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Comment by ghufran_syed

Are you sure it was "capitalism" that led to the "collapse of trust"? Did Soviet citizens trust the local healthcare system when the quality of care you received depended on your party rank?

From a Wikipedia article on the Soviet healthcare system[1]

"Many medical treatments and diagnoses were unsophisticated and substandard (with doctors often making diagnoses by interviewing patients without conducting any medical tests), the standard of care provided by healthcare providers was poor, and there was a high risk of infection from surgery. The Soviet healthcare system was plagued by shortages of medical equipment, drugs, and diagnostic chemicals, and lacked many medications and medical technologies available in the Western world. Its facilities had low technical standards, and medical personnel underwent mediocre training. Soviet hospitals also offered poor hotel amenities such as food and linen. Special hospitals and clinics existed for the nomenklatura which offered a higher standard of care, but one still often below Western standards"

I think the problem more generally is that of adverse incentives, whether in "capitalist" or "socialist" systems. I worked in the UK National Health Service which is "free at the point of use" which often results in rationing via waiting list. In my experience, many patients believe that their GP is inappropriately limiting their treatment to save money, particularly with respect to limiting testing, which is unsurprising because "gatekeeping" is often an explicit responsibility for general practitioners in the NHS [2][3]

[1] https://en.m.wikipedia.org/wiki/Healthcare_in_Russia#Early_S...

[2] https://www.theguardian.com/society/2001/sep/15/NHS

[3] https://bjgp.org/content/69/681/e224

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