Health Care and Social Protection: what strategy?

The silver lining in the COVID-19 crisis is, undoubtedly, the many lessons we can learn.

In the past, it was sometimes hard to convince people of the need for social protection. Too often, it is seen as paternalistic, reformist and old-fashioned. Today, people want to be free and decide for themselves. Or, solidarity cannot exist in a capitalist system, so, we first have to get rid of capitalism.

Let me give you this quote of Chris Hani, former chairman of the South-African Communist Party:

Socialism is not about big concepts or heavy theory. Socialism is about decent shelter for those who are homeless. It is about water for those who have no safe drinking water. It is about health care. It is about a life of dignity for the old. It is about overcoming the huge divide between urban and rural areas. It is about a decent education for all our people. Socialism is about rolling back the tyranny of the markets. As long as the economy is dominated by an unelected, privileged few, the case for socialism will exist.”

I think this is very clear and very true.

From this statement follow two things:

One, it is the political struggle for these social policies that make another world possible. The current COVID-crisis has made it crystal clear how the homeless, the migrants and asylum seekers, the informal workers, all the vulnerable people are the major victims of an illness that can be avoided by the rich and wealthy. The statements of some about health care as an opportunity for wealth creation are a shame. Health care should be available for all and should be affordable. It cannot be a for-profit asset. As Global Social Justice has been saying for years: what we need is free, public and universal health care. At least, if you take human rights seriously. The awareness of the transformative potential of health care is a first step towards a strategy for system change.

Two, one cannot fight for health care without fighting for water, for shelter, for income, for dignity. And one cannot fight for health care without fighting for preventive policies and for a healthy environment. It means we necessarily have to fight against the tyranny of the markets Chris Hani is referring to. Never before has it been so clear that all these different aspects, from health care to housing to the environment and to the financialisation of our lives have to be tackled simultaneously. This is, I think, the second major strategic element that has to be taken into account.

Never before, it seems to me, has it been so clear that politics are about life and death.

Health care and social protection are not only individual concerns, they are a common interest. It does not help to work for a COVID-free France or China or Mexico, if other countries have no resources to fight the virus and have access to vaccines. In the same way, the environment knows no borders. We are so interdependent that it should be clear to all that we are in this together, not in the same boat, certainly not, but in the same storm. We can only survive if we find solutions for the huge inequalities that to-day, make social life so difficult, if not impossible.

Add to this the necessary democratic procedures with a participation of all concerned people, men and women, rich and poor, North and South and East and West. That is why we talk about ‘social commons’, policies and achievements that are in the common interest and come about in a participatory manner.

Our social protection, then, is a very broad concept, it is not a corrective mechanism but a tool for change. It is very different from other advocates of ‘social protection’ who only think of markets and hide behind a discourse on ‘the poor’ they constantly ignore.

This is the strategy we have in mind: an awareness of the transformative potential of social protection, in the sense of Chris Hani, an awareness of the necessary linkages between social, environmental and economic policies. It obviously is incomplete, it is a long-term project that will have to adapt to national and local circumstances. You can call it socialism or you can call it something else. We think it is crucial.

World Health Day: Declaration of Social Justice Cluster of AEPF

Declaration of the Social Justice Cluster of the Asia Europe People’s Forum on April 7, World Health Day

The Social Justice Cluster calls for the establishment of public and universal health systems, a revaluation of so-called “reproductive” work and taking into account the social health determinants and the real needs of the people

The coronavirus crisis functions as a wake-up call and a warning all over the world, North and South, governments are helpless, health systems are failing, everyone, especially the sick are the victims.


Changes for a post-COVID world

There is something profoundly disturbing about this crisis. The results are frightening: ten thousands of deaths, hundred thousands of sick people, major cities in lockdown, an economic collapse…

Slowly, from China and South-East Asia, the crisis is now hitting Europe, the United States and will inevitably spread from there to the South. And as we know, the majority of poor countries does not have the capacities to care for their people. Almost half of the world population does not even have water and soap to wash their hands.

Speculations are going on on how our world will have to change after the crisis. But will it change? Continue…

The World Bank and its new ‘social contract’

What social model are we heading for?

