32 Chapter 1
adopted new rules and policies in January 1933. It now defi ned the worker
group to include industrial workers, engineering and technical personnel,
scientists, teachers, and senior bookkeepers, and it decreed that this group
should furnish no fewer than 76 percent of patients paid by the insurance
fund at all rest homes and sanatoria and at least 60 percent of those in the
all-union kurorts. The penalties for misusing a worker voucher ranged from
being sent home to shaming in the press to criminal prosecution. On paper,
these measures produced some improvement in possibilities for workers to
receive treatment at all-union resorts. The Caucasus Mineral Waters group
reported that the share of workers alone rose from 53 percent in 1933 to 64
percent in 1935; counting the additional “worker equivalents,” these per-
centages looked even more socially acceptable: 79 percent in 1933, 82.6 per-
cent in 1935. Yet despite these gains, as one kurort director reported in 1935,
unqualifi ed patients continued to be sent on workers’ putevki. In one case,
the director of a factory department arrived with a worker’s putevka, and
when he was refused admission, the factory sent a telegram, explaining that
“due to the lack of a worker, we sent you this patient. We ask you to accept
this patient.” This sanatorium received a fl ood of such telegrams.^56
The persistent manipulation of the putevki rules suggests that in the course
of the 1930s, the health spa as an object of medicine had become transformed
into an object of consumption, its use value (medical utility) enhanced by
its sign value, the prestige of taking a vacation at an all-union resort. By the
mid-1930s, a status hierarchy among vacation destinations had become clear.
Industrial workers in fact received vacation putevki somewhat in excess of
their share of the labor force overall, although far below the targets set by the
regime, a shortfall repeatedly lamented in trade union and health commis-
sariat discussions. The biggest losers were peasants, who represented 48 per-
cent of the labor force in 1939 but who were denied the rights and privileges
of ordinary Soviet citizens: only a small fraction received access to health
establishments.^57 But nonindustrial workers who knew how to maneuver
within the system ended up with putevki to the most attractive places at the
optimal time of year. A 1933 report from the Commissariat of Public Health
provides a detailed breakdown of the social composition of the all-union
resorts. Production workers counted for an average of 34 percent, engineers
and technical personnel 17 percent, white-collar employees (clerical workers
and lower administrative staff) 11 percent. (See table 1.2.) In general, work-
ers were underrepresented in Sochi, Kislovodsk, and the Crimean southern
shore; they generated the largest share of patients in the old spas of Staraia
Russa near Novgorod, Sergeevskii mineral springs in Kuibyshev oblast, and
tuberculosis sanatoria in north-central Asia, where the treatment consisted- “As a whole,” GARF, f. A-8042, op. 1, d. 5, l. 35; f. 5528, op. 4, d. 148 (draft materials
on social composition, 1933), l. 1; f. 9493, op. 1, d. 24, ll. 5, 115; “due to the lack of a worker,”
d. 8, ll. 8, 166. - Vsesoiuznaia perepis' naseleniia 1939 goda. Osnovnye itogi , 93.