Even more so - if suddenly, God forbid (!) - oncology. Prepare the rear today, now. In Europe, this case is much better, in Turkey (where I, of course, will leave sooner or later) - in different ways, but you can find adequate treatment.
What is here? And here, as in everything we have lately - a mess! Deep, stable, like the brains of an inhabitant.
I didn't want to write about it. I didn't want to at all. I’m starting only because writing about it in all health services is just wasting time (we saw it!), All these tips are cautious now (after they found out that this “shadow” fell on me), ceasing to contact little by little, “Olya, and zhahni-ka you article! send away. Because no article will help here. Well, apart from the fact that maybe a few hundred people who understand what's going on will once again grab their heads and start (I insist on this!) Looking for those very rears, and another couple of hundred will groan, groan, but that's okay will not change in your life. And it will be here in front of these very doors of the offices, which I will tell about later.
Oh doors! Oh, those treasured doors! My mother and I (who was diagnosed with oncology - at a late stage, as usual, because she was silent like a fish, and doctors and doctors were not particularly interested, but what is it, and what does it hurt her so much, and what is it? for a bump?) For a month now we have been sitting near these doors for five (I am not exaggerating at all and now I will tell you in detail about everything!) Hours.
Our clocks tick slowly by these doors. In general, there are so few of them - even among healthy people - and cancer patients begin to count them like maniacs, believe me. If you are ready to look under the cut, please. If not, don't look. Indeed, as far as I managed to understand, when I told several “close friends” about the situation, the moment of superstition is very strong (“keep me away”, “stick to him, unstick from me”, “I don’t want to communicate - there is a shadow on her”). What will you take from people? As they were a hopeless darkness, they remained. Until the occasion. Until the case when they find themselves in front of the doors. And humbly, like flocks of sheep, they will sit and hatch. Silently...
So I say again: get out of here! Take your parents away. I'm late. Will not survive the flight and acclimatization. But I know for sure: when my hour comes, I will be far away. Sorry for the preamble. Under cat.
Untitled medical institutions. Without names and surnames. See the paragraphs above for why. Because the devil-on-lez-but!
My mother fell five years ago. Strong and strong. Clinging with his foot to the boards that stuck out as footbridges in the place where now stands a stupid and useless shopping center, near our metro. The boards stuck out because the construction of the center was delayed for several years. Well, the residents of the adjacent houses did not want to admire the walls of the center instead of a public garden and a playground. And the planks-bridges, meanwhile, were sticking out. Mom fell, hit. After a while, a bump appeared. Examined that bump. They said it could be reborn. My mother pushed the problem into the far corner and lived quietly for a few more years. If someone now comes to mind the obvious, namely: "Well, right away, if only then, then we would say goodbye to the problem," I will answer right away. I know all this. But her silence and unwillingness to solve the problem was dictated even then by the fact that she knew the state of our valiant health care (she herself is a doctor), about how many cases of pathologies and new diseases we had and have simply because of the intervention of "doctors ".
Further. In September last year, my mother falls at home due to loss of consciousness. Why did she lose consciousness, you ask? I answer: the cardiologist of the local polyclinic prescribed a course of pills. The course on the third day provided, as it turned out later, a completely understandable reaction - a state of collapse of the body. Because drugs are incompatible with each other. It hit just the place where the tumor was sleeping safely. The tumor woke up, was delighted and gave metastases in different directions. Now, today, we see that there are metastases in the ribs, and in the spine, and even in the bones of the skull. What do you think happened next? Pains began. They are sent for x-rays and x-rays. X-rays honestly show osteoporosis. Treating osteoporosis. Nothing helps. The pain intensifies. Finally, after half a year, the surgeon and neuropathologist of the polyclinic, picking their noses, sagely utter: “Can’t we get rid of this old woman? Why don’t we send her to hell?
