Affordable Medical Care in Russia 2013

Russian pharmacies haven’t changed much since 2000.  This pharmacy has two windows... no impulse items, stationery, candy, as you find in US drugstores.  You never have to wait for a prescription to be counted, packaged, and labeled.

 

A full week of medical appointments

After a long rest from tests and doctors, this week Larissa had me busy.   First,  the phlebotomist, then an annual echocardiogram to check on my pacemaker, later the  cardiologist, and finally a visit with a psychologist who follows heart patients.

Much of medical care in Russia is delivered by neighborhood clinics, some of it free, some paid.  There is a crush of mainly old people every day, and naturally the care tends to be impersonal and hurried.  It’s my good fortune that the expanded federal heart complex was sited just a few miles  from our apartment.

The Almazov Heart, Blood, and Endocrinology Center for Northwest Russia

I knew this first as a simple heart hospital in an old building where I stayed three times for the mandated 10 days after arrhythmia or edema.  Now it is housed in a government funded complex that looks like any modern medical institution in the US or Germany.

How people view their doctors...

Doctors are viewed much more matter-of-factly than in the US.  There isn’t a reverential attitude. Perhaps that’s because medical education is more available and most doctors still do not become wealthy.

No GPs

Medical care is provided in a clinical setting.  I don’t know of any general practice doctors.  No one takes the time to follow your health year in and out.  It’s up to you to figure out how to proceed through the complicated medical system of clinics, technicians, and specialists.

I now view a family doctor as a luxury that a cautious, well-read, and sensible person may do without.  Here all medicine is provided by clinic doctors, specialists, and technicians.  The Russian system is more impersonal but a lot cheaper, and usually effective.

Clean, modern, but not plush medical care...

Many doctors in Russia are women, while men predominate as surgeons.  A cardiologist appointment lasts half an hour. 

My cardiologist is highly qualified, and a kind woman, whom I’ve seen intermittently for most of my time in Russia.  She has a small office in Almazov where patients wait in comfortable chairs in the hall, but - typical for Russia – with no magazines or music.  She does all computer entry and copying during the appointment, Twith no secretarial help. 

Much less expensive than in the States...

Prices are surprisingly affordable - to an American - if  you stay away from the clinics for foreigners.  Russians view as normal that you can call 03 and have a doctor come to your apartment, no charge.  Same for an ambulance ride.

My ledger for last week...

(1000 rubles recently exchanged for $31.71)

Clinical and Biochemical Blood Test	1200 rubles	$ 32
Cardiologist	800 rubles	$ 25
Echocardiogram	1500 rubles	$ 50
Cardiac Psychologist	800 rubles	$ 32
		$139

I’ve never seen a pharmacist in Russia.

Doctors indicate what to buy, but rarely write prescriptions, which are only required for strongly additive drugs.   Pills are sold by women clerks in the same boxes they are shipped in (not counted out of large bottles to little plastic safety containers as in the States).

Are medicines more affordable in Russia? 

Almost always!  I take these heart medicines every morning.  I feel lucky to not pay American prices. 

Diuver (Torasemidum) US brand Torsemide, loop diuretic... 10 mg... 789 rubles = $24.88 . Pliva Co., Zagreb, Croatia.

Hebilet (Nebivolol) US brand Bystolic, beta blocker... 5 mg... 758 rubles = $23.90. Berlin-Chemie, German subsidiary of Menarini, Florence, Italy.

Verospiron (Spironolactone) US brand Aldactone, potassium sparing diuretic... 148 rubles = $4.67. Gedeon Richter, Budapest, Hungary.

American braggadocio...

It’s irritating that some Americans continue to spout that the US has the best medical care in the world.  This reflects ignorance.

Russian medical care is in reach of most of the population, but is what I call spotty.  If you are lucky, or smart enough, and have the initiative to find the best doctors, medical care in the USA or Russia can be very good. 

Ironic...

Russia is gradually shifting to more platna (paid for) services, and higher prices... Ironic, as finally the US is trending toward a more egalitarian system.

Let us know!

My medical care in Russia has been one of the bright spots  of living here the last 13 years.  How do you view your country’s system?  Let us know!

