The demise of Russian health capital: the continuity of ineffective government policy

Abstract

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 healthcare system. Soviet and Russian government policies aimed at preserving health capital have failed consistently. Government policies and intervention have contributed to the crisis. The purpose of this research was to determine a possible explanation for the continuity in ineffective government policy. The analysis indicates the influence of 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 government. The consequence, therefore, is short-sighted and uncoordinated government policy and programs that are underfunded. Long-term improvements to Russia's health capital will require a shift in the political culture. State-society relations must evolve to allow and encourage greater interaction between state officials and the general population. Without government accountability or inidividual responsiblity, health capital in Russia will continue to decline.