Spain: “Health Disobedience” in the Face of Massive Cuts

This post is part of our special coverage Europe in Crisis.

Independent groups of public health workers and participants have created a platform to protest against the recent health reform. The movement is named “I say yes to universal health” (@Yosisanidaduniv) [es] and its main proposal is civil “health disobedience” and to object the new Law 16/2012 imposed by the government in the context of severe austerity measures and social protests.

The decree, which will come into effect on September 1, 2012, has the objective of, according to the Health Minister, “guarantee the universality of this right”, and, according to the governmental Popular Party, it is a step towards “true universality” and “stops squandering” [es].

Health as a business

However, its critics agree that the law, that will leave about 150,000 persons [es] without healthcare, was thought to change the health system and create a new insurance system; that is, a system that distinguishes between insured and uninsured persons. Therefore, it endangers the inclusive health system that Spain had up until now.

The web page of I say yes to universal health [es] understands it as follows:

 Lo más grave de esta reforma sanitaria es precisamente que pasa de un sistema universal de derechos de las personas, basado en valores como la solidaridad social (“Me puedo quedar en el paro”, “Me puedo poner enferma estando en el paro”, “Hoy por ti, mañana por mí”) y de justicia social (“Todas las personas tienen derecho a educación y sanidad”, “Garantizar derechos a todo el mundo es la mejor manera de generar una sociedad mejor”) a un pretendido sistema en el que cada persona recibe lo que paga, y debe justificar que es “asegurado/a”, que tiene un seguro que le cubra ante la posibilidad de estar enferma/o o necesitar cuidados de salud. El retroceso en derechos ciudadanos es abrumador, sin que se vaya a generar un ahorro importante.

The worst thing about this health reform is precisely that it transforms a universal rights system for all people based on values like social solidarity (“I can strike,” “I can get sick while on strike,” “Today for me, tomorrow for you”) and social justice (“Every person has the right to education and health,” “Guarantee everybody's rights is the best way to create a better society”) to create a system in which every person gets what they pay for, has to justify what it means to be “insured,” and has an insurance that covers the possibility of being sick or in need of healthcare. The step back in citizen rights is overwhelming, and it doesn't generate important savings.

Patricia (this was the chosen name), a member of the platform [es] against the decree, explains that the decree wants to lead to a system “like the North American one, where health is a business.”

'I say yes to universal health'

‘I say yes to universal health’

In which way? By restricting the access to a health card. They will take it away from undocumented immigrants as well as people older than 26 who have never registered in Social Security. This adds to the series of other cuts like the prepaid physician or other benefits that used to be free (like prosthesis) and will now have a cost.

Actually, even though the reform affects a huge number of people the immediate fear is for undocumented immigrants who will have no protection after September 1. Twitter users reacted to the news that the government will charge undocumented immigrants 700 euros annually (more than a health insurance company) for health, sparking an almost widespread rejection.

According to Patricia, the law is not only unconstitutional, but also unfair and this is the main reason to consciously object it. The popular outrage grows even more as the government benefits private clinics over public health.

The web's Facebook page [es] has uploaded a video with declarations from people who will be affected and from critics of the decree, with the message “we all have the right to health” [es]:

Instructions for disobedience

Taking into account that conscience objection is a right “recognized but not much regulated,” and that the Universal Human Rights Declaration acknowledges the right to health, the digital initiative proposes to create a critical network in the health arena. To that end, they offer several conscience objection models [es] for teachers, nurses, and non-health personnel as well as to other institutions and informative legal documents.

The idea they defend is that health personnel as well as clerical staff should collaborate, and even users without a health card have to ask for it, and when they deny it to them, “they should insist”. They informed about the possible difficulties and problems an objector may find.

At the moment, close to 1,000 doctors have pledged to partake in the conscience objection initiative [es] and keep assisting undocumented immigrants. Meanwhile, on the other hand, the Ministry of Health has warned them not to provide care for undocumented immigrants if they want to avoid sanctions: the war for health is on.

This post is part of our special coverage Europe in Crisis.

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