And behold, attention! I turn to statistics. cancer center in our region. Arrival at 7.30 in the morning, a war for a ticket to an oncologist, who, as usually happens, replaces the one who went to study, on maternity leave or on vacation. 5 (five, I'm not lying!) hours of sitting in front of the cherished door, receiving 7 minutes and sending to fig. To collect analyzes at the polyclinic, to the district police officer (which we have in the same position as the deputy of everyone and everything, and you need to sign up for it a couple of months in advance) for a certificate stating that there are no contraindications to the operation (20-year-old diabetes, bronchial asthma, obliterating enderteritis and much, much more) and in the end - a wonderful referral to a mammological center in the center of Moscow. We spent 4.5 hours in this mammological center. Sitting near the cherished door was brightened up by contemplation of the morning-afternoon TV block of the cherished 1st annal: "Fashionable sentence", "News", some other shnyaga like "Let's get married" (but not like them). Ahh, also "Dinner Time". Oil and vulgarity. I haven't seen for a long time. Paryvai-shmaryvai with mothers, women "transforming" in the hands of designers, katya andreeva ... Women - visitors to the mammological center - sit in the waiting room and watch, chained, this telly. What else is left? :)
So, let's summarize: 5 hours in the dispensary, 4.5 hours in the center. 9.5 hours. More. From the center of this they drove us to another dispensary. In another. For some reason. Well, okay, you have to. Signed up. We spent exactly 5 more hours (I'm not imagining it at all!) near, you guessed it, the cherished doors. Reception - the same exactly 7 minutes, during which all previous examinations were importantly taken (also, apparently, for examination), and a glass with a puncture was requested, which we did not have with us. I had to make an appointment with this doctor again ("The next day, the next day!", which turned out to be delayed by 10 days), bring glass and ... that's right, make an appointment with him again :) Again in ten days. On this cherished day, for 4.5 thousand we did a scintigraphy of the skeleton (which showed no presence of metastases), after hanging around in front of the cherished doors for another three to four hours for each visit here, we received from the doctor the diagnoses skillfully rewritten from previous conclusions, a few words with good luck and ... were sent to the hospital for treatment. Hospital in our county. Which is one with the dispensary, where we have been from the very beginning. Yes! Do you understand? Are you following a thought? Ah, yes! After all, exactly a month has passed since our first visit to that first dispensary.
And in the hospital, the deputy chief physician was sooo surprised. Why did we go through such a circle? How did it happen. With an air of importance, an iPhone of the latest model was taken into hand (I have the same one, so I know!), A number was dialed and it was said: “Misha, look what an interesting case. A 75-year-old patient with focal bone lesions and an old tumor passed quite a "It's a useless circle: our dispensary-mammology center, which does not belong to us - a different dispensary - and again returned to our district. How is it? After all, she should have been sent to us immediately. Time is running out ... Let me go to I'll send it to you tomorrow, and you and I will take note of this case and pass a sentence on the dispensary authorities.
Exactly at 11.30 we were at this doctor. They ran through the buildings and floors. They started a card, explained that we were by agreement. He sent us to his office, where he held a reception. He explained (they all, by the way, have a habit of starting any address with the words: "My good,"). He explained that at first he would accept everyone who came to him on coupons. From 11:00 to 15:00 we again sat near the next cherished doors. At the reception, which also lasted about 7 minutes, previous studies were studied and, in a special way, scintigraphy, it was solemnly said that it was too late to do the operation, but chemotherapy was needed first, and a new visit was scheduled for May 16 to take some more samples, followed by a consultation (!) with a chemotherapist. For the "follow-up consultation", as you probably already understood, you need to make an appointment too. In advance, yes.
Time costs: more than a month, approximately, according to my conservative estimates, 27-28 hours of sitting in front of offices, as well as, as you understand, nerves and a complete sense of hopelessness. Because everything is so. Everyone goes there, everyone goes in circles and several times. When at least some treatment begins, most do not care anymore.
Get out of here, get out...
© Photo by Marina Boitsova
The Russian AIDS vaccine, which has been in development for 15 years and whose trials have in principle already reached the finish line, will now be ready no one knows when, or maybe not be ready at all. Money, they say, ran out.
Where did they end up, I wonder? It does not happen that yesterday you had money, and today you look - but they are not. Unless, of course, you were robbed. After all, we all somehow calculate our budget, think over expenses, assume what we can spend our money on and what we can’t. That is why most still somehow make ends meet.
Although there are exceptions. You succumbed to courage and drank your money. Or lost in an underground casino. Then you can really say that the money was taken and ran out. But in this case, you are just a fool and you can only blame yourself. There are, of course, other situations. When suddenly something broke - a car, a refrigerator, a washing machine. Or when, God forbid, someone gets sick. In these cases, the money can also end abruptly, contrary to your calculations. But you won't call yourself a fool - fate itself played against you.
