degrowth health public policies
Degrowth public policies
Montemor-o-Novo, Portugal
11/07: Degrowth Health Care System, Vitor Ramos
Health systems
Starting point was the history of implementing health systems in Germany and Austria in the times of Bismarck: Goal was to keep the workers healthy enough to be able to work in industries.
Analysis of prototypes of 4 health systems, that may be mixed in reality:
1. e.g. USA
Patients pay doctors directly, remedies are private and people take care of themselfes. For poor people, the state provides some basic treatment.
2. Bismarck model
Health insurance for central Europe, applicable in rich countries
3. Health as national service (UK)
Public health system is funded via taxation
4. Cuba, former soviet union
Health is a national service, but the state controls. Under the table payments are quite common.
In the past: grandmothers took care with home-made medication, then came centralization. The keypoint is the control of access to drugs.
SWOT Analysis
The group split in smaller group. Each group did a SWOT Analysis about health system in degrowth society. Later the results were matched together as follows:
strengths
the current system has strengths
complex and expensive
differences are good
dr. google-syndrom
access for majority
weaknesses
theeth, glasses often not covered
minority group
burnout, management pressure
less relational
distribution of resources
waste in fragmental administration
balance public-private
pharmaceutical industry
isolation
neoliberal system
maldistribution of care/rural areas
opportunities
alternative medicines/practices/cultures
physical exercises
movement natural
new visions coming
needs of ageing societies
self care
publications
informal local experiences/solidarity
possible holistic approaches
preventative fashions (e.g. vitamins)
References:
Ivan Illich
Barbara Starfield/the resourceful patient
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