Act
against the global health crisis
Working group
"Health, social protection" FST Porto Alegre 2012
The crisis of
capitalism, the ecological and food crisis which are linked and the growing
social inequalities have aggravated the health situation of people worldwide,
this situation leads to various disorders and diseases that reverse progress
made up to now.To take just one example, life expectancy in the U.S. (leading world
power) is a lasting trend of decrease (from 77.9 years to 77.8 years between
2007 and 2008) a study published December 14, 2010 states that in 1998, a 20
year old male could expect to live another 45 years away from a serious illness
(heart disease, cancer or diabetes). This number fell to 43.8 in 2006. A
decrease of 1.2 years ... in 8 years.
The crux of the
health crisis lies in the fact that simultaneously with the degradation of the health
and social situation there are in almost all countries attacks on public health
systems by increasing merchandisation which is exacerbating North/South inequalities
and social inequalities within each country. The poorest layers of the
population and women are the first victims. These reforms appear to be
programmed or planned worldwide as they are similar. They fully meet the
demands of financial markets, health and pharmaceutical multinationals. One can
observe the simultaneous acceleration and attacks against the rights of the
population in terms of healthcare in the form of privatization and destruction
of non-market social protections.
One of the
arguments which is advanced, particularly in Europe, is the (false) pretext for
reducing public deficits imposed by austerity policies (Ex: public spending in
France is not increasing 52.8% of GDP in the 90’s, 52.9% in the 2000’s - source
Le Monde). Yet it is precisely the rescue of the financial system and
safeguarding of profits that have aggravated an illegitimate debt and serve as
a pretext for the majority of governments to destroy the financing of public
health systems.
This contradiction is increasing
and becoming a source of mobilization and many social movements worldwide
fighting against the privatization process of health.
The subject of healthcare is
a major factor in mobilsation because it is a fundamental right not recognized
as such by the capitalist system. To give perspective to these struggles, SF
participants in Porto Alegre, preparatory summit of 20 nations in Rio, proposed
to act together for an alternative system of social protection without borders,
based on the existence of inseparable economic , social, civic and political rights. A health system based
on needs and not the management of resources, based on prevention,
universality, accessibility, quality, state responsibility (public service), on
the statutory and working
conditions
for health professionals, as well as training to ensure quality of care and
caring. A system of Healhcare Democracy managed by the the population and
healthcare professionels. A genuine policy of prevention of health risks at
work.
To face this situation, here
are the policies to mobilize for and the policies to fight against:
Access to
care, Proximity
For :
- Access to health care as an
inalienable right for everyone, everywhere and at all times, even in difficult
to access or sparsely populated areas.
- Reimbursement in all healthcare
systems of Long Duration diseases (eg cancers, HIV, malaria, diabetes,
hypertension ...)
Against:
- All measures aiming at the
selection, discrimination and exclusion of individuals regarding resources or therapies
- Systems of insurance
packages or franchises,
- Fees of professionals
beyond reimbursement systems,
- The disbursement of
prescribed drugs,
An effective
public service present everywhere
For:
- A 100% public healthcare
service (including primary care,
prevention, education, the fight upstream against the causes of disease), a
medical-social and social sector,
public and nonprofit, developed on throughout the territories, with sufficient
resources to meet the needs of all populations,
- A public emergency shelter
and housing service, without access conditions or restrictions whatsoever, for
the rights of all needy and insecure poor people,
- A public hospital system
providing access to quality care and close coordination with all health
professionals, and with all stakeholders,
- Maintaining and
developing local facilities: health centers, abortion clinics, centers for
prevention in psychiatry, emergency shelters...
- An emergency
plan for healthcare at school and work,
- A public psychiatric
sector coordinating and ensuring continuity of care, considering patients as
sick people and not as dangers to society
- Increasing the
number of trained health professionals, recruitment to meet the needs and the requirement
of a balanced distribution of healthcare throughout the territory,
- Independent public
research,
- A public pharmaceutical policy
integrating research, production and control.
