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Synthesis

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Synthesis

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  1. Synthesis RT 9 JP unger

  2. Features of publicly oriented systems • Public mission guaranteed by state • Quality: bio-psychosocial care (and integration) • Access • Co-management / participation = objective • Systemic management / interinstitutional coordination • Bottom up planning / strategic planning • Support by DMOs, LHS federation or other.

  3. Evidence of publicly oriented > commercial • USA = achieved model = disaster • LA (Colombia, Chile, Mexico…) confirm it • Europe (Sweden, Spain, etc) also • Counter-examples in LA confirm: Salvador, Cuba, Costa Rica, • Neoclassical economy assumptions not met: information; competition on pricing • Regulation often impossible: LMICs as US

  4. Europe is rapidly heading to market oriented health systems • Latin America and UK provides a similar pattern of stages to commoditization • Supra-national institutions and international economic treaties are used to overrule national governments and social protection. • Transatlantic treaty is on its way

  5. Why? A post-democratic society? • Why non evidence based policies? Why people vote against their interest? Why one way reforms? • Issues with un-democratic supranational organizations and international commercial treaties overruling national social protection • Corruption: PFI, private insurances  corruption and effective political lobby • Biased information: scientific, professional, public, and educative

  6. Strategies for democratic change in health systems • Information of the public • Scientific arguments (access, quality) • Economic arguments (efficiency) • Alliances with professionals: professional autonomy, new concept of professionalism • Alliances with economic actors • Action in health services: • improved accessibility  peoples support and comanagement • Network coordination • Bottom up planning / strategic planning

  7. Strategically tackling financing capital in health

  8. Political alliances

  9. What to do after our conference? Campaigns • Transatlantic and other treaties • Scientific evidence treaties • International (organizations) transparency campaign • Support to threatened activist colleagues and movements