Health is not a Commodity
Resist the Operations on Health Care!
[On April 20, 2002, 250 persons from Attac groups and other organizations met to discuss the far-reaching amputation plans for the public health system. The following pamphlet is translated from the German on Attac's web site on the World Wide Web, http://www,attac-netzwerk.de/sozsich/20-4/heidel-erklaer.html.]
Healthy living conditions and aid in sickness are human rights though seemingly reserved for the solvent. These rights are withheld worldwide from many people in the poor countries of the South.
Alongside their sickness, patients even in Germany are increasingly plagued with mistrust. Am I sent for examination to use the available equipment to capacity? Are medicines denied me because my doctor has exceeded his budget? Is he focused on favors of pharmaceutical companies? Is the private patient better provided? Will I be released from the hospital because my sickness is too expensive for the clinic's owners? Is the selling off of the public health system trivialized with the old "cost explosion" fairy-tale?
Reason for concern exists. Home care becomes increasingly poorly paid "women's work" since public possibilities are narrowed.
Training apprenticeships in the public health system are reduced. The income of employees is lowered as a way out of the personnel distress. Cheap medical personnel from India, the Philippines or Albania gradually destroy the health care in their homelands. Patent-protected medicines reinforce the indebtedness and dependence of impoverished countries.
Radical incisions are urged. The dogma of globalization winners is lower non-wage labor costs. With the "practical constraints" or "practical necessities" of international positional competition, they justify the further exodus from the parity-financing of the social systems. Their panacea for better care is called competition. Who are the winners? The higher incomes are not mobilized to balance the consequences of wage dumping and unemployment for legal health insurance. Who are the losers? Can deficient quality, over-diagnostics and under-provision be cured by price competition?
Many things could be improved. Health care for all means not abandoning patients and the insured to market forces. A society of solidarity of the strong with the weak, the North with the South and the still healthy with the sick is necessary and possible. However very different operation plans are planned in the health ministries. Solidarity is amputated. The sick are left to competitive markets and private rip-offs. The borders for global health marketers are pulled down.
We firmly resist these cuts.
Health may not depend on the billfold. We want to stop the privatization and market competition in the public health system. A democratically organized health care for everyone should be a worldwide public challenge.
The alliance "Health is not a Commodity" passed a "Heidelberg declaration" at its action conference on April 20, 2002. With this text, we oppose the further destruction of social security. Privatization does not solve any problems in health care but injures. We want far-reaching changes in health care and wage improvements in a solidarian direction as the first step to the definitive end of the neo-liberal dismantling and reconstruction.
In the coming weeks and months, we will canvass publically for a change of the discussion to solidarian security. Tens of thousands affirmed this change by signing the Heidelberg declaration. This will be one of the arguments when the election campaign lyricism ends after the Bundestag election and the parties speak plainly.
Experiences and fresh new perspectives warn us of the trip cases of traditional health policy. The whole direction of the discussion around health reform should be reversed. Many annoying and injurious tendencies appear in the public health system. Patients don't want to be treated unnecessarily only because chief doctors earn money or pharmaceutical firms test new concoctions. "Reform" is always equated with privatization. We reject this. Privatization strengthens the selfish interests in the system. The solidarian mechanisms should be strengthened. Therefore the first and most important consensus of the action conference is ending the neo-liberal dismantling and reorganization of the public health system. Private interests damage health care! This goal is far-reaching. We will have to work tirelessly. The dominant policy focuses on the distribution of nearly a quarter billion Euro circulating yearly in the German public health system and is only incidentally interested in better care of the sick.
The Public Health System is more than a Sector of the Economy
Economic Efficiency Orientation Endangers Humane Treatment of Sick Persons!
[This petition arising from the May 2001 congress of the IPPNW (International Physicians for the Prevention of Nuclear War) is translated from the German on the World Wide Web. E-mails to Dr. Dohmen and Dr. Batsch should be sent to: email@example.com.]
"Cost explosion in the public health system" and "payment stability in health insurance" are slogans that have increasingly marked the political reform discussion in the public health system in the last years. The proposals for redesigning our public health system have provoked an alarming opposition on account of the dominance of economic orientations. We employees in the public health system can no longer be silent. A great congress of the IPPNW - Physicians in Social Responsibility on "Medicine and Conscience" from May 24-27, 2001 with over 1500 participants emphasized that the current changes in health conditions increasingly endanger the humane and holistic treatment of the sick entrusted to us. Under the title "Change at any Price - Clinic doctors in the tension between the economy, technology and humanity", Konrad Gorg presented a merciless but correct analysis in the journal Deutschen Arzteblatt, May 4, 2001. He pointed out that "medical conduct is guided more and more by one-sided economic instructions and reduced to an economic resource". He rightly asks: "Where are the human conditions necessary for doctor and patient if only the expedient, useful and economic are held in high esteem as everywhere in society and the only serious communication occurs in the language of technology, science or economy?"
From 2003, physicians in the future will have to implement a new payment system. This system reduces patients to a summation of diagnoses and our medical treatment to a listing of accountable procedures. The goal of medical conduct is then only the economic survival of the hospital or division. Patients become degraded to objects of economic exploitation. Only deductible technical works determine the value of medical activity. Human attention and entering into the individual desires and fears of patients inevitably fall by the wayside. This structural change will permanently affect the medical self-image in a short time.
We employees of different vocations in the public health system are shocked about this development. Unfortunately we have rarely made common public declarations in the past. Since the political forces in this country, particularly the parties represented in the Bundestag, are hardly distinguishable in their health programs and are committed to increased economic efficiency of all institutions in the public health system as a panacea, the public debate over the future development of our health system has fallen into a dangerous predicament. The most important pillar of our public health system since the Bismarckian social policy - the solidarity of the healthy with the sick - is today in danger! The most important efficiency reserves are essentially exhausted in all institutions of our public health system. What is missing is a surplus in human love and affection and individual care of the sick entrusted to us that can no longer be afforded both in the clinic and in practice with the intensified intolerable working conditions.
The fact that the same share of our gross national product over decades is spent on health services although the portion of older sick persons and of expensive medical progress have increased considerably indicates that we do not face a cost explosion in the public health system. We need a broad public discussion about what our health is actually worth compared with other areas of our life. As many people as possible should participate in this discussion. What is uppermost is not more money for doctors or a greater profit for the pharmaceutical industry but the rank that we give to prevention, treatment of sick persons of all social classes and rehabilitation in self-determined life after the sickness.
With this call, we undersigned employees in the public health system are trying at the last minute to warn about an economically efficient development of our public health system that is inhuman for the affected. We will not be able to do justice to the needs of the patients entrusted to us in the near future without a reorientation of all current reform efforts that set the high importance of health maintenance of all members of our society as the focal point!