Health Ministry Did Not Include HIV Test in Compulsory Medical Exam
Polina Zvezdina RBC
November 21, 2016
Optional and Anonymous
The Health Ministry has changed its annual medical exam program for adults, judging by the amendments posted on the Federal Website for Draft Regulations. Free HIV testing was not included in the document. In September 2016, Health Minister Veronika Skvortsova had promised testing would be included in the annual wellness examination program beginning in 2017.
If the amendments are adopted, beginning next year, general practitioners will be obliged to inform everyone between the ages of 21 and 49 who is undergoing a physical exam that they can take an anonymous HIV test at specialized medical clinics. Physicians should provide patients with a list of the clinics where the test is performed.
The Health Ministry had planned to receive funds to expand the program by eliminating ineffective research. Our sources at the ministry did not explain to us why the HIV test had been turned down for inclusion in the compulsory program.
MPs Fedot Tumusov and Alexandrev Petrov, who sit on the State Duma’s Healthcare Committee, believe the ministry rejected the HIV test as part of its physical exam program due to a lack of funds. Andrei Skvortsov, coordinator of the Patient Monitoring movement, agrees with them.
This is not the first time the government has been unable to find funds in the federal budget to fight HIV. Thus, on November 15, due to a lack of financing, a special interdepartmental commission decided not to add new drugs for suppressing HIV to the list of essential drugs. Elena Maximkina, director of the Health Ministry’s Department for Drug Provision, said that 20.8 billion rubles had been spent in 2016 on purchasing anti-HIV drugs. Yet in the three-year federal draft budget, 17.8 billion rubles have been slated for prevention and treatment of HIV and hepatitis B and C in 2017, 17.5 billion rubles in 2018, and 17.1 billion rubles in 2019.
Skvortsov argues that testing could be included in the medical check-up program if doctors in district clinics and non-specialized hospitals were better informed about the specifics of HIV and the means of its dissemination.
“Medical personnel often refuse to give HIV-infected patients necessary medical treatment, and such patients face other forms of discrimination,” he noted.
Doctors at ordinary clinics are also often not able to carry out the pre-test and post-test consultations that would be required if obligatory testing were included in the medical examination program, said Skvortsov.
Another factor is that patients are now often reluctant to be tested under the voluntary health insurance program, argues Igor Pchelin, chair of the Steps Regional Public Charity Foundation to Fight AIDs. This is due to the fact that physicians may not comply with medical confidentiality and reveal test results to colleagues, neighbors, and friends of infected patients.
Provided there is sufficient financing in 2020, the government plans to test 35% of the public for HIV annually, according to the strategic plan for combating the spread of the infection. From the draft of the plan, which RBC has seen, it follows that financing should amount to an additional 3.2 billion rubles per year. This amount is needed to test an additional 20 million people at a cost of 150 rubles per test. It is currently not known whether the funds will be allocated or not. In 2015, HIV testing covered around 30 million people or 19.3% of the population.
Budget Expenditures on Security Forces to Grow to Two Trillion Rubles by 2019
Vladimir Dergachov and Elizaveta Antonova RBC
October 23, 2016
The authorities have decided not to save money on the security forces, despite the difficult economic situation in the country. The draft budget shows that annual spending on national security will grow to 2 trillion rubles by 2019.
The government has inserted an increase in expenditures from 1.94 trillion rubles to 2 trillion rubles [approx. 30 billion euros] by 2019 under the line item “National Security and Law Enforcement.” These figures are contained in the draft budget for 2017-2019, as submitted by the Finance Ministry. (RBC has the relevant memorandum in its possession.) These expenditures also include the secret part of the budget, which this year grew to 22.3%.
Total budgetary provisions for national security are supposed to reach 1.943 trillion rubles in 2016. Over the next three years, a spending increase in this sector has been laid into the budget. In 2017, 1.967 trillion rubles will be spent on the security forces; in 2018, 1.994 trillion rubles; and in 2019, 2.006 trillion rubles. That is, spending on national security will increase by 63 billion rubles [approx. 933 million euros] over three years.
