Health for all
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Theses on the current problems
1. The Corona pandemic has revealed major deficits in the health care systems of many countries.
2. Austerity, privatization and cost increases in health care have led to increasing exclusion and decreasing health care for poor and near-poor population groups in many places.
3. Although health care workers are among the most systemically relevant occupational groups, working conditions are often precarious and remuneration is inadequate in many places, which has led to increased departures during the corona period.
Ideas for possible solutions
- All people, everywhere in the world, should have access to comprehensive, good-quality health care.
- Individual contributions to health care (basic health care) shall not exceed 10% of wage income. At least 90% of total health care costs should be financed either by direct government contributions (e.g. taxes) or by equal employer and employee contributions.
- Any rationing of health services in primary care is to be rejected; everyone is entitled to the same services, regardless of their income.
- Alternative forms of therapy are to be promoted.
- All forms of therapy - i.e. both conventional medicine and alternative forms of therapy that go beyond this - should be subjected to permanent effectiveness monitoring.
The Corona pandemic has led to an enormous additional burden on the healthcare system in many countries, especially in countries with chronically overstretched healthcare systems. For example, prior to the Covid 19 epidemic, in a 2012 survey, nurses expressed widely varying levels of satisfaction with their working conditions, depending on the country: In Norway, 71% of nurses were satisfied with the working environment in their department, in Switzerland 63%, in Germany 48%, and in Poland just 24% (see Forster 2020:16). On the one hand, the Corona crisis has made the great importance of nursing staff for health care visible - the word of the year 2020 has become fashionable in this context: system relevance - but on the other hand, it has also highlighted the great strain on nursing professionals and physicians, especially in crisis situations. What remains are the frightening images in Italian hospitals such as Bergamo at the height of the Corona crisis in the spring of 2020 - and also the memory of deficiencies in the medical supply of goods such as face masks, respirators, and in some cases also the lack of medicines and the postponement of sometimes vital operations in the first Corona half-year.
The Corona pandemic brought additional economic problems for many hospitals. The German Hospital Federation (DKG) announced in early January 2021 that hospitals needed short-term liquidity support again this year because they had to scale back their service offerings. In an appeal, the DKG warned that Germany's hospitals would face significant economic problems in 2021 (see DKG 2021).
Just how overstretched many healthcare systems were during the Corona crisis was shown, for example, by the example of Great Britain during the first Corona wave in spring 2020: in the months during and after the first Covid 19 wave, around 47,000 people died of the viral infection in Great Britain. Of these, however, only about 5000, or just under 11%, had been treated in intensive care units (cf. Bumbacher 2020:4).
An original proposal was made by Hans-Peter Studer (2010:68/69). He proposed splitting the premiums of the insured into a solidarity share, which would flow into the risk pot of all insured persons, and the other half, which would flow into a personal, earmarked health account. Personal health costs would first be paid from this health account, and only when this health account was at zero would further treatment costs be paid from the common risk pot of all insured persons - minus a cost deductible of the insured person. With longer health and a correspondingly high level of the personal health account, the premium share flowing into the personal health account would gradually decrease to zero. If one disregards the fact that an excessively high cost-sharing is antisocial and should be greatly reduced or even abolished, this proposal seems quite debatable.
- Bumbacher, Beat
2020: Kampf gegen Corona auf dem Buckel der Älteren. Britische Spitäler stehen im Verdacht der Rationierung. In: Neue Zürcher Zeitung vom 27.10.2020. 4.
2021: Deutsche Krankenhausgesellschaft DKG richtet Appell an Bundes- und Landespolitik: Krankenhäuser benötigen Liquiditätshilfen auch für 2021. 1.1.2021. https://www.dkgev.de/dkg/presse/details/krankenhaeuser-benoetigen-liquiditaetshilfen-auch-fuer-2021/(Zugriff 12.1.2021).
- Forster, Christof
2020: Am Krankenbett herrscht Stress. In: Neue Zürcher Zeitung vom 19.9.2020. 16.
- Studer, Hans-Peter
2010: Gesundheitswesen als kosteneffizientes Solidarsystem mit Eigenverantwortung. In: Seidl, Irmi / Zahnt, Angelika (Hrsg.): Postwachstumsgesellschaft. Konzepte für die Zukunft. Marburg: Metropolis-Verlag.