It also good to read about the mistakes and trauma that some countries health care systems have or are facing. This is a 212 page report by the way.
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The Health Care Systems in Transition (HiT) profiles are country-based
reports that provide an analytical description of a health care system
and of reform initiatives in progress or under development. The HiTs
are a key element of the work of the European Observatory on Health Systems
and Policies.
Development of the Russian health care system
In czarist Russia, the overwhelming part of the population consisted of
impoverished rural farmers. Serfdom was abolished in 1861; however this did
little to improve the conditions of peasant farmers. In 1864, as part of the
liberal reforms enacted by Czar Alexander II, public medical care and other
social services were established for the rural poor under the local district
assemblies (Zemstvo). Numerous medical stations emerged, staffed by a doctor
and several auxiliary personnel, as well as some hospitals.
The services were tax financed and were free of charge. By 1890, about 16% of Russian doctors
worked in the zemstvo system. By 1913 there were 4367 rural medical stations,
4539 feldsher posts, and 49 087 hospital beds (35). This network, while
inadequate to cover the needs of 80 million people, provided a solid basis upon
which the Soviet system was later built, as it demonstrated the feasibility of
providing medical care as a free public service provided by salaried health
care professionals (35).
Industrialization brought increased urbanization and a growing proletariat
to a number of cities. Bismarckian style social insurance for medical and
sickness benefits was established in 1912 and covered 20% of industrial workers.
In general, the State tended to foster initiatives focused on public health,
sanitation and the control of infectious diseases rather than care delivery.
Medical care facilities and health workers were insufficient to satisfy the needs:
in 1913 there was one doctor for every 6900 people on average throughout the
Russian Empire. There were 1.3 hospital beds per 1000 people, and the
geographical distribution of these facilities was highly uneven.
In the first part of the twentieth century, the cumulative experience of First
World War, the civil war and the subsequent famine and mass epidemics were
devastating in health terms, having destroyed much of the existing infrastructure
and created a long- term health burden. Shortly after the Revolution, 3 million
deaths resulted from 20 to 30 million cases of typhus fever alone (35)...
More:
http://www.euro.who.int/document/e81966.pdf