The “National Security and Law Enforcement” section of the budget has fourteen subsections, including prosecution and investigation authorities (the Prosecutor General’s Office and Russian Investigative Committee, the Justice Ministry, the Interior Ministry, security, border guards, Interior Ministry Troops, drug police, and the penal system). The section also includes spending on emergency situations, migration policy, civil defense, and specialized applied research.
A government spokesperson forwarded RBC’s questions about spending on law enforcement to the law enforcement agencies.
RBC found out which ministries would benefit from the allocation of funds after the latest reforms in the law enforcement sector.
How Creation of the National Guard Impacted the Budget
In early April 2016, President Vladimir Putin abolished the Federal Drug Control Service (FSKN) and Federal Migration Service (FMS) as free-standing entities, incorporating them into the Interior Ministry. The Interior Ministry, in turn, lost part of its powers. Its internal troops and special forces units were turned into a new security agency, the National Guard of Russia. The National Guard acquired, in particular, the OMON (Special Purpose Militia Detachment or riot cops), the SOBR (Special Rapid Deployment Unit), the Licensing and Permit Center, and the Extra-Departmental Security Service.
As a result, the line item for spending on drug control agencies has been eliminated. (The subsection contains dashes after 2016, in which 27.3 billion rubles were allocated.)
The draft budget also incorporates a spending decrease in the line item entitled “Police Agencies,” from 683.4 billion rubles in 2016 to 625 billion rubles in 2019. (Hereinafter, expenditures are given for the period from 2016 to 2019.)
Spending on the line item “Internal Troops” will nearly double due to the formation of the National Guard: from 114.6 billion rubles to 206.6 billion rubles.
When asked about the growth in spending on this line item, National Guard spokesman Yevgeny Kubyshkin suggested that RBC readdress their question to the government officials who drafted the document.
Among other significant changes in spending due to agency and ministerial shake-ups is the more than tenfold reduction on “Migration Policy,” from 33.7 billion rubles to 285.5 million rubles. This line item incorporates spending on the Federal Migration Service, which has been merged with the Interior Ministry.
The Russian Interior Ministry’s press office confirmed to RBC that appropriations were reallocated when the budget for 2017-2019 was drafted. Monies were reallocated to pay for the Interior Ministry units transferred to the National Guard. Sources at the ministry also confirmed that spending on the abolished FMS and FSKN had been accounted for in the ministry’s budget.
“Thus, the parameters of the draft federal budget of the Russian Interior Ministry for 2017-2019, excluding pension funds, are 695.1 billion rubles in 2017; 691.9 billion rubles in 2018,; and 689.7 billion rubles in 2019. This testifies to the fact that federal financing of the Russian Interior Ministry will remain nearly at the levels of 2015-2016,” a source at the ministry told RBC.
Prosecutors Get More, Security Officers Less
The line item for “Prosecuting and Investigative Authorities” stands out among the expenditures, with an increase from 86 billion rubles to 94.8 billion rubles.
The growth of spending on prosecutors and investigators is due to the fact that, as of January 1, 2017, military investigators will be merged with the Investigative Committee and will be financed out of their budget, Investigative Committee spokeswoman Svetlana Petrenko explained to RBC. RBC is waiting for a response to its questions from the Prosecutor General’s Office.
Spending on the line item for the “Penal System” will be slashed from 196.3 billion rubles to 176.8 billion rubles. Federal Penitentiary Service (FSIN) spokeswoman Kristina Belousova declined to comment.
The subsection “Security Agencies” (which includes the FSB) will be also be cut, from 306.4 billion rubles to 292 billion rubles. RBC’s request for information from the FSB’s Public Relations Office went unanswered.
The line items for “Justice Authorities” and “Border Guards” have been marked for slight decreases in spending. Over the three years, spending on the Justice Ministry will decrease from 43.4 billion rubles to 42.6 million rubles, while the border guards’ budget will be reduced from 124.2 billion rubles to 119 billion rubles. The Justice Ministry promised it would answer RBC’s inquiries at a later date.
