The last episode at the round table of Metasalute, the mutual aid of metalworkers, where Minister Speranza himself did not speak of “divergences” between public interest and private interest but on the contrary spoke of “convergences” and therefore of synergies. But Metasalute is a neoliberal healthcare on demand that wants to replace universalism with the market. And with which the right to health is difficult to converge
18 LUG –
Having horns
Not a day goes by in this newspaper without someone (recently Anaao in its last congress) declaring its faith in public health and its firm intention to oppose any attempt to privatize the system, but at the same time it is not clear why with so many brave opponents in the field, the privatization process does not encounter obstacles whatsoever and goes on.
Indeed, every opportunity is good to give it a boost. The PNRR designed to reorganize health care due to the pandemic, as so many have said, seems like the last chance but to privatize the public system even more.
My impression to put it in a popular way is that everyone knows they “have horns” that is, that public health is constantly betrayed by speculations of various kinds, (recently the decree on simplifications) but everyone pretends nothing has happened and behaves as if nothing had happened. Cuckold and aware of it.
That is, the neoliberal turn that decided above all by the PD in ’99 with Minister Bindi is confirmed despite the pandemic as an incontrovertible political choice.
“Having horns” is different from “false consciousness”.
While the latter, as sociology explains to us, occurs when you are not aware of your historical limits, the latter is a form of active hypocrisy, that is: you know you have horns but you do nothing to not have them because having them is fine by us in the end. .
Convergences“Recently one of the most important insurance funds,” Metasalute “(4 million benefits achieved in 2022), the one to be clear that ensures the” mutual “(fund) of metalworkers, organized a round table on the National Health Service and contractual supplementary health , with the issue of “convergences” at the center of the discussion.
Speaking, Minister Speranza did not speak of “divergences” between the public interest and the private interest but on the contrary spoke of “convergences” and therefore of synergies, literally saying “we need the contribution from everyone, where the supplementary healthcare represents a step that must be inserted in the new season of investments on the NHS, the country’s first relaunch brick ”.
Adding “only by joining forces, each in their own sphere, that it is possible to transform this difficult phase into a moment of opportunity for Italy to relaunch”.
PNRR and neoliberalism
But it does not seem to me that with Speranza we are moving towards strengthening the role of public health. It seems to me that the opposite is happening.
The PNRR is what we could define the orthogonal projection of Bindi’s counter-reform project, but at the same time it is undoubtedly its expansion and extension, think of the quasi-surrogacy role envisaged for the third sector, think of the favorable conditions created to privatize basic assistance, just think that only the reconfirmation of the minimum hospital (DM 70) actually becomes the most formidable incentive to resort to private hospitalization.
If the hospital remains minimal and the need for hospital care remains maximum, the bias can only be recovered with further privatization. It should also be remembered that the government on DM 77 (territorial care reform provided for by the Pnrr) is proceeding without the agreement State regions which obviously (see the disenchanted position of the president of the Campania region De Luca) are strongly afraid of being swindled that is not having sufficient resources to set up the required territorial services.
We know from the outset that to implement the PNRR you will have to resort to the private sector, outsourcing most of the things to third sector cooperatives, various funds, etc.
As we know that the real risk we are running is that of getting into debt with Europe to finance health with the Mes, that is, to finance health that politics considers unreformable and which must therefore be assumed as invariant, that is, with inevitable incremental costs.
The mystification of the truth
What I can’t swallow about Speranza is the mystification he makes of reality.
When I read his speech to Metasalute on integrative health, I remembered two things: that Speranza is the secretary of article 1, that is, of a Gramscian-inspired left-wing party and of a book by Gramsci “For the truth” that I read as a young man then many years ago (Editori Riuniti, 1974).
For Gramsci, truth is not only the formal logic of which I speak to my students about scientific evidence, but “it is the concrete element through which philosophy is transformed into politics”.
If Speranza would take the trouble to examine Metasalute’s performance schedules, he would realize that Metasalute is not what he thinks, that is, a private health that integrates (his goodness) a public health that is deficient and therefore completes it, but is a private health that competes with the public one. and moreover fiscally incentivized for this (cost 6 billion) and which takes advantage of public shortcomings in its favor.
Metasalute is a neoliberal on demand healthcare that wants to replace universalism with the market. And with which the right to health is difficult to converge.
Since Bindi in ’99 admitted among the services to be provided privately also those already provided for in the lea, the so-called supplementary healthcare has in fact become totally substitutive. So in competition with the public.
Conclusions
I do not want to reopen the discussion on integrative health. This topic has been discussed many times by me and others by now.
I will just say that:
- if integrative healthcare were really such I would have nothing against it because I would consider it an extension of the public one,
- what I do not agree with is the political lie of those who know very well they have the horns politically but deny it in order to make us believe that the development of private health is actually an advantage for the public and for the country.
Believe me Minister Speranza, if you really wanted to make public health grow after a pandemic, the path of neoliberalism that you are taking, the same one taken by Bindi, is certainly the less suitable one.
Ivan Cavicchi
July 18, 2022
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