Stefan Pfeifer reports:
Corona: Lessons to learn – Healthcare policy
The year 2020 will go down in history as the Corona year. There are only a few months between a small report from China and a pandemic that is shocking politics, societies and the economy worldwide. And that not only endangers human health but also the fundamentals of human coexistence such as security, predictability, social contact and economic exchange.
We only know a few of the many lessons we will learn from the pandemic. Some of them are in the sector of politics and especially healthcare policy.
Same Virus – but different death rates
So far, the media discussion has essentially revolved around the question of whether governments have reacted quickly and consistently enough to the spread of the virus. Obviously right-wing populist governments show no interest whatsoever in the effects of the corona virus on humans. Insights and information from the sciences were above all irrelevant and disruptive for the autocrats – similar to the subject of climate change. With their ignorance, autocrats have wasted time in adequately responding to the special challenge of this fast, invisible virus and thereby slowing the transmission of the virus from person to person. This is particularly true in the United States, which has the highest numbers of infected and dead people in the world.
It is also striking that the disease is differently fatal in the statistics of the different countries. At the beginning of May, Great Britain recorded about as many cases as Germany. However, in the UK with more than 26,000 people, around four times as many died as in Germany (6623 dead).
Is it a failure of the statistics? A consequence of different test numbers? Or could it be that arrogance and ignorance by governments is life-threatening when combined with a public health care system that is subject to private interests or austerity politics?
Why do so many sick and needy people have to wait together for treatment in a confined space? In centralized health systems, large hospitals are obviously becoming virus throwers. With all the dangers that this holds not only for the sick but also for the employees in these hospitals and care facilities. An example: In order to create additional nursing capacity, the Lega Nord government in Lombardy (Italy) used nursing homes to accommodate the Corona patients. As a result, the virus was able to spread to a population group with widespread previous diseases (respiratory and pulmonary diseases, high blood pressure).
The origin of the NHS is progressive and exemplary for a social system: The NHS is state-controlled and financed. Its mission is to provide primary and primary health care and secondary health care to everyone living in the UK. But:
It is not only important to regulate the system but also to equip it.
Britain has 228 hospital beds per 100,000 population according to the latest comparison statistics. In Germany there are 610 beds per 100,000 inhabitants, almost three times as many beds per inhabitant (data for 2015). A comparison of the numbers of general practitioners and specialists shows that the density of doctors in Great Britain is significantly lower than in Germany: in relation to all doctors, there were 2.8 doctors per 1,000 residents in Great Britain this year, and 3.8 in Germany (OECD 2013).
But even the view of the hospitals and doctors alone is not enough. Because these are only part of a long and interlinked chain of specialists in institutions that together make up the health and social system:
• General medicinal practitioners and specialists on site,
• efficient rescue and emergency services,
• hospitals for inpatient medical treatment,
• specialized rehabilitation facilities and specialist clinics
• Health-promoting stimulation from good nutrition to good pharmacy
• Good nursing homes and supportive personal social services for people in need, such as the elderly, the mentally ill, people with physical and mental disabilities.
In the health policy in Germany, the federal government largely determines the legislation, but the federal states also exercise their options, particularly in matters of health care. The federal states decide on the offer of the hospitals and develop framework conditions. In Germany we have dual hospital financing, which means that the health insurance companies refinance the operating costs and the federal states bear the investment costs.
First lessons from the crisis of the health system behind the crisis
With regard to health care, the corona pandemic teaches to understand and organize health more and active as part of public services. This not only includes the equipment with beds, equipment and protective materials. Above all, this includes staff in hospitals and clinics, nursing homes and health offices. The health system is not just a complex overall system, in which different areas have to work together. Together with care, it is also a very important part of a welfare state, for which the protection of human life and the well-being of its citizens is more important than short-term economic profit interests and political megalomania of politicians.
Stefan Pfeifer