Anyone can get sick. Including AIDS. Well, what happened to our country, which developed a vaccine against this terrible disease? 650 thousand citizens of Russia are carriers of the virus - and they took the money for the medicine for them and ran out! And if only for them.
Literally the day before, I learned how cancer patients were told that the studies that they did in the hospital for free, now they will have to do for money. Or stand in an endless queue for weeks, or even months. And in this queue, these studies lose all meaning, because the most precious thing here is time. You lose time, and there will be nothing to treat. Well, if for money - then a couple of procedures will cost an amount exceeding the pension of a disabled person and all his benefits and allowances.
What happened? Imagine, they also said that the money had run out! Maybe a natural disaster happened to our country, and all this money went to eliminate its consequences? Hurricanes, floods, fires? Or all this at the same time? What happened? The ruble fell? Fell from the sky like the Chelyabinsk meteorite? There is nothing - no elements, no war.
We fight, as you know, for free, on vacation and at the call of the heart. Therefore, the explanation for suddenly running out of money is different. This is a story about that fool who decided to get drunk with the last money or lost everything in cards. We deliberately made this choice. This is not Obama or Merkel - we ourselves have "torn to shreds" our economy and our country. They themselves, with their own hands, wrote a budget, where they reduced all expenses, except for the expenses for the army. There was not enough money for all these vaccines. They didn't run out - they just didn't exist. There is money to kill. And there is no money for treatment. Therefore, my only advice to you: do not try to get sick!
Stop hurting and get better.
Stop losing hope in vain.
SMS is easy to admit
That we strive for the best.
We wish our friends good health often.
Let diseases go by.
Let the life of paint become more fun.
Let the good luck of the heap await us.
Get well soon,
And don't joke with me.
Chase away your illnesses
Don't meet them on the way.
You now promise me
No more pain in life.
Temper, smile
To have immunity!
Stop hurting, get well soon
Waiting for adventure, happiness, business,
Drink vitamins, tea with honey, lemon,
I'm tired of being without you!
Let's get rid of the temperature
If you want, I'll come, I'll help you as much as I can,
This cold has dragged on a little,
I'm looking forward to meeting you!
Come on get well
I wish not to get sick.
Your illness is not long
Don't forget.
Let's remember better
About my past
There were funny cases
I remember still.
Lots of time left
We have with you
The two of us will talk
Great together here.
Today you are sick - so be it
Knocking fists in the heart of sadness.
I don't want to see no one
And you just look out the window.
This state will pass.
And soon it will be the other way around.
Health will come back to you
From joy you will rush along the earth!
You are sick again, and there is pain in your eyes,
You suffer greatly from the disease.
What to do with yourself, how to restore health?
You're on this moment and you don't know.
But there is no need to exhaust yourself so much,
Charge yourself with positivity.
Well, you are treated, you give yourself time,
You will live happily ever after!
Being healthy is essential!
Let the spiritual power come with you
Energy, good mood,
May the environment be good.
Let love accompany
Luck opens its doors
And your life will be happy
Rich, unique!
It's been a week since you've been sick
It's very sad, it's hard for you.
But believe me, health will return again,
Will you smile at me again.
I wish you positive
Rise up your spirit quickly.
And from the thoughts of the oppressed pass by,
You will meet health on the way!
The body often hurts.
Soul OK - hurts stronger.
And right, not in vain
Rest is scheduled for everyone.
After all, the body, like the heart -
Needs warmth.
Don't forget to warm up
In love with ourselves.
If the disease caught you
In the middle of the way.
Don't think it's necessary
Know exactly what's ahead.
Don't refuse treatment
To your body:
Even the birds get sick
The main thing is a healthy mind!
The sickness will not overcome you, -
Don't you dare let her in!
Let the body get a little sick -
Let your body sleep.
Sleep heals everything, don't think
That spring is to blame.
The day after tomorrow will be morning
And you will full of energy, Hooray!
("Novaya Gazeta" No. 115/10)
INTERVIEWED BY LYUDMILA RYBINA
Russians take sick leaves less often than they did in the Soviet Union, and less often than they take now in the EU countries. But now we will pay even less for sick leave.