 

Technorati Tags: Phlebotomist,echocardiogram,cardiologist,arrhythmia,edema,general practice doctors,pharmacist,Diuver,Hebilet,Verospiron.

Advice from Russia to Potential Expats

In America vacations were few and short, but in Russia it’s possible to spend all summer at a beautiful lake next to the Volga.

It’s almost thirteen years since we arrived in St Petersburg from New Jersey.  Given our situation it was for the best.  Still, I caution others who are considering the expat life. 

In New Jersey...

I didn’t realize until after arriving in Russia  how much I enjoyed living in Flemington.  I worked in a small, pretty, safe town and knew many friendly people... politicians, policemen, customers.  I was always yammering in English and Spanish, sometimes taking an hour to get back from the post office because of chats on the street. 

I could stop in a luncheonette and give and get cheerful helloes and smiles.  We belonged to the Presbyterian Church and enjoyed the Sunday service and relished the church suppers.  I got respect as a businessman and active community member that I could never find in Russia... an old foreigner of no consequence stumbling with the language.

The MacDonald Insurance Agency, Inc. was a one man business whose potential was limited by my heart disease.    My association group disability claim was denied, and living costs were rising.  The INS was sending my wife to Russia, and I didn’t want to go back to a lonely single life.

In Russia...

Nowhere anywhere could I have a more loving relationship than I do with Larissa.  It is better to live in a strange country than live without her.  She is attentive and caring and has made my years with heart disease much happier than they would have been.

As a non drinker I don’t see the friendly exuberant people that only exist here with alcohol flowing. Russians are less outgoing than Americans, but have much in their culture that I admire.  Our summer village is beautiful.

We live comfortably on my Social  Security, a small NJ teacher pension, and Larissa’s Russian pension .  We  have state medical insurance, which covers hospitalizations and some doctor’s care, but surgeries, drugs, and dental are our expense. I have received good to excellent medical care including intricate valve surgery while living here.

A FEW THINGS TO CONSIDER BEFORE YOU GO

Tentative becomes irrevocable...

A tentative decision can within a year or two become nearly irrevocable.  So... go for a year or less.  Just like buying property in Florida, don’t burn your bridges before you know what life will be like for you overseas.

Contrast your destination with London and Paris...

Know that life in a cosmopolitan enlightened city can be vastly better than elsewhere.  St Petersburg has beautiful buildings and culture, but lacks many of the amenities of modern life. 

To get a clear contrast, try comparing your destination with London or Paris. For instance...

• London and Paris are walking cities.  Being a pedestrian in St Petersburg is a high risk adventure.
• The British are famous for their civility.  The Russians often display no manners, not even holding a door for another shopper.
• Books and newspapers are available in many languages in England.  I have yet to spot an international newsagent in Peter.

Knowing the language may not be so helpful as you expect.

If you know the language of your host country that doesn’t assure friendly opportunities if the culture is standoffish  Russians are not usually gregarious, and can be wary of social groups.

A charitable, outgoing people are easier to mix with.

In the US many people are charitable towards their church, help the needy, and raise money for such organizations as the American Heart Association.  Russia is a paternalistic country where people are much less likely to help others, and are not likely to take the initiative.

How safety conscious is your new country? 

Not every culture values safety as much as yours. Russians are poor at checking for dangerous conditions and fixing things before accidents occur.  You will have to live with this attitude every day.

Your potential climate and level of pollution.

I miss the clear and often beautiful seasons we had in New Jersey.  St Petersburg  is often overcast, damp or humid, and polluted.

A lot of people are attracted to the challenge of getting through a winter in Maine or Russia, but it gets old after a while, especially as you too age.

Missing the views

Are you truly aware of how much you value the hills, mountains, seaside of your own country?  Living in a flat country with unattractive housing, adorned with few flowers, can have a depressing effect for someone from a scenic environment.

If it is to be, it is up to me!

With me, love trumped all other considerations, but still... it’s wise to think things over before you make the leap!

Comments and emails...

You can comment by clicking below, or feel free to send an email using the Wibiya strip on the lower margin.  I’m eager to know your reactions.  Thanks for responding!

