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
See also http://www.spectrezine.org/europe/Fritz-vs-Bolkestein-EN.pdf