It has been said and it has been repeated: social policies have been the major victims of neoliberal globalisation. During the past forty years, attention for social protection and social development, everywhere, shifted towards ‘poverty reduction’, the IMF’s (International Monetary Fund) and the World Bank’s prescriptions continuously implied cuts in social spending and targeted policies in the South, while ‘austerity’ was introduced in the North with negative consequences on welfare states and labour law.

The changing world of work and the fundamental societal changes – migration, ageing, women on the labour market – recently gave rise to some timid discussions on social protection. The only real debate that took place in the North concerned the possible introduction of a ‘Universal Basic Income’, a basically liberal idea that almost inevitably would make an end to welfare states.[1]


Progressive commons

Some theoretical and strategic reflections

 One of the most positive developments these past years in the resistance to neoliberal policies has been the emergence of a commons movement and of an alternative economy: citizens taking initiatives in different sectors, from agriculture to production, from care to housing and gardening.

For progressive movements, these alternatives cannot be an end in themselves. They need to be conceptualized as strategic tools for social transformation and system change. And we know many ‘social enterprises’ or ‘commons’ do not answer these needs. However much admiration we may have for the quality or innovation of some projects, we always have to look at their potential, their limits and their possible risks. Some projects may indeed be inspired by traditional or conservative values or may not offer any forward-looking perspective. Another risk is that projects initiated as being transformative end up being appropriated by conservative forces.


Public services for all: better than basic income

Read the excellent article of Rosa Pavanelli of PSI on why public services for all are so important:

“Examining 14 trials from India to Alaska, the report found that although UBI trials provided valuable insights into the nature of work and welfare there is little evidence to suggest that UBI is the best tool to address the core challenges of our time: inequality, wealth redistribution, precarious work and digitisation.”

Universal Basic Income: Solution or Part of the Problem?

Is UBI  part of the solution or part of the problem? A new study out this week, published by NEF and Public Services International, finds little evidence to support most of the claims made for UBI. It confirms the importance of generous, non-stigmatising income support, but everything turns on how much money is paid, under what conditions and with what consequences for the welfare system as a whole. There are more effective and sustainable ways of meeting people’s needs and fighting inequalities than just giving cash to everyone.

Read the article

Read the report

The IMF on Basic Income

In advanced economies, universal basic income is often used as an instrument to address inadequate safety nets (and ensure inclusion) and a way to tackle the challenges of technological and demographic changes.

Discussions around universal basic income can be heated, both in a scholarly context and in public discourse, and there is no established common understanding. Very different income-support programs are often labeled “universal basic income,” even when they have little in common or do not aim at the same goal.

Read the article



Universalism … really?

How the World Bank turns meanings to its advantage.

With all the paradigmatic changes the World Bank has been promoting in the field of social policies, one element never changed in the past thirty years. Social policies were meant for the poor, governments had to find the best ways to target those who really needed their help.

The reasoning is simple: poor people, as was spelled out in its first World Development Report on Poverty of 1990[1], were those left behind by growth and by governments. The wrong policies were applied so that poor people did not get access to labour markets and, moreover, these labour markets were made more difficult to enter because of minimum wages and other ‘protective’ rules the poor did not really care about. If one really wanted to help the poor, one had to abolish all these well-meant but adverse policies. Open, deregulated markets, at the local and the global level, were the best programmes for the poor. In its ‘Doing Business’ Report of 2013[2], the World Bank still considered fixed term contracts and 50-hour workweeks as positive achievements, whereas premiums for night-work and paid annual leave were on the negative side[3].

As for the not-so-poor or middle classes, these people are said to have enough resources to buy the insurances they want on the market. Insurances are an economic sector and there is no reason why States or governments should get involved in it[4]. Solidarity is one of the words that has always been shunned by the international financial organisations. Continue…

Basic Income and the Video-Game Myth

Basic Income — a regular payment of money for every resident citizen, regardless of their circumstances, sufficient to pay for essentials.

It sounds like a wonderful idea, but not everyone’s convinced. And one of the main objections people raise is the claim that if you pay everyone a Basic Income, millions upon millions of people will decide to give up work entirely and play video games all day instead. They envisage so many people doing this that the economy will be seriously depressed and might even collapse altogether.

But I suggest this claim is not just overblown — it stands in complete contradiction to what we know about human nature, based on a huge amount of available evidence.

(Robert Jameson in Medium Daily Digest)

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