Technorati Tags: St Petersburg Russia,Flemington NJ,Flemington Presbyterian Church,disability claim,INS,MacDonald Insurance Agency,Inc,heart valve surgery,American Heart Association,Social Security,London,Paris.

Social at 70 with InterNations in Russia

Tactless but true...

“I guess you’re the oldest person here”, a man from Central Europe said glibly.  I was chagrinned, as I have rarely thought of myself as looking that old.  I had just arrived at my first InterNations Get Together, this one at the Liden & Denz Russian Language School in St Petersburg center.

My Global Mind...

The comment was off putting, but didn’t lessen my enthusiasm for InterNations. It’s purpose is to socialize, thereby ‘Connecting Global Minds.” Unlike other organizations, InterNations emphasizes meeting in person more than mainly communicating on the Internet.

Before male expatriates had no such group as provided by the IWC, the International Women’s Club, which continues to be an excellent option for women.  The IWC is expensive and can have a rarified club-woman atmosphere.  InterNations  welcomes men and women of all ages, with no restrictions as to whether you are a local or an expatriate. 

A full membership works out to around $5.25 a month and includes monthly get-togethers with free food and two drinks!  Part of the costs are carried by sponsors for the monthly events. 

An outgoing group...

I joined InterNations a few years ago but only started attending some meetings last October. 

InterNations was the idea of three friends in 2007.  Now it is run by the founder, Malte Zeeck of Munich..  Its expansion now includes 300 cities worldwide, including 35 just in the United States!  They have most of their meetings in bars and restaurants.

Most of the men wear jeans, shirt, and sports coat.  The women, typical in Russia, are more elaborately dressed, and include many Russian women in their twenties.  The hot food and hors d'oeuvres were lavish.

My faltering  Activity Group attempt...

This fall I started a Book Club activity group.  I wanted to see if through InterNations there could be a local subgroup that would enjoy and swap books.

Our first author was Agatha Christie.  We met twice to talk over her writing, once at the English language Mayakovsky Library on Fontanka, another time in a hotel lobby.  I couldn’t generate much interest, so I resigned as book club leader.

Friends in high places are hard to find...

In November we had our get together from the 18th floor of the Azmut Hotel with a scenic view overlooking downtown St Petersburg.  I was planning to meet some Book Club members, as well as a few Scots, and figured I’d recognize them by their name tags.  First, I headed for the scrumptious hors d’oeuvres, planning to find people after having my vertical supper.

Suddenly the hotel management turned out most of the lights so we could get a better view of the city.  Under cover of darkness, more people lit up.  The resulting smoke in the darkened room  made reading name tags impossible!

Take the leap!

As people get older I think it’s sensible to put more money into convenient transportation than in earlier years.  When I go to a meeting I take the metro and walk, but take a taxi home. 

It’s never too late to join a good group, but I especially encourage younger readers to jump in the fun and give and get the most they can from InterNations and not wait until they, too, are the oldest guy in the room!

Questions to cogitate...

Is there an InterNations chapter near you?

How do you feel about smoking during a meeting?

Has your age ever made you feel a little out of place?

Comments and Emails...

I much appreciate your comments.  They’re encouraging! Also, you may send an email to me, or connect with Facebook or Twitter, using the ingenious Wibiya strip below.

 

 

Technorati Tags: InterNations,International Women's Club,Malte Zeeck.

Leaving the Nest Unlikely in Russia

 

 

Security or independence? What we value affects whether and when we leave home.  But, many Russians never are emancipated this way.

Most Americans teens are eager to leave home.

Americans help with college, but at some point they expect their children to sink or swim on their own. The parents want their own independence, filled with hobbies, travel, and activities... not encumbered with adult children at home.

This home-leaving ideal has been tempered by hard economic times and permissiveness in recent years.  The number of grown children living with parents, the Boomerang generation, has gone up.  These stay- at-home adults are called KIPPERS in Britain... Kids In Parents’ Pockets Eroding Retirement Savings ¹ Investopedia [hotlink]

 

Many Russians never fly the coop!

