<div dir="ltr"><div class="gmail_default" style="font-size:large">
<div class="gmail-single-post-container"><div class="gmail-container"><div class="gmail-single-post"><div class="gmail-post-header"><h1 class="gmail-post-title gmail-short gmail-unpublished"><br></h1><h3 class="gmail-subtitle">Decades
of public health cuts have taken a huge human toll, now even more
pronounced with the pandemic. Austerity programmes have forced countries
to cut public spending, including health provisioning</h3><table class="gmail-meta-author-wrap gmail-with-photo"><tbody><tr><td><div class="gmail-account-hover-wrapper"><div class="gmail-user-head"><div class="gmail-profile-img-wrap"></div></div></div></td><td><div class="gmail-meta-right-column"><br><table class="gmail-post-meta gmail-custom" cellspacing="0" cellpadding="0"><tbody><tr><td class="gmail-post-meta-item gmail-post-date" title="2021-08-17T06:48:27.929Z"><br></td><td class="gmail-post-meta-item gmail-icon"><span></span><br></td></tr></tbody></table></div></td></tr></tbody></table></div></div></div></div><span></span><div class="gmail-post-header"><table class="gmail-meta-author-wrap gmail-with-photo"><tbody><tr><td><div class="gmail-meta-right-column"><table class="gmail-post-meta gmail-custom" cellspacing="0" cellpadding="0"><tbody><tr><td class="gmail-post-meta-item gmail-icon"><span></span><br></td></tr></tbody></table></div><br></td></tr></tbody></table></div><div class="gmail-body gmail-markup"><p><strong>Privatised Health Services Worsen Pandemic</strong></p><p>By <a href="http://www.ipsnews.net/author/anis-chowdhury/" title="Posts by Anis Chowdhury">Anis Chowdhury</a> and <a href="http://www.ipsnews.net/author/jomo-kwame-sundaram/" title="Posts by Jomo Kwame Sundaram">Jomo Kwame Sundaram</a></p><p><strong>SYDNEY and KUALA LUMPUR, Aug 17 2021 (IPS) </strong>-
Decades of public health cuts have quietly taken a huge human toll, now
even more pronounced with the pandemic. Austerity programmes, by the
International Monetary Fund (IMF) and World Bank, have forced countries
to cut public spending, including health provisioning.<br><strong>‘Government is the problem’</strong><br> “India’s COVID crisis: <a href="https://independentaustralia.net/politics/politics-display/indias-crisis-a-deadly-example-of-government-failure-,15051">A deadly example of government failure</a>”, “<a href="https://www.theguardian.com/world/2021/jun/27/government-failures-still-hamper-our-covid-19-response">Government failures</a> still
hamper [UK] Covid-19 response”. Such headlines have become commonplace
as the pandemic rages on, with no sign of ending soon. Their godparents
deserve due recognition.</p><p>UK Prime Minister Margaret Thatcher claimed, “<a href="https://www.margaretthatcher.org/document/106689">no government can do anything</a> [good]…
people look to themselves first… There is no such thing as society …
quality of our lives will depend upon how much each of us is prepared to
take responsibility for ourselves and each of us prepared to turn round
and help by our own efforts those who are unfortunate”.</p><p>US President Ronald Reagan declared, “government is not the solution to our problem; <a href="https://avalon.law.yale.edu/20th_century/reagan1.asp">government is the problem</a>”.
Inspired by them, government capacities and public sectors have been
decimated in recent decades, ostensibly to liberate entrepreneurship and
progress.</p><p>Four decades of defunding, delegitimization and
demoralisation of governments and their personnel since Thatcher and
Reagan have taken their toll. Unsurprisingly, most governments have
failed to respond more adequately to the pandemic.</p><p>To justify
social spending cuts, politicians of various hues the world over have
been parroting mantras that government is too big and bad. ‘New
Democrat’ US President Bill Clinton proudly declared the “<a href="https://edition.cnn.com/videos/politics/2013/02/11/memorable-sotu-clinton.cnn">era of big government is over</a>”.</p><p><strong>Neoliberal reforms worse</strong><br>
This ‘politics of small government’ legitimised privatisation of public
assets and services. Authorities have tripped over one another to
privatise potentially lucrative public sector duties and activities,
while reducing taxes and expenditure.</p><p>COVID-19 has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670110/">revealed the nature and purpose</a> of
neoliberal health spending reforms. New policies have included
privatisation and contracting out public services. Social spending has
not only been cut, but also used to pay private suppliers.</p><p>Health system failures highlighted by the pandemic have been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670110/">long in the making</a>.
