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May 18, 2021

Political emergences or emergency policy

Now leaning to the left, now leaning to the right, President Traian Basescu appears to have grown firmer in choosing his political camp, at least as far as the health system is concerned. The president placed his bet on privatization, in the spirit of the good old liberal-conservative tradition. Rather than the so-flawed state monopoly, competition and responsibility by private actors, this is the player-president’s “view”. The whole health system is therefore a delicate matter, and not just on Europe’s outskirts, since even in the world’s no 1 country health reform is the criterion for a governance tilting the balance towards success or failure. Emergency medical care, where efficiency has stringencies of its own, is even more sensitive an issue. The high rate of successful surgery has already become a demand of civilization.

The victims of road accidents, fires or patients with certain disease bouts stand a better chance to survive than they had half a century ago, not to mention the more distant past, thanks to both technological evolution and organization of public utility services. In a certain sense, it is rather the result of several decades of leftist activism. A left that often pretended to have forgotten the millenarian Christian assistance tradition. However, let’s only look at the medical emergency criterion. In the time long past, it was only the kings, some of the richest still, who could afford a permanent doctor, which gave them an extra chance to be cared when emergency assistance was required, within the confines of the medical knowledge at the time. It nonetheless took many reforms in political mentality for the average person lying in the street to be tended to by an emergency medical crew. Let’s go back to our time. A system’s efficiency relies not only on its organisation but also on the spirit that animates it. Behind today’s medical system lies the humanist philosophy. We must save as many lives as we can, to give anyone an increased chance to survive any aggression. Police protection, public hygiene rules and food safety too are tied to the same philosophy. Any life is valuable, this is the slogan of such humanism. In principle, at least. Any political programme on health cannot leave this demand out. People themselves are selfish and everybody dreams of enjoying preferential treatment, which already happens, actually. Who wouldn’t like to be the patient of a comfortable and top performing private clinic rather than queuing to get medical assistance in polyclinics or to depend on the compensated medicine budget? Yet, only some can afford it. The predicament is as follows: we leave millions of people to die without the possibility of receiving medical assistance, as has for so long a time been the case in the richest country in the world? Or we allocate a significant portion of the public budget to a more egalitarian medical assistance, a basic feature of the so-called “welfare state”? In Romania at least, no politician, even its president, can advocate the rich people’s right to have the first, and, sometimes, only chance. Yet, he could extol the benefits of competition and privatization. However, private emergency services have already been operating in Romania. The ongoing dispute, which led to a health sub-secretary whose name is linked to a “success story”, the Mobile Emergency Service for Resuscitation and Extrication (SMURD) refers to competition over access to public funds by such emergency systems. For a person unfamiliar with health policies is difficult to weigh the pro and con arguments of each party. It should also be mentioned the concern raised by those who insist on a certain public-private competitive dynamics, with the former at risk of being swallowed by the latter, and the delivery of medical assistance beneficiaries to the “egotistic” laws of profit. Yet, it is obvious that a principled choice needs to be clearly defined by upcoming political offers, so you could decide between being treated commensurately with your own income, as a sort of preferential reward for social success, or you are willing to accept the “welfarian” egalitarian, or quasi-egalitarian, assistance, out of  precaution (social success could fluctuate) or human solidarity (we shouldn’t overlook the moral spirit and ethos of social construction). Unfortunately, in post-communist Romania, the leftist discourse of rational criticism of capitalist shortcomings and unfairness, has been de-legitimised by the anti-communist rhetoric. Not even the Social Democratic party (PSD) has not steadily followed the leftist lane, if we look at sectoral policies. However, Victor Ponta proved able to make an inspired political move, which costs him nothing, actually, bringing the recently-resigned Raed Arafat into the PSD shadow cabinet, implicitly announcing him as future health minister. The hunt for political figures with a positive media impact is therefore in full swing. This however makes the PSD assume a different medical policy. If it shows guts and inventiveness, then, the electoral benefit will be visible.

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