Russians expect to care for offspring well into adult years. Their culture expects them to devote much of their remaining energy to raising grandchildren and helping their grown children.  

Sometimes the older generation buys a car, or even co-signs an apartment purchase, not thinking how this generosity limits and puts at risk their own security.

Russians find stories - that are normal to Americans - shocking and wrong!

In 1970, at 28, I finished my Navy time, came home to Maplewood NJ,  and started a teaching assistant–history masters program at Seton Hall University in the next town. That winter my mother sold her house and moved to a retirement community at the Jersey shore, and told me to find another place to live.

Our Florida friend was a wild kid growing up in Bridgewater NJ.  Finally his parents had it with him, and kicked him out at 17, no longer welcome to live at home.

For how long and much should parents feel obligated?  Parenting shouldn’t be a life sentence. Children need to be taught increasing independence and self-sufficiency as they grow up.

Get up and go or stay and take over?

The expectation in the United States is that children become independent at 18 or college graduation and find their own way.  Mark Twain left home at 17, Jack London worked in a cannery at 13, and Steve Allen rode the rails as a runaway of 16.

Russia never had the same exuberant can-do spirit traditionally found in the United States.  Even now, it’s difficult to get up and go on a whim.  Rigid registration laws make it inconceivable that you could travel to another region of Russia without a arranging a job first.

In Russia, society assumes children will stay home until marriage, and often, even then not leave, but just add a spouse to those living in the apartment.  Instead of grown children leaving, they gradually take over!  No wonder pull-out beds are popular in Russia.

Hard to shake your kids in Russia...

It’s difficult for young adults to be financially independent in Russia.  Students are not expected to have part time jobs, which could lead toward more financial independence. Children here don’t look for work cutting grass, shoveling snow, baby sitting, as they do in the United States.

Part of the contrast is because of the Soviet effect of propiska... that everyone has a right to a place to live from which he cannot be forced out. An individual still cannot be evicted without the where-with-all for a replacement place provided.  (Russian Housing Code, Art. 31, part 4.) 

People confuse the former propiska law with registration laws now in force. Those officially living in an apartment may have a right to a proportionate share in its sale value. You can’t kick your son out... because he has a traditional right of ownership of a proportion of the apartment you all live in.

What cultural expectations are in your life script?

Russia for centuries has laid heavy expectations on parents.  As they age, it’s expected the older people, especially the grandmothers, will take on much of the care of grandchildren.  Grandparents often make  room for a growing family in the apartment by moving to a smaller room, and assuming a lesser role.

In America, people talk about old age as the Golden Years, and a time for fulfillment.  As, they say in the States, Freedom is when the dog dies and the children finish college.  But here people frequently say,  Ста́рость - не ра́дость.  Starost – nee radost. Old age is no fun.

Cultural expectations teamed with economic realities are as strong as the salmon’s instinct to swim upstream, spawn, and die.  There’s no right or wrong, but they determine much of your life script.  Do you feel their pull?

You’re invited to make a comment, or send us an email using the strip at the bottom of this page.

Technorati Tags: Le aving the nest,leaving home,Boomerang generation,Kippers,fly the coop,Mark Twain,Jack London,Steve Allen,propiska,Russian registration laws.

Waiting for Sunrise Near the Russian Arctic

 

http://www.google.ru/imgres/StudentDoc/Archives/mbarraga/continents.

Russian Exaggerated Time.

Our time zone should be called Russian Exaggerated Time.  The problem goes back to initiatives of Peter the Great, Joseph Stalin, and Dmitry Medvedev.

Our second winter of year-long summer time is enervating.   Larissa and I feel time is disappearing, flying by...poof!  We have given in to sleeping way late, sometimes not getting our of bed until after 10 AM.

First, in 1703 Peter founded St Petersburg just 7 degrees from the Arctic Circle.  Next, Stalin in 1930 added an hour to what was sensible standard time.  And then Medvedev  added another hour in 2011!

St Petersburg’s location in such a northern latitude makes time coordination with central Russia difficult.  Arctic Climatology and Meteorology states... 

The Arctic Circle is an imaginary line that marks the latitude above which the sun does not set on the day of the summer solstice (usually 21 June) and does not rise on the the day of the winter solstice (usually 21 December).

