two-tier system—one for the “gray masses” and a different onernfor the bureaucrats and their intellectual servants, hi the So-rn’iet I fnion it was not uncommon to have workers and peasantsrndying in the state hospitals while the medicine and equipmentrnthat could have saved their lives sat idle in the institutions ofrnthe nomenclatura system.rnRussia is obviously in the grip of a horrible health crisis. AsrnNick Eberstadt has pointed out, in the modern era—withrn”cheap food, clean water, mass education, rapid communication,rneasy travel, conrpetent doctors, wonder drugs, and thernlike”—it is difficult to stay sick for a long time or to die young.rnYet in Russia, it is easy to do so. hi certain regions of Russiarn(Sakha, Karakalpakia, Kalmykia, etc.) life expectancy is 20rnvears less (49 for males and 56 for females) than in the UnitedrnStates. And in rural areas of the Russian Federation, the lifernexpectancy of males is as low as 45 years due to widespreadrnalcoholism and the absence of decent |)riniary health care facilitiesrn(36 percent of all hospitals located in rural areas ofrnRussia have neither running water nor sewage systems).rnecay and appallingrnquality of servicesrnare characteristic notrnonly of ‘barbarous’ Russia and otherrnEastern European nations, but ofrnother nations who suffer a governmentrnmonopoly on health care. In England,rnfor example, the waiting list forrnsurgery is nearly 800,000 out of arnpopulation of 55 million.rnThe official infant mortalitv rate in Russia is more than 2.5rntimes as large as in the United States and more than five timesrnthat of Japan. This rate of 24.5 deaths per 1,000 live births wasrnrecently questioned by several deputies to the Russian parliament,rnwho claimed that the real figure is twice as large, hi thernrural regions mentioned al)ove, the infant mortality rate isrnclose to 100 per 1,000 births, putting these regions in the samerncategory as Angola, Chad, and Bangladesh.rnPollution is systemic and growing worse. Pollution is thernmost disastrous product of central planning, stemming in particularrnfrom the “ratchet principle” of constantly rising output.rn”It was no secret that on nianv occasions in the past 70 years,rnworkers’ health had been sacrificed to the needs of the economyrn—although the cost of treating the resulting diseases hadrneventually outweighed the supposed gains,” stated RussianrnState Public Health Inspector E. Belyaev. The misuse andrnoveruse of pesticides and fertilizers and the release of industrialrnwaste and heavy metal solutions into the water supply presentrndeadly threats to the population. The air in Moscow hasrntwice the permitted amount (even bv lousy Russian standards)rnof hydrocarbon pollutants; parts of the Volga River have 700rntimes too much petroleum; 68 big industrial cities have atmosphericrnpollution described as “critical.” Two-thirds of Russianrndrinking water is now below minimum standards of puritv.rnMan-made ecological disasters like the catastrophes at nuclearrnpower stations near Chelyabinsk and Chernobyl, the literalrnliquidation of the Aral Sea, the serious contamination of thernVolga, Azov Sea, and great Siberian rivers—all have made unbearablernthe quality of life in both the major cities and therncountryside. According to Alexel Yablokov, Minister for Healthrnand Environment of the Russian Federation, 20 percent of peoplernlie in “ecological disaster zones” and 35 to 40 percent morernlive in “ecologically unfavorable conditions.”rnIn Russia today, influenza strikes tens of thousands of infantsrneverv year, and the proportion of children dying from pneumoniarnis on the increase. Rickets, caused by a lack of vitaminrnD and unknown in the rest of the modern world, kills manyrnvoung people. Uterine damage is widespread, thanks to the 7.3rnabortions the average Russian woman undergoes during childbearingrnyears. Alcoholism is pandemic. In the beginning of thern1990’s, per capita intake of alcohol in Russia was about threerntimes as high as in the United States. As a sad result of socialistrneconomizing, a Russian citizen compared to the averagernAmerican has to work 25 to 30 times longer to buy meat, 18 torn20 times longer to buy poultry, 6 times longer for milk, 40 timesrnlonger for butter, 15 to 25 times longer for eggs, and 20 timesrnlonger for bread. “Families in Russia devote nearly the samernproportion of their income to alcohol as American families devoternto food. Soviet foremen mark their workers as sober if the’rncan stand,” says Eberstadt.rnWith the failure of perestroika and glasnost—the last attemptrnto save socialism—the government has finally admittedrnthat it cannot guarantee even a minimal level of health care tornits citizens. The situation has deteriorated so far that Russia hasrnhad to cut imports of vital medicines sharply, since there is nornmonev left to pay for the supplies after feeding 4 million soldiersrnand 15 million government bureaucrats. The lessons fromrnthe Soviet experiment with socialized medicine are obvious:rn”We should all be thankful to the So lets because they havernproved conclusively that socialism doesn’t work. No one canrnsa they didn’t have enough power or enough bureaucracy orrnenough planners or they didn’t go far enough,” says Paul CraigrnRoberts.rnIt is beyond the ability of economic analysis to calculate thernopportunity cost of the socialist experiment in Russia, but thernhuman toll is estimated by Russian historian Roy Medvedev atrn41 million people who perished in a dreadful gulag during Stalin’srncollectivization, purges, campaigns against “unearned”rnincomes, and other devilish deeds. Even today, the agony ofrnsocialism takes a human toll. As a sad legae’ of the socialist experiment,rnwe observe a marked decline in the population ofrnRussia, and experts predict a continuation of this trend throughrnthe end of the century. According to the Russian State StatisticalrnOffice as cited by ITAR-TASS last February, there were 1.4rnmillion births and 2.2 million deaths in 1993. Only because ofrninward migration of Russians from “near abroad”—formerrnSoviet “republics”—was the net decrease in populationrnlimited to 500,000.rn”Despite the recent collapse of socialism and communism inrnSoviet Russia and Eastern Europe, socialism is still alive andrngrowing,” says Nobel laureate Gary Becker, meaning it still possessesrna mortal danger to freedom, health, and quality of life forrn22/CHRONICLESrnrnrn