According to the government’s draft budget, spending on “Protecting the Populace from Emergency Situations” will be reduced from 81.2 billion rubles to 70.1 billion rubles. On the other hand, spending on “Fire Safety” will be increased from 109.9 billion rubles to 119.4 billion rubles. RBC has sent an inquiry to the Emergency Situations Ministry and is still waiting for a reply.
“Non-Transparent” Expenditures Grow by Two and a Half Times
However, expenditures on “Other National Security and Law Enforcement Issues” will grow by two and a half times, from 108.4 billion rubles in 2016 to 237 billion rubles in 2019. According to the budget classification codes, this subsection includes expenditures having to do with the “leadership, management, and provision of support for activities such as the development of overall policy, plans, programs, and budgets, as well as other undertakings in the field of national security and law enforcement not covered by other subsections in this section.”
The Russian budget already contains a voluminous secret section, and line items like “Other Expenses” make expenditures even less transparent, Vasily Zatsepin, head of the military economy lab at the Gaidar Institute for Economic Policy, told RBC. According to Zatsepin, this subsection could contain anything whatsoever, for example, “financial assistance to certain districts in the Donetsk and Lugansk regions [of Ukraine].”
However, the subsection “Applied Research in the Field of National Security and Law Enforcement” will be slashed from 27.5 billion rubles to 22.3 billion rubles, respectively.
The government memo makes clear that overall allocations for the entire national security section of the budget amount to 2.3% of GDP. Their share of total federal spending is 11.8%.
Although spending in this category in terms of GDP will drop from 2.3% to 2% by 2019, spending on national security in terms of overall spending will increase over the next three years, from 11.8% in 2016, to 12.2% in 2017, to 12.5% percent in 2018, and to 12.6% in 2019. This is more than combined spending on education, health care, culture, sports, media, and environmental protection.
The regime’s priority is to redistribute the budget toward foreign policy and the deep state, as well as social welfare payments to the populace to maintain stability, Nikolay Mironov, head of the Center for Economic and Political Reform told RBC.
“Everything else is overlooked, although education, health care, and the national economy, whose line items have been cut, are strategic areas. Investment in them does not pay off in the current year, but always pays off later,” argued Mironov.
Translated by the Russian Reader
Political Scientist Ekaterina Schulman on Why You Should Vote
Anya Chesova and Natasha Fedorenko The Village
September 16, 2016
This Sunday, September 18, the country will vote for a new State Duma, the seventh since the fall of the Soviet Union. The peculiarity of this vote is that it will take place under a mixed electoral system for the first time since 2003. 225 MPs will be elected to five-year tears from party lists, while the other 225 MPs will be elected from single-mandate districts. Several days before the elections, The Village met with Ekaterina Schulman, a political scientist and senior lecturer at the Russian Presidential Academy of National Economy and Public Administration (RANEPA). We talked with her about why you should vote if United Russia is going to win in any case, as well as about the changes in store for the Russian political system in the coming years.
The Upcoming Elections
The Village: On Sunday, the country will hold the first elections to the State Duma since 2011. The social climate in the city and the country as a whole has changed completely since that time. Protests erupted in 2011, and the people who protested on Bolotnaya Square and Sakharov Avenue believed they could impact the political situation. Nowadays, few people have held on to such hopes. What should we expect from the upcoming elections? And why should we bother with them?
Ekaterina Schulman: Everything happening now with the State Duma election is a consequence of the 2011–2012 protests, including changes in the laws, the introduction of the mixed system, the return of single-mandate MPs, the lowering of the threshold for parties to be seated in the Duma from seven to five percent, and the increased number of parties on the ballot. These are the political reforms outlined by then-president Dmitry Medvedev as a response to the events of December 2011. Later, we got a new head of state, but it was already impossible to take back these promises. The entire political reality we observe now has grown to one degree or another out of the 2011–2012 protest campaign, whether as rejection, reaction or consequence. It is the most important thing to happen in the Russian political arena in recent years.
