Demise of Russian Health Capital: The Continuity of Ineffective Government Policy

摘要

Health capital in Russia is in steep decline. Today the Russian population is decreasing by more than 700,000 per annum. Life expectancy has decreased significantly since it peaked in the mid-1960s. Infectious diseases, including an emerging HIV/AIDS epidemic, are threatening to worsen Russia's health crisis and further overwhelm a dilapidated health care system. Both Soviet and Russian government policies aimed at preserving health capital have consistently failed. Government policies and intervention have contributed to the crisis. The purpose of this research is to find a possible explanation for the continuity in ineffective government policy regarding health care. The analysis indicates that a paternalistic political culture permeates the political process. As a result, the government is free to pursue its own agenda without a significant degree of accountability to the population. Issues affecting health capital are not a priority of the Russian government, which has resulted in short-sighted and uncoordinated government policy and programs that are under-funded. Long-term improvements to Russia's health capital will require a shift in the Russian political culture. State-society relations must evolve to allow and encourage greater interaction between state officials and the general population. Without government accountability or individual responsibility, health capital in Russia will continue to decline.