A-Infos (en) Germany, ESPIV: Black and Red Flag #4 - The Chronic Disintegration of the Health Care System - West Suburbs Political Newspaper (ca, de, it, pt, tr)[machine translation]

We will begin this article with a basic observation regarding the 
chronic condition prevailing in the public health system. This is none 
other than the chronic underestimation that characterizes the E.S.Y., 
the underfunding, the understaffing, the lack of infrastructure and 
equipment and the tarnished image presented by the state hospitals. This 
condition is known to all of us who have had to be hospitalized, 
examined, have an operation or rush to a state hospital for all of the 
above for a relative or friend. There we have come face to face with all 
the above deficiencies and inadequacies, as well as the long delays, the 
months-long waiting lists for surgeries and examinations that 
characterize the E.S.Y. and which unfortunately have been fatal for the 
life and health of many people. Health workers (doctors, nurses, 
paramedics, etc.) know this condition better than all of us who struggle 
every day to be able to do their jobs, while at the same time the 
majority of them have to deal with grueling hours, low wages as and some 
of them the insecurity of the fixed-term contract regime and the 
non-permanence of their positions.

The turning point for the extreme degradation of the public health 
system was the period of the memorandums starting in 2010 until today. 
The E.S.Y., pharmaceutical costs and over-indebted insurance funds, the 
resources from which were used to buy bonds, were targeted by austerity 
policies. Over the years, public funding for health has been greatly 
reduced  and everything has been geared towards reducing operating 
costs: hospitals have been closed or merged with others, the use of 
medical devices that were costly to the public coffers has been 
restricted, while  purchases of basic medical supplies and equipment 
decreased, creating major shortages. At the same time, in the context of 
the cuts in pharmaceutical costs and insurance benefits, the number of 
drugs covered by public insurance decreased, while the "participation" 
for medical examinations increased.

Health workers who were faced with reductions in their salaries, mass 
layoffs, understaffing (eg the memorandum measure of hiring one employee 
for every five who leave or retire) were repeatedly targeted by the 
memoranda policies  ). All this has led on the one hand to extreme rates 
of work intensification and to the professional burnout of employees and 
on the other hand has resulted in many hospitals, prominently those in 
the province, being under-functioning and hospital units being closed 
due to the lack of specialized staff.

If we consider all of the above, we can reasonably come to the 
conclusion that  health management is done  in terms of cost-  benefit 
and not based on social needs and the value of human life. The condition 
of waiting for months for an examination or an operation,  as a result 
of which in many cases you are forced to resort to private hospitals 
paying heavily , the condition of not having ICUs to be hospitalized, 
the condition of having to pay exorbitant amounts either as 
participation or entirely for necessary medication certainly does not 
refer to a health that  is perceived as a public good accessible to all. 
In the midst of all this, over the years we have seen the attempt by all 
governments to shift the cost of public health onto our backs: from 
Georgiadis' 5 euros for hospital admissions to the increase in workers' 
insurance contributions by Katrougalos .

In  this situation that we described  in rough lines  above, the 
manifestation of the  COVID-19  pandemic found the E.S.Y, which, being 
in a collapsing state, was, as was logical, unable to respond to the 
needs that existed. We all remember,  especially  during periods of 
outbreak, that patients are piled up in hospitals, that ICUs are full, 
with the result that patients are intubated in simple wards and there is 
a "sorting" for who will enter the ICU, that the health  staff is not 
sufficient even for example, and at the same time under the enormous 
pressure of the pandemic, the rest of the operation of the hospitals 
freezes with planned surgeries being canceled and the operation of the 
outpatient clinics in many hospitals being suspended.

In the face of all this, from the side of the state administration, 
there was no substantial strengthening of the E.S.Y and as a "solution" 
the opening-closing with successive rolling lockdowns was used as a 
"solution" which was applied according to the needs of the economy and 
the demand per season in specific sectors (eg during the tourist season 
we had "we are open and we are waiting for you") and when the health 
system reached its limits the measures were returned. We are talking 
about a political management of a combination of restraining the smooth 
functioning of the capitalist market and defraying the political costs 
of a huge increase in deaths and hospitalizations that the collapsed 
health system could not manage.