The statements made by Vyacheslav Volodin, the president’s deputy chief of staff, on the need to hold honest elections, Vladimir Churov’s replacement by Ella Pamfilova as head of the Central Electoral Commission, the departure of someone more important than Churov from the CEC, deputy chair Leonid Ivlev, and the vigorous sacking of chairs of regional electoral commissions are all consequences of the protests. If they had not taken place, nothing would have changed. We would still have the same proportional voting system, the same seven-percent threshold, the same old Churov or Churov 2.0. Continue reading ““We Have a Surrogate Democracy”: An Interview with Ekaterina Schulman”→
Demolishing the Population’s Income Is a Big Mistake by the Authorities
Special to Novaya Gazeta
October 17, 2015 Novaya Gazeta
Why the government prefers oil to people, why poverty could touch half the population, and why social services are losing out to defense spending
In previous years, when it submitted the latest draft budget to the Duma for consideration, the government repeatedly emphasized its social focus: it was all about people, they would say. Now, as the 2016 budget is being worked out, the authorities prefer not to think about this. Spending on the most people-focused items—education and health care—will be significantly reduced. Despite annual inflation’s soaring to nearly 16%, public sector wages will not be indexed at all, while old-age pensions will be indexed only by 4%. Tatyana Maleva, director of the Institute of Social Analysis and Forecasting at the Russian Academy of National Economy and Public Administration (RANEPA) told us how the social sector would cope with all these blows.
Based on your analysis of the projections for the 2016 budget now being submitted to the Duma, which of the social sector issues do you see as most acute?
Those caused by the insufficient indexation of old-age pensions. The government has chosen the most economical solution to this problem.
A 4% indexation does not correlate at all with the expected outlook for inflation. Thus, the budget risks reducing the real value of pensions.
The acuteness of the problem is amplified by the fact that, if we look at the history of incomes in post-reform Russia over the past twenty-five years, we see that pensions have fallen lower than all other sources of income such as wages and benefits. Only in 2010, thanks to the valorization of pension rights [a one-time increase in the monetary value of the pension rights of citizens with time in employment before 2002 – Y.A.] and pulling the minimum pension up to the subsistence level, we pushed the real value of pensions to where it had been at the outset of reforms in the nineties. It had taken twenty years to restore the purchasing power of pensions. But now, during a crisis, they are being demolished again by the budget under consideration. This is a big mistake by the authorities.
But why? After all, budget cuts are not the government’s whim, but hard necessity dictated by the economic crisis.
As events of the last two years have shown, there are basically only two kinds of resources in this country, oil and people. The price of oil has collapsed, but the people are still here.
It is people who are, in fact, the most reliable of all resources. Sooner or later, investment in people produces economic growth. Oil, on the contrary, is impacted by circumstances unconnected with the Russian economy; we cannot influence the market price of oil. It turns out that one key resource makes us hostage to the situation, while we are voluntarily refusing to support the other resource. So I would argue that during the crisis we should look for ways to support people and even risk a larger budget deficit if necessary. Most economists, including me, are forecasting a long crisis. It is only beginning, and demolishing people’s real incomes right at the outset of the crisis is fundamentally wrong.
How painful will the decision to partially index pensions be?
The government thinks that indexing pensions by 4% will affect only the 38 million pensioners. This is misleading. Models of consumption and survival are based not on individual strategies, but on the strategies of households, meaning families. Around 40– 45% of Russian families include pensioners. The experience of the nineties tells us that even miserly pensions, when they were paid, served as a safety cushion against poverty in families when their younger member lost their jobs or faced nonpayment of wages. Because, in this case, pensions support the household’s minimum consumer budget and act as social insurance. Consequently, the forthcoming partial indexation of pensions will reduce the budgets of 40–45% of Russian households. Meaning that the real impact of this decision will be the growing risk of poverty not among pensioners but among nearly half the country’s population.
