Saturday, August 24, 2019

Admitting ‘Optimization’ has Failed, Putin Calls for Medical ‘Modernization’ but Some Fear That will be ‘Optimization 2.0’

Paul Goble

            Staunton, August 22 – Vladimir Putin doesn’t often admit a policy he has been closely associated with has failed, but he has done just that with regard to medical ‘optimization,’ a program intended to improve efficiency but one that has left doctors angry because there is less money for them and patients furious because they face greater difficulty getting care.

            At a meeting this week, the Kremlin leader said that “patients justly are complaining about poor conditions and long lines to see doctors and specialists, and medical workers are dissatisfied by their level of pay and overwork.” The government must respond by October 1 with medical “modernization” in place of the failed “optimization.

            Andrey Konoval, the vice president of the Action Medical Union, says the most important thing in Putin’s remarks is the word “failure,” a word he has uttered only because of “the Italian strikes” doctors have organized across the country and the questions they and patients submitted to Putin’s Open Line program (

            Calling Putin’s decision to replace optimization with modernization a victory for his union and for patients, Konoval expressed skepticism that this would in fact be something more than playing with words. Despite his criticism, Putin hasn’t changed the officials who will be implementing any new program and hasn’t indicated that there will be a significant infusion of new funds.

            As a result, the union chief says, there is a real danger that “modernization” will turn out to be “optimization 2.0” and that both doctors and patients will have to increase their protest activity to force real change.

            Putin’s optimization program in health care has hit rural areas especially hard with many medical points closed or combined, something experts say has led to a rise in mortality rates because Russians can’t get care (

            But it has hit people in the big cities as well, including those needing special care and no longer able to obtain it ( and

            Consequently, this has become an issue everyone can understand and one that is contributing to Putin’s declining ratings. But if his latest admission of failure does not lead to real change, he beyond any doubt will face more problems in this area, including more strikes by doctors and protests by patients. 

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