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Married With Bears's avatar

As far as private clinics, in my Russian city they are only for specialties: blood work beyond what the public hospitals offer (e.g. Israeli, American, etc. screenings that aren't in the approved list for the public system), infertility, cosmetic surgery, etc. There is a "western" private general hospital but it catered mostly to foreigners and had a pay-for-service / western insurance model. Dentist offices are now almost all private. They provide the required services on the public plan (mostly pulling teeth I think) and normal dental care for pay.

Primary care is done in-home. There are no general hospitals, and hospitals are much smaller than their U.S. counterparts. There is a maternity hospital on my street, and a cardiac care hospital not far away that specializes in heart surgeries and rehabilitation. If you are sick, you call to a facility based on where you live. We have a lot more ambulances than U.S. cities. They are crewed with a physician. Response times are reasonable. For example, if your child is sick, they'll ask you their temperature when you call in (and people know to do so beforehand). If it is a high temperature, a GP will visit you in your home within usually four to six hours. Emergency situations have responses similar to other western countries.

Russian people as a whole are better informed about first response care than Americans in my experience. Everyone has classes in school on how to do CPR, how to recognize different medical problems, and what to do.

Russian hospitals are more holistic than western ones I think. I had a friend who had a stroke and required an operation here. I also had a family member who had a heart operation in the U.S., and visited them in the hospital there. The Russian hospital recovery room was organized for visiting. There was a tea pot and cups, and chairs to sit on during visits. There were a lot of house plants at the end of the hallway in the window. There is an effort to make recovery areas feel like home. The U.S. hospital was very sterile. The idea of a house plant in the patient room hallways there is inconceivable to me.

On quality and paying for service, there's one thing about corruption in Russia that I think westerners do not understand. It is always possible to do something by the normal way. By that I mean for example, some years ago I was smoking a cigarette too close to the entrance of a metro (underground subway train) station. You must be at least 20 meters or something from the entrance. The station officer came and told me that, and ordered me to come into the police station inside. There was a fine for the offense. I gave my passport. The normal way to pay is that the fine (about $100) is recorded against your passport number. If you ignore it, you will eventually have problems: when you try and renew your passport, when you try and go through passport control, etc. The officer also offered a "quick" way: pay the same fine in cash, and it wouldn't be recorded. Is it corruption? Theoretically, no, the officer could apply the payment in the system (there is a unified payment system for utility bills, speeding fines, and everything else). All corruption in Russia is generally like this (the normal way is possible).

And so it is with medical care. There are lots of extras you can pay for if you need a procedure done, but you don't need to pay any extra. Examples are a single room for recovery, perhaps lots of other things. The general idea is that people do pay for operations as "extras". A friend of mine's grandmother needed serious and extensive surgery last year, and my friend paid some thousands of dollars (USD) extra for the care. But the grandmother would have gotten adequate care without it. Part of it is that everybody knows that doctors and nurses are seriously underpaid in the public health system, and so people generally offer money in order to make sure their care is as attentive as possible.

But there are several surgeons and doctors in my circle of people close to me. I know a young man who is in medical school now. They are no different than physicians in the west. The paid "extras" are just part of the system that has evolved to make it a career that's solidly middle / upper-middle class financially. It is a weird American thing to think that doctors should be paid in the top 1% - there are lots of smart people in Russia, being a doctor doesn't seem like a unicorn kind of thing like the Americans take it to be. There are lots of doctors, too (Americans restrict their supply of physicians artificially to keep pay high). A doctor expects to make the same as an engineer or any other professional with comparable education (and an American physician with a Bachelors in Social Science before entering medical school doesn't really have "8 years of higher education").

Teachers are the same. You don't have to pay anything for your kids to get an education. But people know that teachers are underpaid. So they typically make it up in different ways by supporting whatever "extras" the teachers offer. For some, it's organizing a two week math camp in the summer. For others, it's after-school tutoring. For some, it's a literary club and fees to "rent" books that are reused by the teacher year to year. It's not the best system, but it's organic and it works. And the government isn't spending $2 trillion USD a year that it doesn't have, nearly guaranteeing the eventuality of hyperinflation and societal collapse.

