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History of Science and Engineering

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THE EVOLUTION OF ATTITUDES TO THE SEMASHKO MODEL IN POST-SOVIET RUSSIA
M.N. Korotkova

The study focuses on the Soviet health care system, named after its founder, the Semashko model. The research subject is the history of the development of attitudes to the Semashko model in post-Soviet Russia. The author of the study systematizes opinions and arguments; traces the evolution of attitudes to this model; identifies and analyzes the factors that caused the changes. The article uses: general documents, speech by top public officials, official statistics, and results of sociological surveys, including the author’s survey. The study used general scientific methods, the method of sociological survey, as well as a system-structural approach. Critics of the Semashko model (usually market economists) focus on the fi nancial insolvency of the Soviet healthcare system: ineffi cient use of resources, lack of incentives for labor productivity and low quality of work. Supporters of the Semashko model appeal to its social and demographic achievements, territorial optimization, an effective training system, and the principle of solidarity. The overthrow of the Semashko model in early post-Soviet Russia was due to public demand for market-oriented models, epidemiological transit, demographic shift (the aging process of the population), a constant underfunding. The main reasons for the revival of interest are a new epidemiological wave, the inability of the market to solve systemic health problems (unsatisfactory quality of services, chronic underfunding and a constant shortage of personnel). The relevance of the Semashko model is based on its historically proven effective functioning in the conditions of epidemics (centralized nature of management, extensive hospital beds and stuff); consonance of the ideas of preventive and personalized medicine; social orientation (guaranteed public and free services). These factors are of interest to the "medical and "historical" parts of the scientifi c community, medical specialists, Russian population and the government. The main conclusions of the article can be used in scientifi c research on the history of medicine and state policy in the health care system; in the development of training courses for students of higher educational institutions of medical specialties in "History of Medicine" and "Political Science".
Keywords: Semashko model, soviet healthcare, social policy, modernization of healthcare, optimization of healthcare, new epidemiological wave, socially oriented models, underfunding, shortage of personnel, social survey.


DOI: 10.25791/intstg.6.2022.1359

Pp. 10-18.

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