Snouts in the trough... but not yet


February 5, 2008 19:42 | by Steve McGiffen

Since the partial exclusion of health care from the liberalisation of services brought about by the EU's notorious directive of 2005, we have been waiting with some trepidation for the European Commission to make its next move.

To this writer - and I hope also to his readers - a functioning, efficient, equitably funded and affordable system of health care is the absolute fundamental of a civilised society.

Others look at health care through different eyes, of course.

Here is a multi-billion pound industry the widespread public ownership of which means one less well-swilled trough into which piggy can stick his snout.

And since this figurative individual (and my apologies to real pigs, whose treatment at the hands of the EU is even worse than our own) is the one dearest to the European Commission's heart, it was only a matter of time before the Eurocrats sought to ensure that the weakly-worded, unconvincing health care exclusion found its way into the clinical waste bin of history.

So where is the Commission's proposal on the liberalisation of health care services, which we were, in the end, promised for last November?

It was the European Parliament, which increasingly vies with it in its enthusiasm to do corporate capital's bidding, which last May called on the Commission to reintroduce health services into the Services Directive.

In a report described even by social democrats as "a total catastrophe", it was proposed that health care be robbed of its 'privileged' position as an essential service.

The Parliament wants to see an unrestricted patient mobility across the EU's internal borders, which it is well aware would make publicly-owned and collectively-financed health care services untenable.

It wants the Commission to enable codification of European Court of Justice case law applying to the mobility of services.

This would ensure that internal market rules, the freedom to provide services and free movement all apply to health services, and that these principles are put beyond doubt.

In fact, the Commission's work programme for 2007 already contained such a proposal, but the Parliament wanted action.

Its report was an attempt to cajole the Commission into smuggling health care services back into the Services Directive.

This would do nothing to address the real problems of Europe's health care services, which to one degree or another reflect those of the NHS.

Patient mobility may have a role to play, but only if it forms part of a coordinated system of resource pooling based on principles of efficiency and, where appropriate, solidarity.

Collectively-funded health services which are free at point of care - such as almost all NHS treatment - are financed nationally and will remain so for any foreseeable future.

Patient mobility must not be allowed to undermine such services.

EU regulations on the coordination of social protection schemes already deal with many of the real problems arising from cross-border patient mobility, though they have clearly been found wanting when it comes to lining the pockets of private health care providers.

Supplying a high quality and efficient health care infrastructure where people live is, in any case, a much better way to avoid waiting lists for treatment.

Dutch left MEP Kartika Liotard, who initiated the amendment which led to the exclusion of health care from the Services Directive, says that "what we definitely do not need is another bogus 'balanced compromise' of the Service Directive type. We demand that health services and social services, in common with all public services and services of general interest, be excluded from internal market and competition rules. High quality health care for all is not a commodity, but a public good."

Adding that her views had found support from MEPs across the political spectrum, she says that she was "shocked" to see the issue return.

"We fought extremely hard to keep health care services out of the scope of the services directive" says Liotard. "Health care is much too important to allow it to be exposed to unrestrained market forces."

So does the delay to the European Commission proposal mean that Liotard's arguments may have prevailed?

Only, unfortunately, in our dreams.

What the hold-up really means is that the Commission, along with all who support the top-down integration of Europe and its transformation into a paradise for corporate capital, are well aware that health care liberalisation will prove about as popular as toothache.

And while this unpopularity is not going to change, the liberalisers are prepared to wait until the most sweeping liberalising measure of all, the renamed European Constitution, is approved by all of the national parliaments and the only electorate which will be allowed to have its say, the Irish.

"EU member state citizens are not expecting still more liberalisation, and certainly not in health care," Kartika Liotard explains. "The Commission is afraid that resistance to this will throw a spanner in the works when it comes to ratification of the reform treaty. The public would then for once find out the full extent of the EU plans, and perhaps they would also become more critical of the new 'constitution'." Far from welcoming the postponement, she describes it as "simply scandalous" and "evidence of a lack of political courage.".

Heavy political pressure from the Commission has already ensured that after Ireland no other member state will hold a referendum on the reform treaty. "But," Liotard says, "evidently there is still disquiet and a feeling that until the treaty is finally ratified any proposals which might prove controversial should remain out of sight. This is typical of this Europe: keep everyone sweet until the ink is dry on all of the signatures and then get on with unpopular, far-reaching measures which have long been planned."

Steve McGiffen edits Spectrezine. This article was written for the Morning Star

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