How health privatization increases health inequities

This article was exclusively written for The European Sting by Ms. Diana Marcela Mantilla Barrera, a 21 year old fourth-year medical student at Universidad Industrial de Santander in Bucaramanga, Colombia. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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WHO defines health inequities as “systematic differences in the health status of different populations”. One of the mechanisms established to mitigate inequities is the universal health services approach, which reduces the barriers to health access for vulnerable communities and guarantees a fundamental right for the entire population. Proposing a system based on privatization is equivalent to a commodification of health and segmentation of the population, making health care a benefit of few. Two basic concepts that support an universal health system are solidarity and risk redistribution. Theoretically, people who generate higher incomes will cover the deficit of populations with fewer contributions and all will have availability health services that include prevention, promotion, treatment, rehabilitation and palliation. In contrast, a private health system will only be available for people with high economic incomes who have the ability to pay for insurance membership or lower-middle class families with borrowing capacity, besides the investment will be much greater because of the competitive market in which a private system is born, the higher administrative expenses and the aim of generate incomes and reduce losses. The individual perspective from health privatization reduce the importance of primary health care and community health actions, therefore, the management of public health problems. Also, avoids an adequate distribution of risk, and those population groups exposed to a greater risk or who demand greater medical attention have more limitations of access to the system, despite having capacity purchasing. The privatization is not the only culprit of health inequity, however it creates barriers to direct access to care for large part of the population, making the ability to access to insurance  the determining factor of health status, affecting patients in their economic, working and social spheres. From this point, any intervention by the state from the structural social determinants is in vain, so it reduces its intervention as a guarantor of the right to health while the gap and the health inequities increases all around the world. About the author Diana Marcela Mantilla Barrera is a 21 years old fourth-year medical student at Universidad Industrial de Santander in Bucaramanga, Colombia. She has been active member of The Standing Committee on Public Health (SCOPH) attached at SEIMED UIS (Medical research student society of the Universidad Industrial de Santander) and ASCEMCOL since 2016. Her work has been focused in cardiovascular risk detection, healthy lifestyle and mental health in students and populations in Santander. She has been active member of Infectology hotbed of research at Universidad Industrial de Santander since 2018 and has intervened in multiple reviews about nosocomial infections