Once again, our state, which has proclaimed itself social, wants to save money on those who really work and live, counting their labor rubles, from paycheck to paycheck. The Ministry of Health has submitted to the State Duma a bill amending the law “On compulsory social insurance in case of temporary disability and in connection with motherhood.”
If the bill is passed, 100% of the average sick pay will only be paid to people with more than 15 years of work experience. Those who have worked from 8 to 15 years will receive 80% sick leave, and those who are less than 8 years - only 60%. So far, all patients with an experience of 8 years receive their money in full. This threshold has not changed since Soviet times - since 1972.
Well, do we have so many newsletters that the Social Insurance Fund (FSS) has a shortage of funds? It turns out that we take much fewer sick days than in Europe and than we ourselves took in Soviet times.
The Government adopted the Concept of long-term socio-economic development of the Russian Federation until 2020. The main goal outlined in this document is to increase the average life expectancy to 73 years. So far, we have 7 years less than in the "new" EU countries, and 12.5 years less than in the "old".
Does the new bill help achieve this? We asked Guzel Ulumbekova, executive director of the Association of Medical Societies for Quality (ASMOK), which brings together more than 20 professional medical communities.
How often and for how long our citizens are on sick leave is directly related to the health of the working population. Now, on average, one worker in our country has 7-8 days of disability due to illness per year (according to the Ministry of Health and Social Development), confirmed by sick leave. Before 1990 in Russia, each working bulletin published an average of 10 days a year. In the EU countries (according to the World Health Organization), this figure is now from 12 to 20 days a year, for example, in Germany - 14 days, and in the Czech Republic - 20. But the fact that our employees take fewer sick days does not mean that that we are healthier.
Our morbidity (it is considered not only for sick leave) in terms of 100 thousand of the population has increased by 46% compared to 1990, and the death rate of people of working age over the same period has increased by 40%. And there are fewer sick days. Russians are afraid of losing their jobs with private employers or losing a certain level of earnings, they do not apply for sick leave and carry the disease “on their feet”. Chronization of diseases, complications are the consequences.
And in order to achieve the goals of the Concept-2020, it is necessary to improve health, reduce the mortality rate of the working-age population at least to the level of 1990 (respectively, from 6.9 to 4.9 people per 1 thousand able-bodied population per year), i.e. almost 1.5 times. It has been calculated: if the mortality rate of the able-bodied population is reduced from 2010 to 2020 by 1.5 times, i.e. to level Soviet Union in 1990, the lives of almost 1.5 million people will be saved (who, even if we think only about the economy, will contribute an additional 1.2 trillion rubles to the country's GDP over this period). This contribution is commensurate with government spending on health care in 2009.
Foreign employers have calculated the economic effect of additional (in excess of government programs) investment in the health of workers - it is $4 for every $1 invested.
And in order for the Russians to live longer and die less, a sick person must receive qualified assistance, if necessary, then with a break from work. There should be no obstacles for this. The reduction in sick leave payments will stop people from going to the doctor: the income of 60% of the population is below 15 thousand rubles. per month. How can a sick person live on 80 or 60% of such a salary?
And how much should the state spend on medicine in order to improve the health of the population?
At least 1.7 times more than now, if we want to achieve the targets set by the government by 2020, namely, to increase life expectancy to 73-74 years and reduce overall ratio mortality to 11.0 (this is the number of deaths per year per 1000 population, today this figure is 14.2). Such indicators were in our country in the 80s. The indicators of the "old" EU countries, where the life expectancy of the population is 81 years, and the mortality rate is 9.2, are, unfortunately, unattainable for us.
In 2009, the state spent almost 1.380 trillion rubles on medicine, or 3.5% of GDP (GDP in 2009 - 39.06 trillion rubles). These are expenses from all sources: federal, regional and municipal budgets, as well as funds from compulsory medical insurance. On average, developed countries public sources spend more than 6% of GDP on healthcare - 1.7 times more even in relative terms. In absolute terms, i.e. per capita in dollars valued at purchasing power parity ($1 PPP in 2008 = 15.5 rubles), about $635 PPP is spent from public sources in our country, or 3.4 times less than on average in developed countries - $2184 PPP.
There are calculations that show that the indicators of health and mortality of the population directly depend on state investments in health care, in the area up to $1,500 PPP (at higher costs, such a direct relationship is no longer obtained). From these calculations it follows that in order to achieve the given mortality rate of 11.0, per capita spending on health care in our country should be at least $1,100 PPP, i.e. grow by 1.7 times.
