spea magazine


To Russia, With Love

“We take a lot of things for granted.”

natalia rekhterNatalia Rekhter couldn’t help but notice the wistful look in her companions’ eyes. She was touring Riley Children’s Hospital with Russian health care administrators, who were stunned by the Indianapolis hospital’s inviting atmosphere, the huge stuffed animals that lined the atrium, the toy-filled rooms.

“They assumed Riley must be a privately run, high-profit hospital that only served wealthy patients,” says Rekhter, a trustee lecturer in health care at SPEA, IUPUI. “In Russia, the old medical system is collapsing and the new system is still in transition. Even the wealthiest persons don’t have care like that.”

Drs. Oleg and Marina Kuligina, who told Rekhter they felt “like characters in a futuristic movie who had been transported to another planet,” had come to help develop an exchange program for Russian and American faculty and students. It is a project near and dear to Rekhter’s heart; she immigrated to the U.S. from Russia in 1991 and is intimately familiar with the shortcomings of that country’s health care system.

Students will see it for themselves this May when a group of SPEA’s health administration students travels to Ivanovo, a city 220 miles north of Moscow, where the Kuliginas work. Site visits will include outpatient care centers, social services departments, prenatal care centers, and a local medical resort with rehabilitation services. The overarching goal, says Rekhter, is to vividly demonstrate the challenges of Russian health care. “I hope the students will be impressed by the compassion people have for their work under those circumstances and better appreciate their own system and what they have. We take a lot of things for granted.”

On the other hand, students will come to understand some of the relative advantages of a state-run system—the utter lack of interest in making money, for example. Advertising, marketing, snazzy promotions, and filing insurance claims are non-issues for Russian hospitals, allowing administrators to focus “only on the most important things they need with the little funding they get from the government.”

Rekhter believes that it is vital for students to see how the country is coping with this transitional phase of care. “A lot of good things from the original system are gone because they are trying to emulate other countries’ institutions and it’s not working,” she says. “It’s essential for students to see how transition can affect the system.”

Simply going out of the country will be a challenge for some of Rekhter’s students who have never left the U.S. before. “But we are all citizens of the world,” she notes, “and the world is getting a lot smaller.” As the world shrinks, Rekhter is doing what she can to expand her students’ horizons.

Natalia Rekhter is a trustee professor at the School of Public and Environmental Affairs, IUPUI. Her focus is on health care finance, insurance, law and ethics as well as international health care. She is a member of the American College of Healthcare Executives, the International Research and Exchange Board, and the Moscow Sechenov Academy. Professor Rekhter has a Ph.D. from the World Information Distributed University in health sciences.