Public Services International TU and Health: No 50 Shades of Grey!
Dadaism was a pre WWI artistic movement which campaigned against war preparations with derisory mocking street Art, making fun of politics and seeking to expose lies behind the public appearance 'make believe' discourse. Here the PSI was pocking fun and digging holes in the public-private 'partnership' discourse and practices throughout.
Unusual for a Geneva conference, PSI held its congress in a myriad of languages: all TU could speak in their native language, and all the announcements, logos and documents were 'Dadaists'.
The General Secretary Rosa Pavanelli, reelected for a second term spoke in her native Italian although she speaks more than 5 languages perfectly. In her opening speech she highlighted the new orientation of PSI in the wake of the 2008 financial crisis: increasingly the TU group has sought to ally with civil society and public interest researchers to develop an in-depth understanding of policy making and to promote the public interest in many fields.
PSI's main drive is to denounce Public Private Partnerships in which city services, from water to schools, to energy, transport and large parts of the health systems are handed over to private enterprise, while trustees of pension funds are required to make maximum profits, even at the expenses of layoffs.
At a press conference Rosa indicated that PSI will participate in the World Social Forum section on Social Security System planned for next spring in Brazil, by organizers who decry the government's decision to freeze public spending for.. 20 years, a clear case of overreach.
The Dadaists would be happy to hear that mockery in information campaigns will color all of PSI's campaigns.
The round table on Health was chaired by Roberto Bissio (Third World Institute). The later is one of the figures in the civil society mobilization around the Sustainable Development Goals (SDGs), and part of the TU and civil society coalition authors of the report SPOTLIGHT, presented in New York this past July and whose aim was to 'reclaim policies for the public' and 'assess how privatization and corporate captures have become obstacles to progress under the 2030 Agenda'.
"The proponents of privatization and public-private partnerships (PPPs) use these trends to present the private sector as the most efficient way to provide the necessary means for implementing the SDGs. But many studies and experiences by affected communities have shown that privatization and PPPs involve disproportionate risks and costs for people and the public purse."
Among the targets of PSI for exposure, we noted:
Henri Garrido, a TU leader and Trustee of a major pension fund in New York City: he pointed out that out of the 20 trillion dollars these represent, about 10 trillion is invested in the public sector, the basic idea today (supported by the World Bank) is to promoted funding into long term infrastructure especially in the developing world. In an age of enforced austerity, it can be appealing for governments to handover management and provision of services, from water to schools or roads, to a private sector who would do the job, he said.
But, among the problems, says Garrido, is a 2016 Obama sponsored law (one of the few cases where the Republican Congress agreed) which basically says the Trustee is responsible to bring about the highest return on investment for pensioners (target around 7% in NYC), and in practice is means that the private provider will cut down wages, reduce the labor force, reduce quality of services and increase costs to consumers, to the population itself. And it's presented as a good deal to the Municipalities: a deal over 100 years, no money to be disbursed now...
However there is now a wide movement which has gone out to expose how PPP are corrupt and not working and over 300 municipalities have (re)municipalised services.
Opponents of PPP were on the podium and were cheered as the report of the High Courts in the Philippines declared 'unconstitutional' the privatization of services in the capital of Jakarta.
On the Health policy panel, chaired by Bissio, the WHO representative of the Commission on Health which included PSI and the ILO, Jim Campbell, WHO Director of the Health Workforce Department, highlighted the importance of the sharing in information, yet expressed real unease in view of the denunciation of PPPs by People's Health movement representative and public health actor in India, Amit Sengupta.
Amit said it's been 30 years now that the World Bank has campaigned to stop public funding for health, arguing that private works better. In UHC "Coverage" is not public health language, he said, and it has become public expenditures but private provision of health care. The United Nations discourse is that it doesn't matter if it's public or private, he added, but, it does matter, all successes are public. Cuba, Costa Rica, etc.
Today the privatization is done 'brick by brick demolition: first the dialysis services are outsourced and privatized, then the cleaning, next comes the ambulances, leaving clinical care intact... However when clinical care is left by itself, then it's privatized and there's no one left to support it."
Why the public sector is superior is not ideological, (counter sector) but practical, deeply rooted in public health, economies of scale, do not operate from moral hazard, and private sector in poorer countries like India will not go into areas where people have no money.
From Australia, a TU leader explained the organization of a successful campaign to block privatization of five hospitals decided up by a conservative government in Sydney.
The Niger based president of the TU in Health and Social Action (SUSAS), Boubacar Bobaoua spoke of the difficult struggle of health TU in the midst of the Ebola crisis as the TU members went on strike to request protective gear to deal with Ebola cases in Sierra Leone. The Ebola epidemic claimed many lives of health workers in the three most affected West African countries, and this was mostly due to the lack of protective clothing and equipment, leaving health workers at the mercy of contamination. PSI organized a TU meeting in Ghana on Ebola, said Boubacar, and this helped health workers from other countries obtain necessary protective measures, for example in Nigeria.
Visibly afraid of so much denunciation of private sector involvement in health and PPPs, the WHO representative insisted upon intervening a last time, even though the session had been officially closed, and he blurted out that PPP were not all white or all black as some presented, but rather "PPPs are ALL SHADES OF GREY".
Amit jumped up to have a last word, saying that privatization means death for some people, so it's not 'shades of grey', he concluded : "PPP are 'partnerships... between a goat and a lion!"
Reported by participant, Zython de G.
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