mit themselves "to convalescent and nursing care" (Jacobs "Are the Restrictions..." 1989, p. 12). In 1991, a failed Soviet coup represented the final effort of the Communist Party to regain control over the nation. In the wake of that coup, the door has again been opened to the possibility of positive reforms in the area of public health. In view of these changes, it can be seen that medical cooperatives serve an important function in the former Soviet Union. Specifically, they provide a step in the transition of Soviet medicine from a state-run monopoly to a system which is characterized by freedom of choice among its consumers.
In the traditional Soviet system of socialized medicine, all matters of health care are handled by the state. The Minister of Public Health is in charge of running the national medical system. All of the doctors and nurses working within the system are employees of the state. Furthermore, in the Soviet system, "all hospitals, clinics, and dispensaries are state-run" (Rywkin, 1989, p. 104). The purpose of socialized medicine is to provide free medical care for all. However, the Soviet experiment with socialized medicine has shown that there are a number of problems with the system. It was these problems that prompted the establishment of the first medical cooperatives in 1987. One of the problems with the traditional system is that it fails to provide a decent quality of health care for the people as a whole. Another major problem is the fact that the system encourages the giving and taking of bribes in order for adequate medical services to be provided.
The Soviet state guaranteed free health care to its citizens; however, the facilities providing that care were "inefficient, overcrowded and often of poor quality" (Fein, 1989, p. A3). The state was able to boast a large number of both hospital beds and doctors (Rywkin, 1989, p. 104). However, despite this emphasis on quantity, the Soviet...