We must not leave our healthcare system to the free market!

For some time now, dark clouds have been gathering over Luxembourg’s health care system. The discussion about the strengths and weaknesses of our healthcare system, which has gained momentum as a result of the pandemic, has recently served as gunpowder mainly for those pursuing a clear self-serving agenda.

The fact is that the Marie-Lise Lair study commissioned in 2017 already showed that Luxembourg, just like most European countries, is heading full steam ahead toward a shortage of staff in the sector. It is also a fact that the pandemic has shown that our system does have some strengths, but that our well-being is mainly in the hands of the thousands of employees in the sector. So our absolute priority must be to build on those strengths in the future and to pay particular attention to protecting health and care professionals.

However, if today private speculators in Luxembourg are investing in infrastructures that have as a goal to house heavy medical equipment in the future and thus be operated as private mini-hospitals, it is mainly because private investments in health and care have become highly attractive. This is not surprising from an economic point of view, since their financing by contributions from the insured provides incredible security.

The related lobby of the liberal medical association AMMD, which politically tries everything to pave the way for such commercial structures by law, on the other hand is scandalous. Again and again, attempts have been made in recent months to call into question the public nature of our system, which is its real strength, in order to subject entire parts to private market logic and to suck public money, which is invested to guarantee high-quality medicine and care, out of the system as private profits.

Abroad, however, numerous examples of the damage that such a commercial development logic can do to the health sector are already visible. In our neighboring countries too, privatization has repeatedly led to capacity being reduced and hospitals being closed, this because private operators generally limit themselves to standardizable and lucrative treatments. This is already illustrated by the job advertisement with which the private medical center Cloche d’Or is trying to attract doctors. Here the argument is purposefully listed in job advertisements that the medical profession in these structures, unlike in hospitals, does not have to do shift work or standby duty. The fact that by such arguments the lack of physicians in the hospitals can be only intensified does not seem to disturb the operators.

The OGBL welcomes meanwhile the political courage in Luxembourg, not to imitate these mistakes, by summarily imputing such excesses in the health care system to already existing public institutions.

What a lack of such political courage results in, however, can be observed at the same time in the care sector. A recent press article in the Tageblatt has revealed that the French conglomerate Orpea has been trying to gain a foothold in Luxembourg since 2014, but has been “vehemently” rejected in the past. After the attempt to privatize parts of the public provider Servior 2 years ago, the liberal Minister of Family Affairs, according to her own statements, saw no other option today than to open the door to Luxembourg for Orpea, and this despite the fact that the company has made negative headlines all over Europe, both in terms of rationing of services, mistreatment of residents, misappropriation of public funds and the exploitation of its own staff.

All this because Orpea has been proven to use its care activity as the only means to maximize private profits and build an international real estate empire. This, in turn, because private market logic did not prevent it and would not prevent it in the same way in the Luxembourg healthcare system, should we allow it today.

Our health must not become an attractive good for capital investors, speculators and investors. In this optics it is the responsibility of our government not to permit openings in the system, which would make it possible that our tax funds flow into private pockets, instead of arriving at the staff, highquality supplies and thus above all in the quality of care of the patients and dependent persons.

The OGBL Health and Social Services Syndicate therefore welcomes the fact that the public logic, which works hand in hand with the solidarity principle, is currently being strengthened in the health sector and demands the same determination in the care sector.

Beyond that it is both in the hospital system and in the “extrahospitalier” at the time to act in the short term, in order to work against the shortage of staff. Put an end to part-time and temporary contracts in the sector. It cannot be that young people are fobbed off with precarious employment contracts while every helping hand is needed in the sector. Especially in the field of mobile care, such contracts are used to retain maximum planning flexibility on the part of employers and to the detriment of employees. In addition, we need an increase in staffing levels in the short term, coupled with minimum staffing levels, both in terms of the number of employees and their qualifications per ward.

Only when these factors work together, consistent, best possible care for all patients can be guaranteed.

Communicated by the OGBL Health and Social Services Syndicate
on January 16, 2023