Public Health in the Other Economy

Benedictin nun from Sant Benet de Montserrat Monastery Barcelona, Spain

Teresa Forcades i Vila

My freedom ends where yours starts, is what capitalism states, menacing and violent. Nobody will be fully free until we are all free, states the anarchistic and feministic maxim. The last constitutes the frame of the new economy and the idea of health that belongs to it: Nobody will be fully healthy until we are all healthy. It is only by overcoming the dichotomy that separates the I from the us and thinks of itself as being happy in a fanciful solitary self-fulfilment, it makes sense to talk about public health in an alternative way. The four main characteristics of this other public health are to my understanding: independence from commercial interests, unmedicalisation, plural therapeutic options within a maximum scientific rigour and a dialogical model of integral assistance to patients.

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risky side- effects are proved. The EMEA has compromised to keep a database of public access about side-effects of medicines commercialised in Europe, but actually it is impossible to get useful information from it. The groups of experts that advise the WHO are in most cases totally integrated and financed by the pharmaceutical companies. Medical schools, specialised medical magazines, scientific congresses and basic and clinical investigation depend today increasingly on these companies and their private economic interests. The alternative is to radically separate health and market: health is not a product, it is not bought or sold, it is a right of the human being that implies all society. It is not up to the State, however, or to society, to impose any healthy life style, however reasonable it may seem. To drive without a safety belt or helmet, to 1. Independence from commercial interests (wibe sexually promiscuous and drink alcohol, smoke or thout excessive regulation) take other drugs should not be penalised in the new The World Health Organisation (WHO), the agency economy. Why should we agree to finance among all that oversees health in the planet, was established of us those lifestyles that are dangerous for health? after the II World War, based on a free adherence Because it is absolutely economically viable if specuof member countries, which made a compromise to lative profits derived from health commercialisation provide it with enough funds to function adequately are eliminated and because it is the adequate frameand independently. In the last years, as the neoliberal work of freedom for a trust anthropology, that does crisis developed and the national budgets were slowly not assume the human being should be controlled, dwarfed beside the net profits of some mega-multina- but should be promoted and encouraged. What must tionals, the private capital has offered very generous be controlled are the companies not the people. donations to the WHO, accounting today for more than a 50% of the organisation financed by private 2. Unmedicalisation capital. One of the companies that has more weight In modern times, as medicine advanced illness in this financing is Microsoft, through the Bill and receded. In our days, as medical developments thrive, Melinda Gates Foundation. The European Medicines illness also increases, so that today what is normal Agency (EMEA), the agency in charge of approving the is to have a diagnosis or even one at a young age and commercialisation of medicines in the European Union consume medicines, or have periodical check-ups or and of controlling the appearance of unexpected side- restrictions to our lifestyle according to them. 45% effects after commercialisation (drug surveillance), is of adolescents in the USA have at some time taken financed in more than a 75% by the pharmaceutical psychoactive medicines due to depression. 10% of industry itself who benefits from a quick commerciali- children in primary school in Holland take psychoacsation of new medicines and a slow retrieval when tive medicines due to hyperactivity and attention

Translation by Alice Mendez

4. Dialogical model of integral assistance to patients. The respect due to any person just because it is a person should be accentuated even more when this person is ill, because he is more vulnerable. To organise health services in a way that the priority is personalised attention is not a utopia, and it is the basis of satisfaction not only of the medical professional but also of the patient. The experience of illness and of dependency can be lived as a personal and community enrichment. At the entrance of the infirmary of the Bose monastery in Italy, there is a painting showing a young monk taking on his back an older monk. The legend accompanying this painting says: who is taking who? Debates at present about public health rule out the possibility of these ill persons or dependent elderlies being a source of richness for society, because only monetary richness is valued. In monasteries and in many homes that have not been commercialised yet, the illness experience or that 3. Plural therapeutic options within the maximum of dependency can be lived still as an opportunity scientific rigour. of growth, not only for the ill person but also, and The separation of public health from private inter- above all, for those who take care of him. The look ests will naturally give birth to plural therapeutic op- we send to the elderly or the ill, what is it like? What tions, larger than the one existing today. Treatments message is it transmitting? In the new economy the such as acupuncture, neural therapy, homotoxicology, ill or dependent person can never be regarded only homeopathy, naturopathy and a large list of etcet- and mainly as a burden, because in this person we eras, should be studied with more interest and should can see the depth of dignity of a person, that anthrobe integrated totally to the public system, given its pological dimension open to transcendence that, inpotential to solve or improve health problems or the dependently from productivity and utilitarian criteria, quality of life of patients. Today, these are therapies gives the human being its dignity. In M. Nativitats reserved for those with the highest income. The false words, who died in my monastery at 100 years of age: controversy between conventional medicine (depen- This body is worthless, but is mine and I love it. dent on medicines and directed by economic interests) and alternative medicine, as if conventional was the sole scientific and those called alternative were based on outdated traditions that do not resist rigorous investigation. This is not true. The medical movement based on evidence (MBE) has shown that more than 70% of treatments put forth by conventional medicine have not enough scientific basis to support them and are made either out of routine or due to associated commercial interests. Science and the scientific method should continue to be the essential arms of medicine. The other one is the art of medical practice and about this I will talk in the last chapter. deficit. Social problems such as economic injustice are labelled medical (depression or anxiety) and are thus depoliticised, individualised and treated with medicines. Unmedicalisation happens by dismantling the relationship health-market, but it also happens by changing our way of thinking about the meaning of life: to live longer should not be a goal in itself, it depends on the objective of life. Where does the definition of health by the WHO leave the prophets? Health is a state of total physical, psychical and social wellbeing. In which way can we say the prophets have a total social wellbeing? Beware the risk of labelling as insane the social dissatisfaction! Jesus of Nazareth, according to this definition of the WHO, would be ill and so would be all the critical people who show cognitive dissonance with respect to the hegemonic thinking.

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