Complementarity needs in the health system
The Economy of social care (children, the elderly and people with disabilities) and tackling poverty.From state interventionism to social interventionism and social enterprise
The health and social care sector is a growing sector of employment that will presumably not be constrained by the “technological unemployment” that exists in other sectors of the market economy. In particular, in the social care sector of preventive health for chronic diseases and elderly care, which needs personal daily care and there are increased needs, as these are not adequately covered by the current health systems and are mainly burdened by families.
And this is despite the fact that it is now recognized by the scientific community that adequate health resources can stimulate economic growth by allowing people to remain active and productive in good health for longer. Given that, the health status of citizens has an impact on their ability to participate in the labor market and their productivity. It is also recognized that investing in the health of the population contributes to the reduction of future costs for treating diseases that could have been prevented and not burden the health system. And this in turn contributes to an effective workforce in the healthcare industry.
The coronavirus pandemic has brought the issue of care to the top of society’s priorities, revealing the central role that public health systems play in guaranteeing citizens’ right to care. In effect, therefore, it shifted the center of gravity from the unnecessary of consumerism to the necessary of the real economy, which is nothing more than nutrition, health and social care needs and unemployment benefits.
According to the forecasts of the Organization of the OECD, public expenditure on health in the major industrialized countries will continue to grow and is expected to reach 9.5% of GDP among member countries in 2060, compared to 6% in 2010.
Other countries such as France and Denmark, followed by the Netherlands, are well above the OECD average and will see their health spending exceed 11% of GDP by 2060, even if they make efforts to check them.
More progressive economists argue that the optimal health policy is for health spending to reach 15% of GDP.
However, even these expenditures, which mainly concern the public and private sectors, are not sufficient to cover the growing needs of social care. The private sector obviously does not cover the fact that a third of the population is on the poverty line. This part can only be covered by social health enterprises that operate at a reduced cost.
If we consider that, a low pensioner who has health problems or a disabled person cannot afford the costs of care services from the private social care sector. Nor do public services for child care, child education, disability cover long-term care, and elder care when it comes to low-wage earners who are not 100% covered by their insurance.
This picture certainly differs from country to country within the EU.
Let’s see what the real picture is in a Mediterranean country like Greece in relation to preventive health care.
✅Today 90% of Greeks do not have access to a family doctor.
✅The poor pay 20% of disposable income to cover health needs and 2 million postpone or cancel examinations and visits to Doctors due to financial problems and geographical limitations.
✅100% of Dental care is not covered by social security.
✅50% of the cost of Medicines is Private Expense.
The private expenditure on Hospitals, which for decades and until 2012 was at 8% of Private expenditure, has risen to 39% and together with medicines they cover almost 80% of Private expenditure.
✅2.5 million Greeks do not do preventive examinations, do not visit Doctors and cut from clothing, Heating and other basic needs if they want to pay for Medicines and Hospitals.
✅The interruption of the historical continuity of benefits after 2011 has led to 10 years of experimentation at the expense of the majority of citizens.
Given these deficits, in the poorest and over-indebted Mediterranean country, the social economy as an institution in the field of health is a necessary alternative proposal to secure resources from three sources: the public, insurance funds and donations to reduce the cost of social care through institutions, boarding schools and preventive health structures.
Institutions in the field of health have an excellent tradition, which can be generalized with the participation of the insured in health entrepreneurship. With self-management of social care. Thus, the investment of the social economy in the reduction of inequalities in the health sector, in the long term, comes to stimulate the entire economy as they are based on real needs of human living and on the reduction of mediation.
Here, it is worth pointing out that inequalities in the health sector do not only entail a loss of human potential, but also potentially huge economic losses. On the contrary, by ensuring everyone’s access to health services, we contribute to the reduction of poverty and the fight against social exclusion.
While the increase in employment results from the increase in social entrepreneurship.
The Economy of social care and poverty alleviation
The health system, which after the war relied on the welfare state, now needs to strengthen preventive health as well as post-hospital care for a large proportion of citizens who need it and cannot meet the high costs of services and private help at home. The gap that exists in social care is often covered by families, women and girls are asked to cover a significant part of formal care.
A function that is partially absent and covered by unpaid and unrecognized care work, within the family – work that is assumed by their family and social environment as a “natural obligation”. The alternative proposal to this problem is social entrepreneurship in the health sector that can work at a reduced cost and bearable for families.
In this sense, the care economy has to do with strengthening the health-welfare systems, but at the same time with the values that are obviously the opposite of the economy of speculation and over-catalization, as well as the economy of over-exploitation of natural resources.
At the level of state interventionism in the economy, we observe after many years, the strengthening by the state of all those affected, not only the workers but also the businesses, and this demolishes the doctrine of self-regulation of the market in the field of health
✅Today 90% of Greeks do not have access to a family doctor.