- Job stability, stable
organization of work and social rights (family, retirement, etc.) taking into
account the difficulty of the health professions.
- A staff of professionals
based on care needs, care and prevention
- The phasing out of private
for profit healthcare companies
Against:
- Job cuts, closures of
activities, closures of services, authoritarian regrouping in all of the
health, medical-social and social sectors.
- The dismantling of public
psychiatric care and the instrumentalisation of it to create security fears.
- The application of
financial profitability criteria in hospitals and in all healthcare institutions,
- The privatization of
activities and facilities,
- The competition between healthcare
facilities,
- The organized looting of
medical or health professionals from one country to another,
- degraded working conditions
and precarious status for health professionals,
- Just-in-time hospital
management.
Secure
Funding based on solidarity
For:
- Social protection, open to
the entire population, based on the principle "everyone contributes
according to their ability and receives according to their needs"
- Social protection for which
funding is guaranteed and based on the redistribution of wealth.
- Support for the loss of
autonomy within the framework of social security with the guarantee of a
universal right guaranteed at 100%
- The total disconnection of
the financing of social protection from the financial markets, private banks,
insurance and profit structures,
- A move towards the removal
of all the "extra charges".
- A 100% financing of
healthcare by employers of all diseases and conditions related to working
conditions.
Against:
- Any transfer of welfare
benefits to the mandatory health-complementary private insurance,
-Any exemptions for employers
from social security contributions or other healthcare contributions,
- Closed budgets and
"pricing of each act" for the financing of health facilities leading
to the financial strangulation of institutions and structures.
- All private funding which
is conditioned by a private stake
in management or other interest.
Healthcare
Democracy
For:
- The definition of the
democratic needs of the population, development and monitoring of projects,
involving users, professionals, elected on an equal footing,
- A real representation of
users, staff and elected representatives in decision-making at all levels.
- The right of workers' to
decide on working conditions to help prevent diseases related to occupational
causes.
The global mobilization
against capitalism of June 5, 2012 decided by the Assembly of Social Movements of
January 28, 2012 in Porto Alegre, the European Conference of Defence of the
health and welfare held in Paris in May 2012 or the summit of peoples at
Rio +20 in June 2012, are appointments that will further the exchange of
experiences, discussion, actions, and move forward on policy proposals to
address the global health crisis for social justice and Environmental, against
the merchanisation of life in defense of the "common ".
Annex :
Recent victories against the privatization of healthcare.
Romania.
Share of GDP for social protection = 12.8%
State budget for health = 4%
Life expectancy = 69.7 years
Romania
suffers from one of the worst two years of austerity cures. In late
December, the government of Emil Boc attacked the healthcare system.
This was to be the last straw and the starting point of the movement of
outraged Romanians. The Romanian healthcare system is ailing. But the
planned reforms will only benefit the private insurance funds. While
Romania spends only 4% of its GDP on health, compared to 8% of the EU
average, it is still going to cut spending by opening up to "private
operators". The proposed privatization of emergency services was
explosive and it happens that the man who founded this service, Raed
Arafat (Palestinian-born doctor)who is extremely popular, currently
Deputy Secretary of State is hostile to these reforms. He has publicly
opposed the privatization and resigned. This action has encouraged the
explosion of indignation that swept Romania in recent days. Peaceful
mobilizations have spread throughout the country, very socially mixed,
with a significant proportion of young people. Police violence has
injured several dozen. Thousands of people took up the slogans of
December 1989: "We are dying of hunger", "follow us". But they also
demand the resignation of President Basescu. Faced with growing
opposition aroused by his project, The President has announced its
withdrawal. But this change did not calm the population, and Romanians
continued to march through the streets of the country, extending their
demands to austerity raging since 2009. "We are tired of having to
swallow everything from pay cuts in 2010 to corruption" ...