Four decades of neoliberal policies — including marketisation, or
commodification of healthcare — have greatly increased private
provisioning.</p><p>Private healthcare provisioning in low and middle-income countries (LMICs) <a href="https://www.tandfonline.com/doi/full/10.1080/09692290.2019.1624382">took off in the 1990s</a>. It gathered pace after the 2008-2009 global financial crisis <a href="https://onlinelibrary.wiley.com/doi/10.1111/dech.12517">with more hedge fund and other investments</a> in hospitals and allied health services.</p><p><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00342-1/fulltext">Such provisioning</a> now accounts for most <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00344-5/fulltext">health services in many LMICs</a>, catering mainly to <a href="https://www.degruyter.com/document/doi/10.3138/9781487515904/html">medical tourists</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/23581671/">patients with means</a>. Thus, profit considerations and financial markets have remade LMICs’ national health systems.</p><p><strong>Unhealthy reforms</strong><br>
Increasingly privatised and outsourced, public health systems in
developing countries have been underfunded, undermined and
understaffed. <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30242-2/fulltext">Fractured</a> health systems, with poor governance and regulation, have become even less <a href="https://prospect.org/economy/austerity-abet-ebola-crisis/">able to respond well</a> to new challenges.</p><p>Such
changes have been promoted by new aid-sponsored financial arrangements,
such as public-private partnerships, as urged by the World Bank. The
pandemic has exposed the results as grossly inadequate, ill-suited and
vulnerable.</p><p>Profitable private services remain parallel to and
separate from the public system. The reforms have not only undermined
public health systems, but also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218352/">weakened governments’ ability</a> to cope. Even in rich countries, <a href="https://prospect.org/economy/austerity-abet-ebola-crisis/">about 40% of health spending is now for private services</a>.</p><p><a href="https://pubmed.ncbi.nlm.nih.gov/15563995/">Neither</a> privatisation
nor commodification have improved the quality of care, equity and
efficiency of public services. Thus, deregulation, privatisation and
liberalisation have <a href="https://www.sciencedirect.com/science/article/pii/S0277953619304897">squeezed health access, raising morbidity and mortality</a>.</p><p>Meanwhile,
donors have been diverting aid from governments to non-government
organisations (NGOs), especially ‘international’ ones. But patchworks of
foreign-run NGOs <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504287/">are no substitute</a> for integrated national public healthcare systems.</p><p><strong>Austerity kills</strong><br> Analyses of economic shocks around the world, from the 1930s’ Great Depression to the 2008-2009 Great Recession, show <a href="https://www.youtube.com/watch?v=EkfsCZZraoo">fiscal austerity kills</a>. In England since 2010, austerity has been linked to <a href="https://bmjopen.bmj.com/content/7/11/e017722">120,000 more deaths and over 30,000 suicide attempts</a>.</p><p>Despite <a href="https://www.bbc.com/news/health-39785742">declining alcohol</a> abuse and <a href="https://www.theguardian.com/society/2016/sep/20/number-of-uk-smokers-falls-to-lowest-level">smoking</a>, and without counting flu and other epidemic fatalities, <a href="https://www.theguardian.com/commentisfree/2018/aug/08/austerity-kills-life-expectancy-standstill-britain">100 ‘early deaths</a>’ daily were expected in the UK, even before the pandemic. <a href="https://www.theguardian.com/society/2017/jun/28/social-care-cuts-to-continue-in-spite-of-1bn-boost-english-councils-say">Social security cuts</a> have also been devastating.</p><p>Despite growing patient demand and rising healthcare costs, during 2010-2020, the UK National Health Service suffered the “<a href="https://www.kingsfund.org.uk/blog/2015/10/nhs-spending-squeezed-never">largest sustained fall</a> in … spending as a share of GDP in any period” since its creation after the Second World War.</p><p>Earlier, <a href="https://www.nytimes.com/2013/05/13/opinion/how-austerity-kills.html">Greece</a>’s