The government contends that real incomes have fallen by 2–3%, and real wages by 9–10%. Do you agree with these figures?
At one time, incomes showed a more moderate decline, but now they are rushing [downwards] hot on the heels of wages. Because the factors that were propping up incomes, including pensions, have ceased functioning, and incomes are going to fall, maybe even lower than wages. Over the last year, we have experienced a huge reduction in incomes. Basically, the entire growth they had achieved over the previous three or four years has imploded. And there is no reason to expect the growth will be restored. The decline might simply slow down due to arithmetic: the base for comparison will decrease from month to month, and therefore the rate of decline in real wages may turn out to be 7–8%, not 9–10%. But this does not alter the fact the population’s income is likely to be reduced.
How hard is inflation hitting people’s wallets?
Apparently, by year’s end we will be seeing 13–15% inflation. It is inflation that has a total effect on all incomes by devaluing them, regardless of social classes and age groups. But the risks that emerge among different social group because of high inflation are different. For examples, employees face the risk of job losses and cuts in nominal wages. This is already happening. We see cuts in benefits, reductions in allowances, and the axing of bonuses around the country. Moreover, while individuals are capable of combating other causes of income reduction such as job loss or reduction in wages by looking for a new job or retraining, they can do nothing to withstand inflation.
The number of poor people in Russia increased sharply over the past year—by three million people. Are the authorities capable of dealing with this scourge, or does everyone just have to wait for a rise in oil prices?
It is appropriate to recall how poverty has evolved in Russia. In the nineties, over 30% of the population was poor, but this was shallow poverty. When economic growth began in the nineties, poverty was significantly reduced. Many poor Russians moved into the so-called sub-middle class, rather than sinking into outright poverty. Economic growth reduced poverty levels relatively easily all by itself, without a restructuring of social benefits, without support for various social groups. But as soon as the country shifted from growth to recession, this seemingly happy trajectory turned into a disaster for us. Since, during the “fat” years, a reasonable system of targeted social support for the poor was not established, we are now reaping the consequences of its lack. Very many types of social support were eliminated in 2015, and certain “visionary” regions gutted many social benefits as far back as late 2014. Therefore, poverty will grow, and in this sense, indeed, the only hope is a hypothetical rise in the price of oil.
If the price goes up, there will be more money in the budget, and maybe benefits will return. But I am not so certain of this. It is absolutely not a fact that federal revenues are converted into institutions of social support. I think that in this case there will be a serious struggle with a high probability of the social sector’s losing to the military-industrial complex.
The country made this choice long ago, and it is clearly not going to be revisited.
The official unemployment rate in Russia has not exceeded 6%, which is quite a favorable figure by international standards. At the same time, there is lot of evidence that hidden unemployment has grown. What is your overall assessment of the employment sector?
Indeed, 6% is not a high figure at all. Actually, a low unemployment rate has been traditional in Russia in all phases of the economic cycle, whether the economy has been in growth, crisis, boom or recession. Over the quarter century that Russia has been living in the market economy, it has not really experienced unemployment. But economic laws still apply, and during crises, pressure on the market increases. Ultimately, the market extends possibilities for part-time employment, and this can be interpreted as hidden unemployment. People are willing to work a full workweek, but employers offer them part-time work, either half a day or two or three days a week.
The labor market has formed a kind of social contract under which employers save on costs by not dismissing employees, because the Labor Code forces them to bear exorbitant costs when letting employees go. Employees remain employed, which gives them the chance to earn seniority. And the state pretends not to notice any of this, because it also has a stake in the situation. It saves on unemployment benefits and thereby reduces its financial obligations.
Overall, how has the current economic crisis aggravated social problems in the country? Are there factors capable of causing society to protest and take political action?
It is not just the matter of the crisis. Long-term factors are also capable of impacting the social sector. Even during phases of economic growth, many social processes in Russia were not entirely favorable. Take demographics: the long-term trend has been determined by previous generations, and it cannot be changed. Nothing can be done about the fact that each successive generation in Russia will be smaller than the previous generation.