✅The poor pay 20% of disposable income to cover health needs and 2 million postpone or cancel examinations and visits to Doctors due to financial problems and geographical limitations.
✅100% of Dental care is not covered by social security.
✅50% of the cost of Medicines is Private Expense expense.
The private expenditure on Hospitals, which for decades and until 2012 was at 8% of Private expenditure, has risen to 39% and together with medicines they cover almost 80% of Private expenditure.
✅2.5 million Greeks do not do preventive examinations, do not visit Doctors and cut from clothing, Heating and other basic needs if they want to pay for Medicines and Hospitals.
✅The interruption of the historical continuity of benefits after 2011 has led to 10 years of experimentation at the expense of the majority of citizens.
Given these deficits, in the poorest and over-indebted Mediterranean country, the social economy as an institution in the field of health is a necessary alternative proposal to secure resources from three sources: the public, insurance funds and donations to reduce the cost of social care through institutions, boarding schools and preventive health structures.
Institutions in the field of health have an excellent tradition, which can be generalized with the participation of the insured in health entrepreneurship. With self-management of social care. Thus, the investment of the social economy in the reduction of inequalities in the health sector, in the long term, comes to stimulate the entire economy as they are based on real needs of human living and on the reduction of mediation.
Here, it is worth pointing out that inequalities in the health sector do not only entail a loss of human potential, but also potentially huge economic losses. On the contrary, by ensuring everyone’s access to health services, we contribute to the reduction of poverty and the fight against social exclusion. While the increase in employment results from the increase in social entrepreneurship.
The Economy of social care and poverty alleviation
The health system, which after the war relied on the welfare state, now needs to strengthen preventive health as well as post-hospital care for a large proportion of citizens who need it and cannot meet the high costs of services and private help at home. The gap that exists in social care is often covered by families, women and girls are asked to cover a significant part of formal care. A function that is partially absent and covered by unpaid and unrecognized care work, within the family – work that is assumed by their family and social environment as a “natural obligation”. The alternative proposal to this problem is social entrepreneurship in the health sector that can work at a reduced cost and bearable for families.
In this sense, the care economy has to do with strengthening the health-welfare systems, but at the same time with the values that are obviously the opposite of the economy of speculation and over-catalization, as well as the economy of over-exploitation of natural resources.
At the level of state interventionism in the economy, we observe after many years, the strengthening by the state of all those affected, not only the workers but also the businesses, and this demolishes the doctrine of self-regulation of the market in the field of health.
At an international level, the state is called upon to save the economy and businesses. The 2 trillion granted by the American government to deal with the economic effects of the pandemic and the approximately 1 trillion from the EU and the development fund show the size of the state intervention that is necessary to get the economy moving forward again after the pandemic.
The essential thing about state interventionism is that the orientation changes. The state undertakes a mission that the market economy cannot naturally undertake. It is obvious that only the state can redistribute resources beyond the basic needs of the real economy and social entrepreneurship in health.
From state interventionism to social interventionism and social enterprise
We are in a time when the state, after the pandemic and in a critical period, is taking precedence over the private economy and the banks. Many are talking about a new Marshall Plan in social care. The governments that gave primacy to market forces and in the field of health are now obliged to take on a corrective role, in the vortex of an inexorable historical necessity for economic interventionism.
In fact the state as an institution is somehow forced to increase health spending, while the private health sector is weakened as it has high costs for many. On the contrary, the problem that existed with high-cost statism, from bureaucracy and parasitism, is now being dealt with technocratically, with the reduction in the cost of running the state thanks to the possibility that comes from the digitization of the state and technological developments. These are effects that, despite the economic crisis, strengthen democracy in the allocation of resources and human rights.
The internet can be an ally for patient-directed and patient-controlled health services. First, they share information and medical data that is necessary to manage health problems. Creating common spaces and platforms to provide encouragement and help to one another. To spearhead pressure groups and push Governments, insurance companies and the medical community to rethink established medical views and procedures in every sector of the healthcare space and modernize services.
Today it is a fact that, worldwide, there are many websites and social media platforms where millions of people connect, support and help each other to promote advances in Medicine and public health. Communities of the chronically ill, communities of the elderly, disabled, etc.
These communities collect resources for scientific research, but also for social health enterprises, which expand the front of dealing with health problems. The great advantages of this process are that they constitute a social capital that mobilizes and mobilizes resources for greater speed in addressing life-saving health problems.
Thus, social interventionism and social enterprise in the health sector offer two creative effects. Greater expansion and efficiency in the health system and expansion in this area of employment.
by Vasilis Taktikos