Germany
Share of GDP for social protection = 28.7%
State budget for health = 10.6%
Life expectancy = 79.4 years
In
a context of violent attacks and closures of local hospitals in
Germany, on January 29, 2012, the people of Dresden (Germany, Saxony)
84% voted in favor of keeping hospitals under municipal ownership and
therefore against privatization. The necessary minimum of voters (at
least 25% participation) was exceeded with 37% voting. So this blocks
plans to privatize hospitals for three years. A victory!
Municipal
authorities had intended to merge the two municipal hospitals into a
limited company, remaining public but can be privatized at
any time by selling shares. An "Alliance for hospitals" was formed,
composed of, among others, the staff of both hospitals, the Verdi union,
the collective "Hands off hospitals", political organisations such as
the SPD , Die Linke and SAV (Sozialistische Alternative) ... 37,000 people signed the petition for the maintenance of municipal status of hospitals.
In
the referendum of January 29, the question was: "Do you agree that the
hospital Dresden-Dresden-Neustadt and Friedrich keep the status of
Municipal enterprises of Dresden?" The "yes" won by 84% of the votes
cast. The same privatization model is projected in Stuttgart ...
Slovakia
Share of GDP for social protection = 16.3%
State budget for health = 7.3%
Life expectancy = 74.9 years
Excerpt from Pravda, Slovak newspaper:
Although
the projected transformation of 31 public hospitals into private
limited companies has been suspended until after the elections next
March, " doctors continue to resign." Approximately 2,400 public sector
practitioners are threatening to leave their posts in protest against
the project of the Ministry of Health. The Slovak Chamber of Physicians
considers this project as «privatization by stealth" which will
potentially worsen working conditions. They also demand that their
salaries be increased to reach between 2,000 and 4,000 euros per month,
and more government subsidies for the healthcare sector. "Promises are
not enough for them, they want guarantees." The reform project will be
the subject of a special debate in Parliament on November 11, at the
initiative of Robert Fico’s opposition party Smer, , who, according to
Slovak Spectator, seeks permanent abandonment of the project.
England
Share of GDP for social protection = 26.1%
State budget for health = 7.8%
Life expectancy = 80 years
The
reform of the NHS, the public healthcare system which is popular in the
UK despite some shortcomings, is subject to a reform project aiming to
introduce private funding. It is also about redundancies among the 1.7
million NHS workers, closure of hospitals and adapting reimbursements to
patients behavior (obesity, alcohol, ...) which is deeply shocking for
professionals and associations . The Royal College (public doctors)
medical, emergency doctors, psychiatrists, midwives, radiographers and
the national association of users have made their opposition public to
this reform. Internal tensions within the government but also the
movement of the ‘Outraged’ in Romania which appeared following the
reform of Romanian healthcare two days earlier, forced the UK Health
Minister Mr. Lansley to announce changes to the reform.
Brazil
Share of GDP for social protection = 12.5%
State budget for health = 5%
Life expectancy = 72.7 years
Brazil
experienced a major healthcare reform after the fall of the
dictatorship in the late 80s. It allowed the establishment of a health
system with minimal public financing through social contributions called
SUS (Single Health System), it is free but not universal, it leaves
room for private insurance and a network of private clinics in addition.
It works with a democratic system from the municipal healthcare level
to the federal level with national health conferences - CNS- which make
decisions on healthcare policy.
It
is precisely in this context, during the 14th CNS that the "National
Front against the privatization of health" composed of associations,
political parties and unions won a huge victory: The rejection of the
government's privatization.
The
Ministry of Health ( Minister Alexandre Padilha, a militant of
healthcare reform ...) had proposed to amend the fundamental Healthcare
law by providing opportunities for funding by private foundations,
public interest associations, private health service companies and
public-private hospital partnerships, in a new governance of the
healthcare system. The conflict is hardening with the government
refusing to accept the vote of the conference. The 200 signatories of
Front against privatization announced that they would call for mass
mobilizations if healthcare democracy is not respected by the
government.
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