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These devastating health concerns have not gone unaddressed, but government reforms have
changed the face of public health without producing adequate results. The Glasnost period of the
1980s illustrated the obstacles of state health care, as the system was highly stratified by location
and political status. While there was an abundance of medical staff, most were poorly trained and
lacked proper medical equipment. Moreover, corruption plagues the system, as the commonality of
low salaries among medical workers led to the normalcy of bribes, causing the quality of treatment to
be determined by the patients wealth. In 1993, President Yeltsin signed a decree entitled On
Immediate Measures to Provide Health Care for the People of the Russian Federation,
constitutionally changing the previously socialist model of health care to include compulsory medical
insurance. While private funding and new free market providers was intended to promote both
efficiency and patient choice, public health was allotted less than 1% of the budget in 1995, while
the United States budgeted more than 12%, limiting the resources to finance the new law.
Russias health has scarcely improved since the 1990s, but the gravity of the situation is growing
more apparent. In 2011, Prime Minister Vladimir Putin pledged more than 300 billion rubles ($10
billion dollars) in the next few years to improve health care in the country. These funds will go
towards modernization of medical institutions, increasing access to medical services, and increasing
salaries of medical personnel. However, the November protests of Putins plans to close over 20
hospitals and fire about 7,000 health care professionals in the Moscow area confirm the shallow
intent of health care reform, leading 5,000 Russians to march in the city streets. Already struggling to
maintain domestic peace over international tensions and a poor economy, this public upheaval may
persuade Putin to reevaluate the urgency of further health care reform.
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