Privatization as a symptom of health inequity


(Julián Ricardo Zapata Rozo, Unsplash)

This article was exclusively written for The European Sting by Mr. Julián Ricardo Zapata Rozo, a 22 year old medical student at Universidad Industrial de Santander in Bucaramanga, Colombia. He 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.

Currently, after several pronouncements of the World Health Organization, coverage and equity of access to health are global goals and are on the agenda of the United Nations. In this desire to achieve better health care rates, interdisciplinary efforts have been made and the health economy has gained strength in the design and monitoring of health models.

The classic dispute between privatization and statization is no stranger to this race. Private or mixed models are proposed with great success in countries such as Norway or France, whose policies are sound and aimed at a significant amount of GDP to health. However, it is necessary to evaluate the promotion of neoliberal privatization models of health by organizations such as the Inter-American Development Bank and the World Bank. These bets that capitalist logic is the solution for health (and a number of other problems), may be due to the protection of private interests, the maintenance of a system with little fluctuation of inequality or a simplistic look at specific problems of developing countries.

The evidence on the application of neoliberal or capitalist health models in developing countries is poor and controversial. In some countries, as is the case in Colombia, a mixed system between public and private entities has been adopted; however, despite having a solid theoretical basis, based on the choice of the service according to the needs and limitations of the users, the reality after 26 years of application of Law 100 shows that the goals of quality, coverage and Equitable access has not been achieved, despite considerable increases in public and private expenditures.

In spite of the fact that capitalist logics benefit economic elites and that this affects the differences in access to health services; the privatization cannot be exclusively blamed for inequity in access to health service, since similar inequities occur in systems with greater public sector participation. Privatization is not the origin of inequity in health, but only one of its symptoms, since it is born as a response to the need for better quality of medical care for those who can pay for it. The origin of this inequity is the disability of the public system to correctly meet the needs of the population in health services. This disability has several country-specific reasons. In the case of Latin America, high rates of corruption, bureaucracy, political sponsorship and low investment in health are limiting in the management of resources and in ensuring equitable access to health. Encouraging more active user participation could improve the use of resources in public and privatized systems.

About the author

Julian is a 22 years old medical student at Universidad Industrial de Santander in Bucaramanga, Colombia. He is the current Director of the Student Center for Scientific Training (CEFC) of SEIMED UIS, local association of ASCEMCOL. Head of the Editorial Review Department and associate editor of the “Medicas UIS” magazine.

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