OBSERVATIONS ON HEALTH-CARE ISSUES IN THE FORMER SOVIET-UNION

With the demise of the Soviet Union, the health care systems that rema in in the component countries face many problems not seen in Western c ountries since the late 1800s or early 1900s. The author traveled to s everal countries of the newly independent states (NIS) of the former S oviet Union and observed problems in hospital sanitation, public healt h, medical equipment and supply distribution, food quality and safety, and the delivery of medical services. The author makes several sugges tions to improve the delivery and quality of health care services in t he NIS. His recommendations include: developing health care standards similar those that were first implemented in the U.S. by the American College of Surgeons in 1919; the use of practice guidelines and outcom es measures; building on organizational structures from the old state health system for professional and public health education; and restru cturing the old delivery system to form a new delivery model based on centers of excellence and group practice managed care. Because of so m any needs, the author stresses keeping reforms as simple as possible s o as not to overburden the health professionals. The author also calls on Western countries, particularly the U.S., to assist with the rebui lding of the health care delivery system of its Cold War adversary as it helped Germany and Japan after World War II. Such aid should be vie wed as humanitarian in nature and should be distributed to private/pub lic partnership efforts. The author says recent Congressional proposal s to cut off aid in order to influence the Russian government's positi on on nuclear technology sales to Iran and the Chechen war are short s ighted and will only hurt the citizens of these countries while having little or no impact on the leadership.