Furthermore, if we look at a longer trend, we have to admit that wages and other types of income have fallen undeservedly much lower than GDP has sunk. This has predetermined very many processes in the economy. Low-wage labor and a low-income population cannot be effective. We have repeatedly been taught this lesson over the last twenty-five years. Coming to terms now with a drop in incomes and wages means recognizing the inefficiency of our human resources. Yes, of course, no one gets rich during a crisis. But it is not a worsening of social tensions in the country due to a sharp collapse in incomes that we should be afraid of. We should be afraid of social apathy, of the population’s withdrawing into itself and washing its hands of the situation. From the socioeconomic viewpoint, this is a step backwards. This apathy can hold us back for many decades. And even if drivers of economic growth do emerge in Russia, and we expect that people will respond quickly, this might not happen.
But what is the source of this apathy?
In the nineties, the population really lent a helping hand to economic reforms by a creating a strong platform for the informal economy. Everyone predicted that society would explode, but it did not happen. The population thus gave an advance to the government that was carrying out reforms. The country managed to make this incredibly difficult transition from one type of economy to another. The people’s patience was rewarded. We are seemingly now in the same situation. However, our vector is pointing down, not up. The current patience of Russians might pull the country down. The population has not been integrated into this economy; it has not become its subject. It has elaborated its own behavioral trajectories, tactics, and strategies, which do not correspond in any way to state policy. The state and the populace lead separate lives.
Are you not idealizing the nineties? After all, even now, during a crisis, people’s living standards and incomes are much higher than they were then.
What saved people from hunger and many people from death in the nineties? First, grassroots unorganized trading, whose symbol was the famous shuttle traders. A huge informal trading sector was formed, flea markets emerged, and so on. But this sector ultimately disappeared, losing out to powerful commercial chains. Second, a powerful sector of private household plots formed in small towns and villages in the nineties. Even if they provided no cash income, people lived off the land. During the years of economic growth, this sector has turned into dacha villages with lawns, and has also ceased to exist as a source of subsistence for households. Third, a small business sector took shape in some form, albeit a specific form with many negative traits. Nevertheless, there was entrepreneurial freedom. Now, all attempts to get small business on its feet have led to nothing. The administrative obstacles erected in recent years have shut the door to the big economy for small business. Fourth, by the early noughties, a small but noticeable nonprofit and NGO sector had been established in Russia. Now, many of these organizations have been labeled “foreign agents.” Formally, [many of] the NGOs continue to operate, but they do not have the ability to act freely as they see fit.
These are the four legs that have been sawed off the Russian market economy stool, and it will not be able to stand up without them. The set of factors that prevented social catastrophe in the nineties is no longer functioning.
Maybe other mechanisms will be developed, but so far I do not see them. So everything is going to depend on the speed, depth, and duration of the crisis. But if we proceed from the most probable assumption, that the crisis will shift into a protracted, sticky recession, the quality of services will fall, despite the fact that, purely superficially, universities, schools, and clinics will continue to function. We do not know yet how the population will respond economically to these challenges. It has very few options. In fact, its only option is to wait for mercy from the state. People have been prevented from taking care of themselves.
Translated by the Russian Reader. Thanks to Ilya Matveev for the suggestion.
And yet a little over ten years ago, it was the old-age pensioners (rather than portfolio investors like Mr. Rabinovich or the “rising middle class”) who mounted the first serious, massive grassroots challenge to Putin’s policies and his rule.
Maybe the old-age pensioners have gone silent now and no longer want to mount such challenges to Putin’s rule. But it is quite amazing to observe so many able-bodied and mentally competent folks in the prime of their life engaged in casting around for whole (mostly imaginary, mostly disempowered, mostly lower) classes of people to blame for Russia’s slide into totalitarianism lite. What sense does it make to say that any whole class of people “votes” for Putin and constitutes his “base,” when we know that elections in Russia are rigged six ways to Sunday?
