Healthcare and the Private Sector
Another post that’s been lounging in obscurity:
Interesting report on healthcare reform in Kazakhstan. Specifically, a grad student from Kazakhstan did a survey of doctors on the decision of working in public or private sector.
The result seems to be that doctors move from public to private when they fear the public sector is unstable or risky. Interestingly reforms meant to better the sector are seen as increasing instability. So fear of change and pessimism that any change could be bad appear to be big motivations.
The most interesting point made, I feel, was that doctors reported discontent that they were not consulted about changes or reforms to the public healthcare sector:
According to Chukmaitova, Kazakhstan’s health care workers also complained “that there are too many reforms that are being implemented, [and that] they are being implemented in a top-down approach, physicians are not being consulted or asked for their opinion in terms of whether there is need for another reform.”
“There is no ownership or engagement coming from the physicians so they have no idea what is happening and they are not feeling comfortable with all these reforms the ministry is implementing,” Chukmaitova added.
This will come as no surprise to anyone who has lived in Kazakhstan and worked with the government.
I did have one complaint, that the research appears to assume working in the private sector is better so that the guiding question was, “How can we get doctors to leave public hospitals and start private practices?” That may or may not be a good thing for Kazakhstan. Because of the way government dominates the social sector, in fact reforming the public sector (with doctor and nurse and patient input) might be the best possible solution for getting good healthcare to everyone.