We oppose the commercialization of health. Health is a social good, not a privilege for the few

«The bourgeoisie…has transformed the personal dignity of man into an exchange value, and has replaced the countless freedoms—granted and won—with the single, shameless freedom of trade.»

(  K. Marx, F. Engels, The Communist Manifesto, 1848  )

Since the late 1980s, public healthcare has everywhere—especially in the EU—been one of the sectors most affected by capitalist restructuring. According to the OECD, total healthcare spending has risen sharply in real terms from 1991 to the present, while the share allocated to public healthcare, also in real terms, has remained essentially stagnant—or has even declined significantly in Italy, Greece, and Spain. This has occurred alongside a corresponding increase in public funding for private healthcare through general taxation, the growing reliance on private health insurance, and the expansion of costs not covered and paid directly by users (so-called out-of-pocket expenses).

Public healthcare facilities are being transformed into enterprises and managed according to private-sector criteria by hospital managers, whose primary objective is not patients’ health but financial performance. Chief physicians and other senior medical staff are often co-opted by healthcare and pharmaceutical companies under profit-driven business logics, which often results in medical decisions being made not on the basis of purely healthcare-related criteria and the patient’s best interests, but rather with the aim of serving the financial interests of those companies. Medical and paramedical staff are deliberately and significantly understaffed, waiting lists for medical services grow longer, patient co-payments increase, while the remaining services still covered by public healthcare decline in both quantity and quality—services which are not truly free, since they have already been paid for by taxpayers. All of this pushes those who can afford it toward private insurance and private healthcare, while those without sufficient means are forced to forgo treatment—a troubling and growing phenomenon that reveals a class-based discrimination, effectively denying the universality of healthcare provision and the right to health hypocritically proclaimed in bourgeois constitutions.

The outsourcing of services and treatments to private companies, NGOs and social cooperatives, in place of public provision, proves even more costly for public finances than maintaining such services within public structures, while reducing quality and increasing the exploitation of workers, in terms of longer —often exhausting— hours and more intense workloads combined with low wages.

Faced with growing needs  for care—due both to increased life expectancy and to the intensification of exploitation in production, as well as the physically and mentally exhausting nature of labor—the bourgeois state strengthens surreptitious forms of privatization, the so-called public-private partnerships that dismantle public healthcare and turn health into a commodity to the benefit of capital operating in the sector, whether directly (such as pharmaceutical companies and private healthcare providers) or indirectly (such as banks and insurance companies).

The resources thus diverted from protecting the health of the popular masses are instead used to finance rearmament and public support measures for private accumulation and profit, in a form of reverse welfare that takes from the working class and popular strata to the bourgeois class. This process finds its legal basis in the European Semester Recommendations and in the macroeconomic constraints of the Stability and Growth Pact, adopted by the European Commission and the bourgeois governments of EU member states—constituting yet one more reason to strengthen the struggle to exit this and all imperialist alliances.

While capitalism dismantles public healthcare and forces proletarians and the popular strata to endure serious injustices, inequalities, and disparities in treatment even in the field of healthcare —despite the tremendous development of scientific discoveries and technological capabilities—, we wish to recall that socialism has always guaranteed the right to health and to high-quality, completely free healthcare for all. Even today, socialist Cuba, despite the enormous difficulties caused by the criminal blockade imposed by U.S. imperialism, remains at the forefront of medical research and in ensuring free healthcare for its people.

Communists declare that the right to health is a universal right—above all a social one—of the human being, fundamental to ensuring the quality and dignity of life, as well as its duration. Like all the rights that capitalism denies us, this must be asserted by demanding no sacrifice for the profits of capital or the slaughterhouses of war, in opposition to the privatization of the sector, and by demanding universal, free public healthcare in the direction of our broader struggle for socialism-communism.