This is not say that Russia’s old-age pensioners shouldn’t be distressed by their deteriorating economic fortunes, as reflected in the distressing and real figures cited by Mr. Rabinovich, above, but the search for the “rubes” who have buttressed Putin’s rise to minor godhood should start with the classes of Russians who have really benefited from his rule. It has most signally not been the mass of old-age pensioners who have made out like bandits, although they may be more vulnerable, in some instances, to Putin’s propaganda machine and, at the local level, to the blandishments offered by the United Russia electoral machine.
But it must be nice for Russia’s worldly and well-heeled urban hipsters, thirty- and fortysomethings, and go-getters (whose brains, again in my limited experience, are no less addled by the popular prejudices of the Putin era, and whose bodies are no less averse to putting themselves in harm’s way) to imagine that Putin’s “base” is made up of old-age pensioners, the chronically poor, blue-collar workers, and residents of the Russian hinterlands.
Putin Reforms Greeted by Street Protests
Steven Lee Meyers
January 16, 2005 New York Times
KHIMKI, Russia, Jan. 15 – Mikhail I. Yermakov, a retired engineer, has never before taken to the streets to protest — not when the Soviet Union collapsed, the wars in Chechnya began, the ruble plummeted in 1998 or President Vladimir V. Putin last year ended his right to choose his governor.
On Saturday, however, he joined hundreds of others in the central square of this gritty industrial city on the edge of Moscow in the latest of a weeklong wave of protests across Russia against a new law abolishing a wide range of social benefits for the country’s 32 million pensioners, veterans and people with disabilities.
Demonstrations were held in at least three other cities in the Moscow region, in the capital of Tatarstan and, for the fourth straight day, in Samara in central Russia. In St. Petersburg, several thousand demonstrators blocked the city’s main boulevard, with some calling for Mr. Putin’s resignation.
Taken together, the protests are the largest and most passionate since Mr. Putin came to power in 2000. They appear to have tapped into latent discontent with Mr. Putin’s government and the party that dominates Parliament, United Russia.
“It is spontaneous, and this is the most dangerous thing for the authorities,” said Mr. Yermakov, 67, as speakers denounced the government from a step beneath a hulking bust of Lenin. “It is a tsunami, and United Russia does not understand that it is going to hit them.”
The law, which took effect on Jan. 1, replaced benefits like free public transportation and subsidies for housing, prescriptions, telephones and other basic services with monthly cash payments starting at a little more than $7.
In a sign of bureaucratic inefficiency, some of those eligible have yet to receive any payments.
Mr. Putin and United Russia’s leaders have defended the law as an important reform ending a vestige of the old Soviet Communist system, but they clearly failed to anticipate the depth of opposition from those who relied most on the subsidies: millions of Russians living on pensions of less than $100 a month.
The protesters have denounced the payments as insufficient to cover the cost of the benefits and as miserly for a country that recently reported a budget surplus of nearly $25 billion.
As the protests unfolded in city after city across Russia, the Patriarch of the Russian Orthodox Church, Aleksei II, who typically allies himself with what is known here as “the party of power,” questioned the law and the government’s handling of it.
“What counts is that this policy should be fair and effective,” he said in a statement on Thursday. “It should be met with understanding by the people. The latest events show that these principles are not observed in full.”
Aleksei P. Kondaurov, a Communist member of the lower house of Parliament, said the law and the protests underscored the shortcomings of the political system that had evolved under Mr. Putin, one dominated by United Russia, which has refused to debate with opposition parties, let alone compromise with them.
“It was clear that it was not carefully calculated,” Mr. Kondaurov said of the new law in an interview.
Mr. Kondaurov predicted the protests would grow and spread to other pressing social issues, which he said Mr. Putin’s government and United Russia were ignoring.
At a minimum, the protests have raised doubts about Mr. Putin’s other proposed reforms, including those in banking, housing and electricity, which were supposed to be the centerpieces of his second term.
