If you can believe his admirers inside and outside the Soviet Union, Kremlin boss Mikhail S. Gorbachev is determined to get the sluggish Soviet economy moving, and will use a combination of disciplinary measures and economic reform to get the job done. But the question of questions is whether Gorbachev, on doing his sums, will face up to the fact that the most needed reform of all is a reallocation of resources from the military to the long-suffering Soviet consumer.
The truth is that the average Soviet worker doesn't work as hard or as well as his counterpart in the West. There are many reasons for this situation, but the most basic is the enduring shortage of goods and services that he might want to buy. Until and unless this situation changes, he has little incentive to work hard for a few extra rubles.
The main reason for the systematic shortchanging of the consumer industries in the Soviet Union is the lopsided allocation of money and manpower to the military-industrial complex, which gobbles up twice as large a share of the gross national product as does the defense budget in the United States.
For stark evidence of what these distorted priorities have done to the Soviet Union, one need only look at the deteriorating situation concerning health. The Soviet Union is the only major industrial nation in which such key health indicators as longevity and infant mortality are going the wrong way.
At the end of the 19th Century the average life expectancy in Czarist Russia was only 30 years, and one infant in four died before reaching its first birthday. By 1960 average life expectancy in the Soviet Union had risen to 68.7 years, and the infant-mortality rate was down to less than 2 1/2%--figures that compared well with those in Western Europe and the United States.
Beginning in the early 1970s, however, there was a change for the worse. In 1975 the official Soviet Central Statistical Bureau reported that the infant-mortality rate had increased by more than a third since 1970. No official Soviet figures have been published since then, but an official told a Moscow press conference four years ago that the infant-mortality rate was 30 per thousand--well over twice the rate in the United States and Europe, and markedly worse than the figure in the Soviet Union for 1960.
The same official admitted that the life-expectancy figure for men had fallen since 1971, when the average was already down to 64 years. Dr. Zhores A. Medvedev, a Soviet emigre who is a specialist in research on aging, estimated last October that life expectancy for Soviet men is now down to 62 years.
Dr. Murray Feshbach, an American expert in these matters, points out that such projections are consistent with published Soviet statistics showing an increase in the annual death rate from 6.9 per thousand in 1964 to 10.3 in 1983--an "incredible" 50% jump.
On the surface the Kremlin has invested generously in medical care. The Soviets have 37 doctors and 125 hospital beds per 10,000 people, which compares well with advanced Western countries. But twisted priorities have had an effect. The starting pay for a doctor is less than for a mechanic on the Moscow subway. Even after 20 years a doctor earns less than the average Soviet wage of 185 rubles a month. Nurses are even more underpaid.
The result is a severe shortage of nurses, and it is common gossip that medical personnel demand under-the-table payoffs from patients in order to supplement their official incomes. Meanwhile, health officials complain publicly about shortages of medical supplies and equipment ranging from antibiotics and high-technology devices to antiseptics and ordinary thermometers.
Most outside experts, however, do not consider inadequate medical services to be the main cause of the rising death rate and declining longevity. Instead, they point to broader social factors like unbalanced diets, the increasing number of traffic fatalities and industrial accidents--and, most important of all, "pandemic" alcoholism.
Just last week the Kremlin announced a package of measures that are aimed at discouraging the consumption of alcohol, including an increase in the legal drinking age from 18 to 21, a cutback in the production of vodka and heavier penalties for drunk drivers and makers of samogon , or Russian moonshine.
The problem isn't so much the quantity of alcohol consumed--Russians actually drink about the same as Americans and less than the French and Italians--but the economic and social effects, which are related to the high proportion of alcohol consumed in the form of vodka and other hard liquor.
The country's press has carried numerous articles decrying the rise of alcohol abuse among women and also expressing alarm over the high mortality rate among infants born of alcoholic mothers and the high rate of mental retardation among the survivors.