Sequels of the pandemic in the malaise of medicine in the West

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The covid-19 pandemic could be for Beijing like Chernobyl for Moscow: the beginning of the end. The future of China is not foreseeable, but, in view of the current riots, the disease has become the biggest threat to Xi Jinping since he rose to the pinnacle of power ten years ago.

At the beginning of the pandemic, the isolation criterion was soon imposed, while doctors and scientists looked for solutions for the future. This policy undoubtedly saved lives, but thanks to vaccines and antivirals, it was soon seen that one could open up, also to avoid the economic and social consequences derived from the spread of the coronavirus and the rigidity of the precautions adopted.

Xi Jinping clung instead to the zero virus policy, perhaps because he did not recognize that his scientific research was far from that of the West… In fact, everything indicates that China is worse protected against a virus than, within its mutations, seems to become endemic, difficult to control, even with loss of lethality. But, as The Economist points out, by maintaining the lockdown policy, despite the effects on the economy, public doubt arises about one of the main assertions of the Chinese Communist Party: that only its power can guarantee stability and prosperity.

Curiously, in the West, the fight against the pandemic -with abundant displays of heroism on the part of health professionals- has become the trigger that has brought to light the limits of health systems. The problems have little or nothing to do with the cynical stereotype of Spanish illiberal leftism, which reduces almost everything to the demonization of the private as a sterile Numantine defense of public health. I find the last sign of the common roots of the malaise in the strike of the French liberal doctors, that is to say, for whom medicine continues to be, although not entirely, a liberal profession.

Approaching medicine with Marxist theses on ownership of the means of production, or capitalists on extreme economic efficiency, causes the dehumanization of medical care, demoralizes its professionals and increases citizen discontent.

We can continue dreaming of the wonders of the application of “artificial intelligence” to cure diseases, especially in the field of preventive medicine. But, for the moment, quantitative planning does not stop throwing to the shore the remains of its failed predictions. I’m not talking about communist policies like five-year plans. I am thinking of democratic countries -such as Spain- that long ago adopted a policy of numerus clausus in the academic teaching of the health professions: a policy, moreover, very consistent with the so-called “Bologna spirit”, inspiring university reforms that They don’t seem to be reaping big wins.

A few days ago the first nursing staff strike in over a hundred years was called in the United Kingdom. A collective conflict as unusual as that of the French doctors, who have begun the month of December by closing their consulting rooms. It coincides with the second strike by the biologists who work in the analysis laboratories.

They logically have economic demands, for example, regarding the amount of consultations, which is paid by social security: currently, 25 euros. But the reason is not so much to earn more as to work better, since current rates are not enough to count on a secretarial assistant, when in reality 30% of their hours go to bureaucratic tasks. In addition, the social security budgets -approved with little discussion, since the government has applied the equivalent of the decree-law- aggravate the problems derived from the lack of doctors and the greater number of patients assigned to each one.

Fear of deteriorating working conditions has led to a kind of “common front” by practically all unions in the sector, including those representing medical and pharmaceutical interns: they have taken thirty university hospitals to court, which would not comply decisions on working hours of the Council of State, the highest court in the French administrative sphere.

I don’t know the date medical unions were born. Its creation responds to a large extent to the economicist approach to a very personal activity, which was governed by professional associations, of a legal nature more in keeping with their function. Much to its regret, it has become progressively bureaucratized and commodified. The unions may have been a failed reaction to the loss of the predominantly liberal character of the medical professions. That is, in my opinion, the core of the issue, hardly addressed by governments and trade union organizations. The consequences for the quality of patient care are clear, both in the field of social security and in that of private insurers.


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