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Russian Health Care Marred by Corruption

h Organization recommends at least 5 percent.

This is one of the few nations in the world where life expectancy has declined sharply in the past 15 years. The average Russian can expect to live only to age 66 at least a decade less than in most Western democracies, according to a 2005 World Bank report. For men, the figure is closer to 59 meaning many Russian men don't live long enough to start collecting their pension at age 60.

Mixed with alcoholism, heart disease claims proportionately more lives than in most of the rest of the world. Death rates from homicide, suicide, auto accidents and cancer are also especially high.

Russia's population has dropped sharply in the past 15 years, to below 143 million in what President Vladimir Putin calls "the most acute problem of contemporary Russia."

The state covers all Russians under a standardized medical insurance package, while well-heeled citizens can buy extra insurance and be treated privately.

In the Soviet era, patients occasionally rewarded doctors with money or gifts, but were largely guaranteed free treatment. The Soviet Union's public health system was, for a time at least, considered among the world's best.

After the Soviet collapse, the health care system declined as it failed to keep up with the western medicine. Today, many who can't afford to pay or bribe especially those in remote provinces may never receive proper care.

Experts here say new spending does little if it fails to tackle corruption.

"Corruption in health care is a threat to Russia's national security in the broadest sense of the word," said Yelena Panfilova, head the Russian branch of Transparency International, a global corruption watchdog.

According to a summer 2006 study commissioned by the group, 13 percent of 1,502 respondents who had sought medical help during the previous year had to pay an average of $90 unde
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