More than the severity of the coronavirus pandemic, worries the high level of contagion in a short time, which is the cause of the overflow of the health system. If it were to last for two years, as some experts foresee, but there were no major hospitalization peaks, the situation would be less serious.
In summary, the heart of the problem lies in the health systems, which have been deteriorating as a consequence of neoliberal policies to reduce social spending and privatize services. A brief review of the number of beds per inhabitant in different countries reveals the crisis in the health system.
Changes accelerated in the wake of the 2008 crisis. In 2006, the European Union had 574 beds per 100,000 inhabitants, but in 2017 the figure had dropped to just 504 beds. A decrease of 12%.
At the top of the graph is Germany with 800 beds in 2017 (830 in 2016), the only European country that complies with the recommendations of the World Health Organization, of no less than 800 beds per 100,000 inhabitants.
It is no coincidence that Germany currently has one of the lowest levels of deaths from infected people: 24 out of 9,257 infected as of the publication date of this article, just 0.26%, ten times less than China and thirty times less than Italy, which exceeds 7%.
Italy is one of the lowest places in the European table: in 2006 it had 399 beds per 100,000 people and in 2017 it fell to just 318, a steep decline of 20%. Much poorer countries, such as Romania and Poland, increased beds per inhabitant from 674 to 689 and from 647 to 662, respectively.
Bulgaria, which has a GDP per inhabitant four times lower than Italy, increased its availability of beds by more than 18% in the same period. General data that teaches that health does not depend mechanically on the wealth of a country, but that its authorities consider it a service or a business.
In Latin America, the arrangement of beds shows an even worse situation. Cuba leads the way with 520 beds per 100,000 inhabitants, followed by Argentina with 500. Uruguay is followed at a great distance, with 280 beds, Brazil and Chile with 220. A list that closes with Haiti, Honduras, Venezuela and Nicaragua, with less than a hundred beds.
Privatization, the other pandemic
The privatization of services is another fundamental fact, since increases inequality in access to health. In Spain, private healthcare already represents more than 30% of healthcare spending, something that translates into greater opacity and less transparency, according to the Federation of Associations for the Defense of Public Health (FADSP).
According to the same organization, Madrid is the region that leads the privatization indexes, as well as the percentage of private beds over the total (27.7% in Madrid versus 5.1% in La Rioja). In private, the data teaches about the use of expensive studies, such as diagnostic imaging tests. A report by the UGT union ensures that “in the last four years, the percentage of investment in private multiplied by three that of public.”
An investment of a speculative nature, since it did not prevent the coronavirus crisis from having its main focus in the Spanish capital, with 44% of infections in the country and 72% of deaths, as of March 17.
Madrid allocates large sums to “specialized care”, expensive and with dubious results, while “it allocates very little to Primary Care, which requires a strong and urgent investment because it is the first step in healthcare,” according to Marciano Sánchez Bayle, president of the FADSP.
In Italy, in ten years, 70,000 hospital beds were lost, 359 departments were closed, and numerous small hospitals were abandoned. Between 2009 and 2018, health spending grew 10%, compared to 37% for the OECD.
Between January and February, the Spanish health sector lost 18,320 workers, in full expansion of the coronavirus. In addition, unions in the sector report abuse of interim hiring and job insecurity, while working conditions are increasingly harsh.
United States, the world leader in dismantling health
We could establish a geopolitics of the dismantling of health and the health crisis. One of the epicenters would be the United States, according to sociologist and urban planner Mike Davis.
“The 2018 flu season, for example, overtook hospitals across the country, showing the outrageous shortage of hospital beds after 20 years of cuts in hospitalization capacity for the benefit.”
Davis highlighted the closings of private clinics and the shortage of staff, imposed by market logic, that “have devastated health services in poorer communities and rural areas, shifting the burden to underfunded public hospitals and veterans’ clinics.”
The emergency services are overloaded, which ensures that his country faces a “health Katrina”, in reference to the hurricane that devastated the city of New Orleans in 2005.
Davis reminds us that “as many as 380,000 nursing home patients die each year from these entities’ failure to comply with basic infection control procedures.”
As we know, The United States is the leading country in the privatization of health. Davis alleges that large pharmaceutical companies stopped investing in the development of new antibiotics and antivirals.
“Heart medications, addictive painkillers, and male impotence treatments top the list of the most cost-effective, but not those intended to combat hospital infections, new diseases, and traditional tropical pathologies.”
So he predicts that “in a year we may retrospectively admire China’s success in containing the pandemic, but we are appalled at the failure of the United States.”
THE AUTHOR’S OPINION DOES NOT NECESSARILY MATCH THAT OF SPUTNIK