How should this money be spent?
The first and main step that must be taken is to increase the salary medical workers. Today it is 21% lower than the national average (in Germany - 3 times higher, in the US - 5 times, in the "new" EU countries - 1.5-2 times higher). And this means that in Russia thinking, young, mobile personnel prefer to go to other sectors of the economy. In the very near future, especially given the demographic failure (decrease in the number of school graduates), we will inevitably face a shortage of income medical personnel into the industry. No doctor - no physical accessibility medical care.
Some experts believe that the number of doctors per capita is still high.
It is a myth. We should take into account that in our country more than 50% of doctors are of retirement and pre-retirement age, which means that they will retire in the next 3-4 years, and in the absence of sufficient replenishment, we will face a serious shortage of personnel. The morbidity and mortality of the population, respectively, and the need for medical care in our country are 40% higher than in the developed countries with which these comparisons are made. Accordingly, the number of doctors should also be higher. Today, there is already a catastrophic shortage of doctors in the countryside, an acute shortage of doctors in a number of specialties: phthisiatricians, oncologists, radiologists, radiologists, pathologists, anesthesiologists-resuscitators.
The second area requiring investment is the advanced training of doctors.
The third thing you need to spend money on is free medicines on an outpatient basis. People should not hesitate to buy medicine or, better, apples for a child. The patient should receive the medicine prescribed by the doctor mainly free of charge. This is a guarantee of the success of treatment, reducing disability and the risk of death at working age.
For the next two years, medicine will receive an additional 460 billion rubles, and this is very important for our healthcare system. But most of these funds will be spent on the material and technical base. And only about 26% - for the standards of treatment, of which the salary of doctors will be slightly increased. It is necessary to repair buildings and equip hospitals with equipment, but only after competent doctors are available to our population. Otherwise, it may turn out that there will be no one to work in the repaired walls.
Managers say that in our country, patients stay longer than in developed countries, they stay in hospitals, and this is very expensive.
The reasons for this bias are clear. In the hospital, the patient receives free medicines, there is someone to look after him. With outpatient treatment, a person has to buy medicines himself, and we do not have proper patronage at home. Therefore, our patients have only one chance - to receive the necessary care in the hospital. In the world, unlike Russia, there are different hospital beds. Intensive care is the most expensive, and here, indeed, the patient should stay for a short time. As soon as he is taken out of a threatening state, he can be transferred to a rehabilitation bed, which costs less, or to be treated on an outpatient basis. There are also long-term care beds for elderly people who need medical and social care, or, for example, for disabled people who are not capable of self-care. In our country, such patients often lie in therapeutic departments for a long time simply because they have nowhere to be discharged, there is no one to take care of them, they have nothing to buy medicines for. Therefore, it is possible to talk about reducing the stay of a patient in an intensive care bed only when the availability of other types of medical care is increased.
IN last years, albeit not as radically as required, but the cost of medicine grew. Did it give results?
Yes, the annual increase in healthcare funding by 10% due to the priority project "Health" made it possible from 2006 to 2008 to reduce mortality by 10%, increase life expectancy by 2.6 years and save 500,000 lives of our citizens. But I emphasize that in order to achieve the goals set by the government to improve the health of the population by 2020, it is necessary to increase funding by at least 1.7 times.
Where can you get money if you need medicine, education, science, and the army?
In the medicine of developed countries, the principle of solidarity works: the rich pay for the poor, the healthy pay for the sick. This provides a progressive tax scale, and in Western Europe taxes for wealthy people reach 50-60% of their income, and the rich pay not only from earnings, but also from dividends and property. And we have a flat income tax scale - 13%, and the collection of insurance premiums is not just regressive, but even has a landslide character, that is, if a person earns more than 415 thousand rubles a year, then insurance premiums over this amount are not charged at all. This means that health care for everyone, including the rich, is paid for by the poor and the middle class.
In the meantime, the rich in our country have such tax benefits, it is difficult to talk about the availability of medical care for the majority of the population. By the way, an increase in the tax burden on the super-rich would make it possible to cover the FSS deficit from the budget. Then it would be possible to avoid such an unpopular measure as shifting the financial burden of paying sick leave onto the shoulders of the workers themselves and businesses, especially since this can lead to a deterioration in the health of workers.
