Tuesday, July 5

Defending Public Health beyond rhetoric

The Ministry of Health has just submitted to Congress the draft law on health equity, which in the words of Minister Carolina Darias is going to “shield” public health. However, and despite months of proposals and negotiations within the Government, the PSOE text does not serve to prevent the National Health System from being privatized and large private companies profiting at its expense.

The main reason is that the Darias Law does not repeal Law 15/1997, with which the Aznar Government opened the doors for private companies to do business with the Health Service, something that is detrimental to the quality of care they receive the patients. The text of the PSOE limits itself to saying that health services will be managed and provided “preferably” publicly, but allows them to be outsourced and privatized “in exceptional conditions”.

In other words, the Darias project remains an exercise in rhetoric that goes no further, because it does not define or specify what those “exceptional circumstances” are in which health care can be privatized. In other words, any assumption is likely to be considered “exceptional” and an ad hoc report will suffice, where an autonomous government so establishes it, so that public health can continue to be cut up, privatized and left in the hands of multinationals and vulture funds.

This concern of United We Can is the same that was expressed this Tuesday, for example, by the spokesman for the Federation of Associations for the Defense of Public Health, Marciano Sánchez Bayle, who warned that the rule proposed by the PSOE “is not adequate” precisely because “the exceptionalities are at the discretion of each autonomous community”, so they will not be able to “reverse” the privatizations. What is necessary, he added, is that “all the money that goes to concerts [con la sanidad privada] is dedicated to strengthening the public system.”

As Sánchez Bayle says, the Darias law is insufficient to deal with governments like that of Isabel Díaz Ayuso, who have already amply demonstrated that they have no scruples when it comes to handing over public services to large private companies. According to data from IDIS – a private Health employers association –, the Community of Madrid spends more than 902 million euros a year on concerts (2020 data) and almost one in ten euros of the health budget goes to the pocket of private companies , 30% more than in 2008. Does anyone doubt that Ayuso will find a way to produce the necessary reports to justify more privatizations, no matter how much Darias recommends public administration?

Aware of this problem, from United We Can we have proposed alternatives to improve the PSOE text and so that this regulation is truly courageous and ambitious in defense of public health. For example, we have suggested to Darias to specify that in no case can a health area be completely privatized, as happened in the Valencian Community during the PP governments, until the Govern del Botànic -with the presence of United We Can and despite the pressure of the lobbies of the private Health-reverted the situation. Unfortunately, the Ministry of Health has refused to include this and many other proposals.

Thus, the conclusion is that the PSOE text maintains the essence of Aznar’s law and that norm is not thoroughly revised, as contemplated in the coalition agreement in its point 2.2.3. This position of our government partner is disappointing, because health is a constitutional right that must be guaranteed through a public system whose sole purpose is the well-being of citizens, and not the obtaining of business profits. Private management models are inefficient and basically involve diverting public money to private companies while worsening the quality of care.

United We Can continue to defend the direct public management of Health to guarantee its quality, a right that citizens believed they had guaranteed but that the policies of the PP and the PSOE endanger, while favoring multimillion-dollar businesses. That same defense of public health and its direct public management is what will guide us in the parliamentary processing of this bill, which we believe must necessarily be modified so that it can have the support of the majority of the Chamber and with the support of our group.


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