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Chima's avatar

About Question #35: Just to add a little to what @simplicius76 has already said. Ethiopia has always held a fascination for Russia and that dates all the way back to early 1700s when Peter the Great adopted and treated as his own son a freed black slave called Abram Petrovich Gannibal.

This adopted African son of Czar Peter would take on a military career, train as an officer in a French Military Engineering School and eventual rise to the rank of General-In-Chief in the Imperial Russian Army and so would his own son too, Ivan Gannibal who was a commander in one of the Russo-Ottoman Wars of the 1700s . More importantly, Gannibal is the maternal great-grandfather of Alexander Puskhin, one of Russia's most revered poet.

The key thing to understand is that most Russians thought Gannibal was of ETHIOPIAN descent, but modern research shows this not to be case as I wrote several months ago:

https://sharpfocusafrica.substack.com/p/the-afro-russian-army-general-abram

Russians helped Ethiopia to repel two Italian invasions partly because of the fascination with Gannibal-Pushkin apparent "family connections" to the African country and partly because it was a fellow Orthodox Christian nation.

Modern day Ethiopia is friendly both to the West and to Russia. This is a legacy of the fact that Western nations (UK, USA) did help the country during a devastating famine that occurred in the middle of Ethiopian Civil War (1974-1991), which killed 1.5 million people.

Like in many cases in Africa, the civil war was trigged by a military coup in September 1974, which led to the dissolution of the 704-year-old Ethiopian Empire and its replacement with a Marxist-Leninist state. Disaffected Marxist renegades picked up arms and fought soldiers of that Marxist state.

Many of the current ruling elites of Ethiopia today were once Marxist rebels. After the civil war ended in 1991, and USSR collapsed, and Eritrea was allowed to break away, the Ethiopian rebels who seized national power, jettisoned their Marxist beliefs and began to follow market economics.

These rebels-turned-national leaders formed close bonds with the Western world that provided loads of food to feed the starving during the famines of the 1980s. Boris Yeltsin's Russia was too preoccupied with its own problems to even pick up the diplomatic ties that the Soviets had with various African states.

The current conflict in Ethiopia---which AU mediators have managed to freeze--is simply a fall out of change in the configuration of power in the country. The Marxist rebels that came to power were led by ethnic Tigray people. Long time leader of Ethiopia, Meles Zenawi, who died in 2012, was ethnic Tigray.

Despite being an ethnic minority, Tigrays have been running the country since 1991 through the formerly marxist Ethiopian People's Revolutionary Democratic Front (EPRDF).

Retired Lieutenant-Colonel Abiy Ahmed Ali is from the ethnic Oromo majority of Ethiopia, which had not been in power for ages. He rode to power through the Tigray-dominated EPRDF. As an elected Prime Minister, he relied on Tigrays who also formed the backbone of the post-1991 Ethiopian Armed Forces.

And then he did something that the Tigrays will consider to be a betrayal. He dissolved the EPRDF dominated by Tigrays and distanced himself from its "ethnic federalism" policy, which stipulates that autonomous provinces must be created based on territories inhabited by each of Ethiopia's ethnic groups. Problem is that certain territories are not 100% inhabited by one ethno-linguistic group so that has led to many problems.

Without going into too much details, the Tigrays refused to join the new Prosperity Party, which Prime Minister Abiy Ahmed Ali formed and that caused the Tigray War (2020-2022). The collective West has always had good relations with EPRDF, especially when it was controlled by the now deceased Prime Minister Meles Zenawi. The Tigray ruling elites ran EPRDF, therefore the US backed them.

For Russia and China, it was quite simple. They supported the Ethiopian state. Prime Minister Abiy Ahmed Ali represents that state. End of story.

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