My Calculation. The Arctic Circle is moving approximately 50 feet north every year, that’s almost two miles since Peter the Great established St Petersburg in 1703.

The northern latitudes experience accelerating sunrise – and shorter days – until the winter solstice.  St Petersburg’s shortest day in 2012 was December 21, and the latest sunrise was 1101 from December 23 through 30.  Twilight on either side of sunrise and sunset gives us some light during two to three hours from dawn to sunrise and from sunset to dusk.

I first saw a far northern sky while on the USS Bordelon in 1969 when we were approaching our incursion of the Arctic Circle.  The St Petersburg sky is similar now... light blue, with clouds hanging in the cold air, wispy, white and moving little.  The sun throughout the day stays close to the horizon.

The latest civil time sunrise in the world that I’ve found for December 21st is at Umba, Russia, just south of the Circle, at 1240 PM.  Vorkuta, just inside the Arctic Circle, is in darkness until its next sunrise the day after Christmas.  Murmansk, within the Arctic Circle, has no daylight whatsoever  from December 1 through January 10.   

How Russia could make telling time so awkward?

The two extra hours added to our time are especially difficult for Russia’s cities close to the Arctic Circle.  St Petersburg’s sunrise is approximately two hours off solar time, but Moscow’s at this time of year is only around one hour.

St Petersburg’s time zone, Moscow Time, jibed with western Russia’s longitude range until June 21, 1930 when it was advanced an hour year-round changing it from 2 to 3 hours later than London.   Then another hour was added with Dimitry Medvedev’s decree in 2011. 

True solar time for the December 21 sunrise is 905 AM but on the civic clock that’s 11 AM!  Oslo Norway, on the same latitude as St Petersburg, but at around 20 degrees longitude west, observes civil sunrise on December 21 at  918. 

Adjusting to whacky man made time...

You might say... Well, why not pretend that standard civil time is closer to solar time and just subtract a few hours at this time of year from the clock, and get up at 8 (resulting ) as you did before?  It isn’t so easy as people and institutions beyond our apartment insist on observing civil time.

My step-father, Ray Clarke told about  his early years in Atlantic Highlands NJ.  His grandpa hated Daylight Savings Time so he carried two watches in his vest pockets... one on his right for government Daylight Savings, the one to his left for true Standard Time... a true curmudgeon! 

Fact Check!  Years later I asked Ray if his account was true.  He hesitated, smiled, and quietly said, No.

Arguments for a change back...

People need to wake up and get safely to school or work.  The general feeling in St Petersburg is that the extra winter daylight time added to short winter afternoons isn’t worth the later mornings.

We are that much further separated from Western Europe, Britain, and the US.  Emails to California can require a longer wait for an answer.

How I deal with Russian Exaggerated Time...

Every morning I check with the website Time and Date [click here], and write the civil times of sunrise, sunset, and solar noon at the top of my memo book.  Then I subtract 1200 from the solar noon time to find the difference between official civil time and real solar time.

What will be the future of time measurement in Russia?

It appeared this fall that Medvedev’s decree would be reversed.  Now any action seems unlikely.  If it were up to me I would abolish both extra hours and work to make civil time closer to solar time.

Further reading.

Over the years this has been a favorite topic of mine.  You  may enjoy these posts from other years... Just click on the title.

The Solstice in St Peters.burg

Watch Out for the Solstice!

Bargain Heating Bills in St Petersburg!

Russian time changes a final time, now told with fewer watches!

Sliding Into a Cold Dark Winter of the Russian North

Comments and messages most welcome!

You can comment just below, or, by using the Wibiya strip at the bottom of this page, send a message, write on Facebook, or Tweet!

 

Technorati Tags: Vladimir Putin,Peter the Great,Joseph Stalin,Dmitry Medvedev,Russian Exaggerated Time,RET,Arctic Circle,elliptical line,twilight,dawn,dusk,solstice,civil time,daylight time,timeanddate.com,USS Bordelon,Umba,Vorkuta,Murmansk,Moscow Time,latitude,longitude,solar time,Oslo.