“To affirm the equality of all people and to work for the overcoming of the simple formality of equal rights before the law, advancing towards a world of equal opportunities for all”. Silo, 2005
By Víctor Piccininni.
We continue with this series of notes entitled Prioritising health. In the first one “It’s not about handouts” we highlight the inequality in the distribution of vaccines for Covid-19 and stress the need for:
A profound transformation in international mechanisms, which should be driven by international agencies (UN, WHO, UNICEF), that coordinates and ensures an equitable distribution of the vaccines that are being produced globally among “ALL” countries regardless of their economic capacity, government ideology or geographical location. This is a profound change in the management of crises and critical social problems facing humanity.
In this second note, we would like to highlight a truism that, in practice, is apparently not so obvious. It can be summarised as follows:
Providing health services by seeking primarily and exclusively a business implies a great contradiction with the very essence of health.
Let us see why.
On the one hand, health is presented, in theory, as a universal human right. This is affirmed in the Universal Declaration of Human Rights (Art. 25), the WHO (in its founding declaration) and in the Constitutions of all the countries of the world. (1)
On the other hand, “business” is, at its core, about making a profit (money, power, resources, tangible goods). When a health service is provided, as a business, it will imply, in practice, that some people will be able to access it, while others will not. It then ceases to be a “universal human right” and becomes a possibility that depends on the material resources that one has or can obtain. This is the fundamentally contradictory root of the “health as a business” approach.
An important clarification. In this note, we are not referring to the dichotomy between public and/or private health. Nor are we referring to the fair remuneration that health professionals should receive. We are specifically limiting ourselves to the “conceptual contradiction” that arises from the desire to make health care conditional on the level of economic business.
This is a conceptual issue that is then transferred to various fields of practice (medicines, treatments, patents, applied scientific and technological advances, discrimination based on areas of residence or social status, etc.). It will be difficult to change what happens in each particular situation if the conceptual problem is not solved at its root.
Having clarified this, let us return to our central theme and show some examples, at random, of this contradiction:
A person has some oncological or unusual disease. He needs some expensive medication for his treatment. Some values: Zolgensma (USD 2.1 million), or Luxturna (USD 850 thousand), or Vimizin (USD 370 thousand), and we could go on… Countless drugs and treatments cost thousands and hundreds of thousands of dollars. A few will have the money. A few others will be able to get help. A large majority will be totally cut off from access. Their chance will be almost “zero”. (2)
Another example. Private health systems (with priority in business) refuse to perform certain treatments if the person’s insurance does not cover it. Sometimes, a “court war” begins to get the necessary care. Some succeed, some don’t.
Not to mention the impossibility of inhabitants of vast regions of the world (in every country, in every city), who, because of their economic impossibility, are prevented from accessing basic health care and treatment.
Who does not know of such situations among their acquaintances or relatives, or who has not heard or read about them in the media?
Examples abound in all parts of the world, confirming the general rule: “health, framed primarily as a lucrative business, is in great contradiction to the basic principle of equal opportunities for all human beings”.
Overcoming this contradiction is no easy task. It implies transforming the very roots of the prevailing social system where “money is everything” (“business and more business”). The first step is to highlight and denounce it. The second step is not to naturalise it and to recognise it as a generator of personal and social suffering. Imagining and then proposing ways of overcoming it is the third…
REHUNO Health
2. www.clinic-cloud.com and www.cepal.org (approximate prices at point of origin)