2010 austerity package required cutting its national health budget by
40%. Infant mortality rose 40% after some 35,000 doctors, nurses and
other health workers lost their jobs.</p><p>As Greeks avoided routine
primary healthcare due to long waits and rising drug costs, hospital
admissions soared. Meanwhile, mosquito eradication programme cuts led to
a resurgence of malaria.</p><p>Austerity also worsened <a href="https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(14)70377-8/fulltext">Ebola</a> in
West Africa. Cutting public health spending from 1990, Guinea, Liberia
and Sierra Leone further weakened their already poor health systems,
undermining their ability to cope with emergencies. Thus, in the year
before the Ebola outbreak, Guinea <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504287/">spent more on debt repayment than public health</a>.</p><p>Meanwhile,
austerity-driven funding cuts to the World Health Organisation (WHO) by
the US, UK and European governments critically delayed responses to the
Ebola outbreak, <a href="https://www.theguardian.com/world/2014/oct/09/ebola-who-government-cuts-delays-in-dealing-with-outbreak">worsening it</a>. Funding shortages also set back needed WHO efforts to respond to future global health crises.</p><p><strong>Government not main problem</strong><br>
Health threats posed by the pandemic have not been well addressed by
the reforms of recent decades. Some have been made worse, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670110/">LMICs</a> particularly hard hit by COVID-19. Unsurprisingly, confidence and trust in governments <a href="https://www.oecd.org/gov/trust-in-government.htm">everywhere</a> have <a href="https://www.pewresearch.org/politics/2021/05/17/public-trust-in-government-1958-2021/">dipped</a>.</p><p>In fact, public health investments before the pandemic were <a href="https://www.nytimes.com/2013/05/13/opinion/how-austerity-kills.html">projected</a> to
yield three times as much in economic growth. Thus, such spending would
have not only saved lives, but also accelerated economic expansion.</p><p>With
COVID-19 endemic, and most government pandemic containment and fiscal
capacities in the global South limited, the pandemic will drag on,
further setting back progress and worsening inequalities.</p><p>Meanwhile, Thatcher and Reagan still haunt us all until the world exorcises their ghosts forever.</p><p><strong>Related IPS Articles</strong></p><p>· <a href="http://www.ipsnews.net/2021/08/sustainably-finance-universal-health-care/">How to Sustainably Finance Universal Health Care</a></p><p>· <a href="http://www.ipsnews.net/2021/02/developing-countries-struggling-cope-covid-19/">Developing Countries Struggling To Cope With COVID-19</a></p><p>· <a href="http://www.ipsnews.net/2020/05/national-health-care-systems-better-others/">Why Some National Health Care Systems Do Better than Others</a></p><p>· <a href="http://www.ipsnews.net/2019/01/hospital-ppps-undermine-healthcare/">Hospital PPPs Undermine Healthcare</a></p><p>· <a href="http://www.ipsnews.net/2018/12/big-business-capturing-un-sdg-agenda/">Big Business Capturing UN SDG Agenda?</a></p><p>· <a href="http://www.ipsnews.net/2018/01/ppps-likely-undermine-public-health-commitments/">PPPs Likely to Undermine Public Health Commitments</a></p><p><a href="https://www.ksjomo.org/post/privatised-health-services-worsen-pandemic">https://www.ksjomo.org/post/privatised-health-services-worsen-pandemic</a></p><p><a href="http://www.ipsnews.net/2021/08/privatised-health-services-worsen-pandemic/">http://www.ipsnews.net/2021/08/privatised-health-services-worsen-pandemic/</a></p></div><table class="gmail-post-meta gmail-big gmail-custom" cellspacing="0" cellpadding="0"><tbody><tr><td class="gmail-post-meta-item gmail-icon"><span></span><br></td></tr></tbody></table><span></span><div class="gmail-container"><div class="gmail-single-post"><table class="gmail-post-meta gmail-big gmail-custom" cellspacing="0" cellpadding="0"><tbody><tr><td class="gmail-post-meta-item gmail-icon"><span></span><br></td></tr></tbody></table><br></div></div></div></div>