If you went to school in the 1980s like me, chances are your teachers taught you to dislike Russia and Africa. Maybe it was the stories of extreme poverty, primitive (by middle class American standards) living conditions, and government oppression that fueled your aversion for these countries. Or, maybe our teachers and politicians relied on stereotypes about these countries to make the U.S. look superior to them. Well, I’ve never been one to go along with the herd—I’ve always wanted to visit Russia and South Africa (Africa is a continent, not a single country).
 
In 2016, I visited Russia, and in 2019 I visited South Africa and a few other African countries. St. Petersburg and Moscow, Russia were as cosmopolitan as any American big city, and the rural areas of Russia resembled some rural areas in America. Johannesburg and Cape Town, South Africa also resembled large American cities. There was nothing strange or exotic about Russia or South Africa. They are poor countries compared to the U.S., but unlike the U.S., they, at least in philosophy and on paper, look to provide health care to all of their citizens as a human right.
 
At Least “They"Support Universal Health Care
 
No vacation of mine to a foreign land would be complete without studying its health care system.
 
Russia and South Africa have major issues with health care access and quality. In the early 20th century, Russia provided free health care to all of its citizens, but later national reforms entitled “all Russians to free healthcare with Obligatory Medical Insurance (OMI). Employers contribute around 2-3% of employees wages into a social tax, of which a small proportion is put into a healthcare fund.” (So, not free.) In practice, however, many take out their own private medical insurance, known as Voluntary Health Insurance (VHI).”
 
The South African government, this month, “published a bill outlining a national health insurance program it intends to roll out over the next seven years. Private insurers will be able to continue operating until the system is fully implemented, after which they will only be able to offer coverage for services that complement those available from the state.
 
The current South African health care system includes a public and private system of hospitals and doctors. Funding comes from fees charged for services and government contributions.
 
The Russian health care system consistently ranks at the bottom among developed nations. It’s common to hear tales of drunken doctors, unsanitary conditions, and bureaucratic chaos. Russia’s private (market) health care system also struggles with quality issues. 
 
South Africa’s public health care system suffers from a doctor brain drain (doctors train in South Africa, but leave to work in other countries), and sub par public health facilities.
 
If Only Americans Could Understand Health Care
 
Americans may not want to trade their state-of-the-art, overpriced health care for Russia or South Africa's, but no country in the world is looking to emulate America's health care system. When I told our Cape Town, South Africa guide that I paid $7,000 a year for health insurance even if I did not receive any medical care, and had to pay the first $7,250 of medical charges if I did need care, he stopped complaining South Africa’s health care system, and said, “that’s awful.”
 
American health care has a so-so reputation around the world, in terms of results and costs. The 2019 World Health Care Index rating for the U.S. is just six points higher than the rating for South Africa. And it’s a well-known fact that America’s health care is the most expensive in the world. And if you think, you get what you pay for, you should know that life expectancy in South Africa (63.98) and Russia (71.36) is lower than in America (79.77), but not by much.
 
You may think: it’s great that Russia and South Africa support universal health care, but what’s the point in providing bad health care to all? That’s not a concern for American health care, despite the scare tactics used by the U.S. health care status quo. America can give high-quality health care to all of its citizens; we just don’t believe we should.

Tags: American Health Care, health care