“It’s not going to be like Ukraine,” Mr. Kondaurov said, drawing a parallel, as some have here, to the far larger demonstrations that overturned the election there for president in November. “But it is clear to me that a political and economic crisis is taking shape in Russia.”
After first brushing off the protests, United Russia’s leaders have begun scrambling to respond. They have accused the Communists and other parties of inflaming tensions and have tried to deflect blame to regional governments, which they say are responsible for implementing the benefit changes.
Some local governments, most prominently the Moscow city administration, have vowed to reinstate the benefits stripped at the federal level, but few other regions are wealthy enough to afford to do so.
On Friday, the chairman of Parliament’s social and labor committee, Andrei N. Isayev, said that next week, lawmakers would consider raising pensions by 15 percent in February, rather than 5 percent in April, as now planned.
Others in United Russia have also tried to distance themselves from Mr. Putin’s new government, which has been in place for only 10 months. The deputy speaker of Parliament, Lyubov K. Sliska, said Friday that she did not rule out the dismissal of Prime Minister Mikhail Y. Fradkov and his cabinet.
But the protests have continued to grow. They began quietly, with a rally organized by the Communist Party in Solnechnogorsk, near Moscow, on Jan. 9, the 100th anniversary of the 1905 uprising.
A day later, here in Khimki, several hundred people briefly blocked the main highway to St. Petersburg in what several of those involved called a spontaneous uprising. After a scuffle with the police, 12 elderly protesters were arrested, but initial threats to prosecute them were quickly dropped.
Since then the protests have erupted in at least a dozen other cities, drawing thousands. In Tula, 110 miles south of Moscow, aging protesters clashed with bus conductors who refused to allow them to board city transport without paying, prompting the city to post police officers on the buses.
In Novosibirsk, in Siberia, a dozen pensioners mailed their cash payments for transit — the equivalent of a little more than $3 — to Boris V. Gryzlov, the leader of United Russia and parliamentary speaker, according to the Regnum news agency.
The protesters here in Khimki’s central square on Saturday represented those who have fared the worst in Russia’s post-Soviet transition.
Mr. Yermakov’s monthly pension equals roughly $85 a month. As a resident of the Moscow region, a separate administration from that of the city government, he qualified for a supplement of $7 to replace the subsidies lost under the new law. The bus fare for three trips to the small tract of land he is allowed for planting a vegetable garden, four miles away, will take nearly half that amount.
Vladilena T. Berova, whose given name is an homage to Vladimir Lenin, served at the end of World War II as a corporal in Soviet intelligence and went on to work as a psychotherapist for five decades in Moscow. Now 78 and widowed, she survives on 2,000 rubles a month, about $71.
“The fascists took my youth,” she said, referring to the war. “And now these people are taking away my old age.”
The protests have included something still rare in today’s Russia: personal criticism of Mr. Putin, who has remained popular by projecting an image of stability, one carefully protected by officials and state television.
“Instead of listening to us, he is listening to an organ,” Mr. Yermakov said, referring bitingly to Mr. Putin’s participation in the unveiling of a newly restored organ in St. Petersburg on Friday with Germany’s president, Horst Köhler.
The benefits law has already been credited, at least in part, with a slip in Mr. Putin’s ratings, as well as a general decline in the public’s mood.
A poll by the Levada Center, released on Saturday, said that only 39 percent of Russians considered Mr. Putin the most trusted politician. That is still higher than anyone else, but a drop from 58 percent a year ago.
Sergei Y. Glazyev, a member of Parliament who challenged Mr. Putin during the election for president last year, said in an interview that “the people’s struggle for social rights” should be decided in a national referendum, rather than imposed by the Kremlin and its governing party. Voters, he said, had been fooled.
“A majority of those who voted for Putin,” he said, “had a quiet different expectation of what they would get.”
Mr. Rabinovich’s Facebook post translated by the Russian Reader. Image, above, courtesy of the Moscow Times