, dentistry and orthodontics, urology,
obstetrics/gynecology, plastic surgery, and drug dependency
treatment for those few who can afford its higher costs. Quality
varies widely by the type of care and from one facility to another.
The legal framework necessary to support a broad network of private
medical institutions with a system of private, or even government,
insurance is still lacking. End Summary.

2. (U) In recent years, Russian media has criticized the state of
Russia's health care system. Although the constitution provides for
free health care at state expense, patients commonly pay for many
supplies, even in state hospitals, including needles, bandages, and
medicines. The rise of an alternative system of private health
services has aroused fears in some corners that these enterprises
may someday replace state-sponsored health care entirely. President
Medvedev, speaking to World War II veterans on August 18, attempted
to dispel that thinking: "Fears that medicine will be handed over to
business are groundless. That will not happen. If private
businesses want to invest in health care, they can set up their own
private clinics. But the state system of medical support will
continue to exist has it has existed."

3. (SBU) Several highly regarded private health clinics operate, but
mostly in large cities such as Moscow and St. Petersburg. The best
known in Moscow are the European and American Health Centers, as
well as the Center for Endoscopic Surgery and Kidney Stone
Treatment, one of the oldest specialty private clinics, which opened
in the early 1990s. Many Russian patients consider the quality of
care to be higher in private facilities. However, a number of
doctors told us that although facilities and equipment are often
better at private health care centers, inpatient care is equal to or
better in state centers. Public institutions performing
cardiosurgery and cancer treatment were singled out as superior to
private counterparts. Doctors consider Russia's inadequate medical
education system to be a common barrier for all healthcare
providers, public and private.

4. (SBU) Russian health professionals see a variety of impediments
to the development of widespread private health care. According to
one contact, the main obstacle is a lack of government regulation.
Legislation has compelled the state healthcare oversight agency
Roszdravnadzor to delegate its regulatory role in quality control to
regional authorities over recent years, and regulatory resources are
not yet sufficient in the regions to ensure adequate enforcement.
Another contact from the Society for Evidence-Based Medicine more
optimistically noted that if the constitution were implemented
properly, private health care would develop over time as both
government and private clinics attain equal access to insurance
funds. With a lack of legal enforcement, however, such development
appears to be unlikely in the near future. Another contact
suggested that high property values in the big cities will
eventually compel the government to sell off most of its state
clinics to insurance companies to make way for private centers.

5. (SBU) Comment: Our limited survey of health practitioners and
NGOs in Moscow suggests that private health care is available for
those few who can afford it. However, quality of care varies widely
by specialty. For the broader population, a system of private
health care facilities with an integrated and functioning insurance
network is a long way off. Though some speculate that the
government will be tempted to sell off state clinics in large cities
to insurance companies as real estate prices soar, it is not clear
if the legal framework for this exists.

BEYRLE

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