On a recent trip to the former Soviet Union, sponsored by People to People, Citizens Ambassador Program, I learned about socialized medicine, Russian style. As part of a multinational delegation representing the American Academy of Pain Management, I accompanied clinicians of many disciplines on a lecture tour to Russia, Hungary, and Czechoslovakia. Our group was headed by William N. Harsha, M.D., M.S., J.D., president of the Academy.
Upon arriving in Moscow, I was quickly ordered by a senior military officer to only videotape delegation members and not the airport. "Why not," I asked in Ukrainian. He simply replied, "You may speak English," and, "Those are the rules."
After settling in at the Moscow Hotel across from Red Square and Lenin's Tomb, the professionals proceeded to I.M. Sechenov Medical Academy where the educational exchange program began.
An hour into the program, I was invited to demonstrate techniques of manipulation in a hospital setting. The invitation was extended by Dr. Victor Tsibuliak, chief of the Department of Pain Syndrome Therapy, National Research Center of Surgery, Academy of Medical Science.
At noon, I was whisked away by Dr. Tsibuliak who escorted me to his office several blocks away. I couldn't help wondering if he was really KGB, taking me on a one-way trip to Siberia. I was relieved when I read the inscription on the building, "USSR Academy of Medical Sciences." Here, I witnessed a gastric ulcer patient being treated by MENS acupoint stimulation to the left hand. I was told that the microwave electrical stimulator was invented in the USSR and is the only one of its kind in the world. My mind flashed back to Dr. Strangelove and the "Doomsday Machine." I asked the patient if she was improving; she nodded yes.
"In America you have many drugs to treat gastric ulcers, but drugs are in short supply here in Russia, so alternative health care is becoming more popular," Dr. Tsibuliak said. I guess necessity is still the mother of invention.
That day, I learned that manual medicine was the Russian counterpart to chiropractic, and that the Russian practitioner must first graduate from medical school before entering the specialty of manual medicine.
Having been born in the Ukraine, and speaking the language fluently, I got along very well with Professors Grechko and Stepanchenko, both Ukrainians, heads of the Department of Nervous Diseases at Moscow's Medical Stomatological Institute. Privately, we spoke openly about the advantages and disadvantages of the Soviet Medical System.
In summary, Professors Grechko and Stepanchenko said the Russian system did not work. The proletariat still consisted of two classes: well-connected party members who receive premium health care at private clinics and in "reserved hospitals" (reserved for those who could pay); the rest of the folks have to make do with drug shortages and substandard care.
On touring one of Moscow's larger hospitals, the odor of what I thought was urine was so strong it would burn your nose. I asked an elderly woman mopping the floors what was in her bucket. "Water and ammonia," she replied; "We ran out of soap last month." One of our hotel employees put it best: "We get free health care, but there isn't any."
Incidentally, the average Russian surgeon earns 750 rubles per month, about $85. A loaf of bread costs six rubles, vodka 60 rubles, and a suit of clothes 2,000 rubles.
In closing, we Americans have it all. Unfortunately, it will take the Russians many years to even approach the quality of life we take for granted.
Nestor A. Stychno, D.M., D.C.
Warren, Ohio
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