Privatised Health Services Worsen Pandemic

SYDNEY and KUALA LUMPUR, Aug 17 2021 (IPS) – Decades of public health cuts have quietly taken a huge human toll, now even more pronounced with the pandemic. Austerity programmes, by the International Monetary Fund (IMF) and World Bank, have forced countries to cut public spending, including health provisioning.

‘Government is the problem’
“India’s COVID crisis: ”, “ still hamper [UK] Covid-19 response”. Such headlines have become commonplace as the pandemic rages on, with no sign of ending soon. Their godparents deserve due recognition.

Anis Chowdhury

UK Prime Minister Margaret Thatcher claimed, “ [good]… people look to themselves first There is no such thing as society … quality of our lives will depend upon how much each of us is prepared to take responsibility for ourselves and each of us prepared to turn round and help by our own efforts those who are unfortunate”.

US President Ronald Reagan declared, “government is not the solution to our problem; ”. Inspired by them, government capacities and public sectors have been decimated in recent decades, ostensibly to liberate entrepreneurship and progress.

Four decades of defunding, delegitimization and demoralisation of governments and their personnel since Thatcher and Reagan have taken their toll. Unsurprisingly, most governments have failed to respond more adequately to the pandemic.

To justify social spending cuts, politicians of various hues the world over have been parroting mantras that government is too big and bad. ‘New Democrat’ US President Bill Clinton proudly declared the “”.

Neoliberal reforms worse
This ‘politics of small government’ legitimised privatisation of public assets and services. Authorities have tripped over one another to privatise potentially lucrative public sector duties and activities, while reducing taxes and expenditure.

COVID-19 has of neoliberal health spending reforms. New policies have included privatisation and contracting out public services. Social spending has not only been cut, but also used to pay private suppliers.

Jomo Kwame Sundaram

Health system failures highlighted by the pandemic have been . Four decades of neoliberal policies including marketisation, or commodification of healthcare have greatly increased private provisioning.

Private healthcare provisioning in low and middle-income countries (LMICs) . It gathered pace after the 2008-2009 global financial crisis in hospitals and allied health services.

now accounts for most , catering mainly to and . Thus, profit considerations and financial markets have remade LMICs’ national health systems.

Unhealthy reforms
Increasingly privatised and outsourced, public health systems in developing countries have been underfunded, undermined and understaffed. health systems, with poor governance and regulation, have become even less to new challenges.

Such changes have been promoted by new aid-sponsored financial arrangements, such as public-private partnerships, as urged by the World Bank. The pandemic has exposed the results as grossly inadequate, ill-suited and vulnerable.

Profitable private services remain parallel to and separate from the public system. The reforms have not only undermined public health systems, but also to cope. Even in rich countries, .
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privatisation nor commodification have improved the quality of care, equity and efficiency of public services. Thus, deregulation, privatisation and liberalisation have .

Meanwhile, donors have been diverting aid from governments to non-government organisations (NGOs), especially ‘international’ ones. But patchworks of foreign-run NGOs for integrated national public healthcare systems.

Austerity kills
Analyses of economic shocks around the world, from the 1930s’ Great Depression to the 2008-2009 Great Recession, show . In England since 2010, austerity has been linked to .

Despite abuse and , and without counting flu and other epidemic fatalities, ’ daily were expected in the UK, even before the pandemic. have also been devastating.

Despite growing patient demand and rising healthcare costs, during 2010-2020, the UK National Health Service suffered the “ in … spending as a share of GDP in any period” since its creation after the Second World War.

Earlier, ’s 2010 austerity package required cutting its national health budget by 40%. Infant mortality rose 40% after some 35,000 doctors, nurses and other health workers lost their jobs.

As Greeks avoided routine primary healthcare due to long waits and rising drug costs, hospital admissions soared. Meanwhile, mosquito eradication programme cuts led to a resurgence of malaria.

Austerity also worsened in West Africa. Cutting public health spending from 1990, Guinea, Liberia and Sierra Leone further weakened their already poor health systems, undermining their ability to cope with emergencies. Thus, in the year before the Ebola outbreak, Guinea .

Meanwhile, austerity-driven funding cuts to the World Health Organisation (WHO) by the US, UK and European governments critically delayed responses to the Ebola outbreak, . Funding shortages also set back needed WHO efforts to respond to future global health crises.

Government not main problem
Health threats posed by the pandemic have not been well addressed by the reforms of recent decades. Some have been made worse, with particularly hard hit by COVID-19. Unsurprisingly, confidence and trust in governments have .

In fact, public health investments before the pandemic were to yield three times as much in economic growth. Thus, such spending would have not only saved lives, but also accelerated economic expansion.

With COVID-19 endemic, and most government pandemic containment and fiscal capacities in the global South limited, the pandemic will drag on, further setting back progress and worsening inequalities.

Meanwhile, Thatcher and Reagan still haunt us all until the world exorcises their ghosts forever.