Putin Speaks, Officials Shrug, and Doctors Are Caught in the Middle – The New York Times TrumPutin PuTrumpin?

That things have gone so awry is a measure of the wide gap between image and reality in a country that revolves around what Mr. Putin calls the “power vertical.” This is the rigidly top-down — and, in theory, stringently efficient — system that he has spent 20 years building to replace the decrepit state structure he inherited from his predecessor, President Boris N. Yeltsin.

Tatiana Stanovaya, an expert on Russian politics, said the “power vertical” has always been a political project focused on protecting the Kremlin from opponents, not on delivering efficient administration for the public’s benefit.