The criminal management of the pandemic, both domestically and globally, 
rang a bell about  the very nature of the state and capitalism, 
highlighting the contradictions of the system. The consequences of 
criminal state management should not be forgotten, as it is certain that 
under different circumstances many of the human lives that were lost 
could have been saved. The choices made are not the product of 
government negligence or incompetence, but conscious choices based on 
the priorities dictated by state and capitalist normality. So, while the 
hospitals were collapsing without infrastructure, at the same time of 
the great intensity of the pandemic, packages of billions were announced 
for the purchase of military equipment, while  the recruitment of health 
personnel was more imperative than ever ,  in the time of the great 
intensity of the pandemic, thousands of new positions were announced for 
the police. It is characteristic that after the worst month of the 
pandemic with the most cases and deaths, in November 2020, a few months 
later the budget voted for 2021 included the reduction of funding for 
health, while during the pandemic hospitals were reinforced with only 
321 permanent health personnel. In particular, for the health workers, 
all that was reserved by the state policy was the famous applause, the 
media reports about "heroes on the front line" and then  the absolute 
indifference, the concealment of their claims and the suppression of 
their mobilizations.

Today, after the great wave of the pandemic subsided and the shock it 
caused in terms of health benefits, making their enormous problems more 
obvious than ever, has anything really changed in relation to what we 
mentioned above? The answer comes again from the reality itself and 
states that the state policy continues to maintain the same situation 
and even proceeds on the path of further commercialization and 
degradation in the health and the exsanguination of the workers in the 
sector. According to the workers themselves, this winter the staff at 
the hospitals is 3000 less than last year, which is due to the wave of 
mass flight of workers who, under the regime of low wages, exhausting 
work rates and job insecurity, are leaving by hundreds per month from 
the public health system. This condition, combined with zero 
recruitment, creates huge gaps, while there is no intention on the part 
of state policy to change. It is indicative that the recently passed 
state budget for 2024, while anticipating increases of 1000 euros in the 
salaries of hospital administrators (the so-called managers), the 
increase in the particularly low salaries of health workers amounts to 
less than 50 euros. At the same time, there is a systematic refusal on 
the part of the government to make permanent the thousands of contract 
holders who work under an insecurity regime with few month renewals or 
termination of their contracts.

The only thing that has changed after the tragic consequences that the 
pandemic brought to public health, are the most communicative appeals 
from the side of all parties, regarding the improvement of health 
benefits. Appeals that if we reflect on the actions of all parties in 
power in previous years, as well as the recent attempted reforms in the 
context of the creation of the "New E.SY." only shame and rage can 
cause. From our side, we don't see anything "new" in E.S.Y. Government 
funding for public health remains stuck at 5% of GDP, while private 
spending (the money we put out of our pocket) on health is the highest 
among EU countries. At the same time, with a series of bills that have 
been passed recently, the further commercialization of health is 
attempted. The latest bills, among other things, envisage the extension 
of the application of PPPs (Public-Private Partnerships) to public 
health agencies as well as within this framework the realization of paid 
afternoon surgeries in state hospitals and the removal of the full and 
exclusive employment of doctors at the E.S.Y., with the possibility of 
private doctors working part-time at the E.S.Y. and doctors of the 
E.S.Y. to work at the same time in the private sector, which with the 
current conditions reinforces the shortages in hospital staff and 
creates clientele (for those who have this possibility) for faster 
services in private medical practices.

It is clear that the lines between free and paid health care are 
becoming increasingly blurred. The acquisition of the health good is 
carried out in clear class terms: if you have to pay you will have more 
direct access and better benefits for your health, if you belong to the 
great majority of society and do not have this financial ability you 
will come face to face with the rajas in the inferior hospitals of the 
E.S.Y., with the delays of months and you will tremble in case of need 
if an ICU bed will be found for you to be hospitalized. It could not be 
otherwise in this system that treats us, the working class and the poor, 
as expendable and is not going to care about our survival, except to the 
extent that we are useful for its reproduction.

INITIATIVE OF ANARCHIST SAINTS OF ANARCHY - KAMATEROU

https://anarchism.espivblogs.net/2024/03/11/i-chronia-dialysi-toy-systimatos-ygeias/
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