How Vladimir Putin's phone-in programme differs from Dmitry Medvedev's Address.
Vladimir Putin's four-hour television appearance last Thursday revealed little connection with President Dmitry Medvedev's calls for modernisation. Nothing the Prime Minister said reminded the audience of the cardinal changes the President called for in his Address to the Federal Assembly. Indeed, Prime Minister Putin's answers to people's questions ruled out the possibility of change even on matters that seriously worry the citizens. The audience was left in no doubt that the country is not going to see any change except when it is planned by Putin.
A typical example was the complaints about the sorry state of the public health system. A plea for help came from Magnitogorsk: "Pregnant women have to sit in queues for four to five hours, they have their medical checkups in the hallway, the hospital has not been repaired since the early 1930s, there is no shower, but it has a lot of patients." A similar complaint came from Pikalyovo: "The infections ward in the hospital has been shut down, the maternity ward has been shut down and there are rumours that the hospital will be shut down." "I am a diabetic, but I have been unable to get free medication for more than a year. The polyclinic writes out prescriptions but there are no free medicines at the pharmacy." Moderators tell the Prime Minister that hundreds of similar complaints have been received. What is Putin's answer? Perhaps he promises to modernise the healthcare system, even if only in the long term? No. Instead the Prime Minister talks about the flu as if hospital wards are shutting down because of the current epidemic and gynecologists whom women queue up to see are engaged in fighting the flu. The Prime Minister tells citizens that the state of hospitals is the responsibility of the local authorities. Could it be that he is unaware that Russia spends a smaller share of its GDP on healthcare than most developed countries: Russia spends just about 4%, compared to 6% in Eastern Europe, about 9% in Western Europe and 14% of GDP in the US.
However, the Prime Minister is nothing loath to talk about innovation where changes have already been prepared and agreed. One such innovation is the introduction of a multi-tiered government control of drug prices simultaneously with the launching of a campaign to prosecute pharmacists. "The prices of the producers of vital drugs will be registered. This is the first measure. The second measure: the Federal Tariffs Service will develop a methodology that would restrict the regions' freedom to decide on what the trade markups should be. On the one hand, the producers' prices will be fixed, but on the other hand retail markups will be limited. These rules will come into force as of January 1, 2010," the Prime Minister says. Those who violate drug tariffs will "pay a double fine or will be suspended or disqualified for several years," and may even "be prosecuted under criminal law." We will see very soon the results of the introduction of state regulation of medicine prices. We should keep our fingers crossed that no shortage of vital drugs develops and that they do not flow into the black market. In all the spheres where tariffs are still controlled by the state - in the power industry, railways and the housing and utilities sector - there are either shortages, or the dictate of the producer or galloping inflation.
The main impression from the Prime Minister's appearance is that while he has current information on the state of the nation at his fingertips, he totally lacks a realistic vision of what causes the problems and of how to eradicate them in the future.
In any case, without the modernisation approach and a modernising vision of Russia's future there is no chance of eradicating the causes of the current problems. The causes are in the institutions, the institutions of competition, political and economic freedom, and independent public control over the authorities. But not a word has been said about it.