Health is like freedom.
You only feel its value when it is no longer there or when you no longer have it.
While a healthy person usually sees a rosy future - without worries, a sick person often looks sadly, drearily and worryingly ahead and longs for improvement, healing and health.
In most cases - as the Corona pandemic has also just shown - it is hardly possible to influence which group one currently belongs to.
Legal basis:
The Basic Law for the Federal Republic of Germany states in Art 2.
(2) Everyone has the right to life and physical integrity.
But what that means in concrete terms is consciously or unconsciously left open.
The World Health Organisation (WHO), which has taken up the cause of "health for all", is more specific.
The pursuit of "the highest attainable standard of physical and mental health" is one of the economic, social and cultural human rights ("ESC rights") as formulated by the UN in the Social Covenant of 1966 (Art. 12).
(See also www.sozialpakt.info)
If health is defined as a human right, then social systems must also ensure that this is the case. Health systems are thus essential tasks of a state. This includes measures to prevent, treat and combat diseases as well as the economic provision of medical care for all. Health systems are systems of solidarity, because the demands of healthy people are often diametrically opposed to those of sick people.
Against this background, is it morally and ethically justifiable to consider health systems only from the point of view of economic efficiency in terms of profit maximisation?
The massive wave of infections caused by the Covid-19 virus in 2020, which has assumed pandemic proportions, has led to an enormous burden on clinics and clearly demonstrated the weaknesses of the health system.
Whether pandemic or other catastrophes - the systems for health security and health care must be put to the test and set up in such a future-oriented way that both intensive care places and the corresponding nursing staff are available in sufficient numbers or these can be created at short notice.
In addition, it is a social task to ensure that health care systems are economical, open to all people and that the basic right to treatment and medicine is accessible to all people.
However, economic does not mean that health systems should work in a profit-maximising way. Profit maximisation means maximising revenue and minimising expenditure. However, this is exactly what has happened in most clinics over the past decades. More doctors - especially specialists - lead to more billable services. In contrast, nursing staff, who are absolutely essential for patient care and follow-up, have been neglected. In the meantime, the nursing profession has become unattractive for many due to a lack of appreciation, underpayment and overwork, which has led to many positions not being filled for years, or not being able to be filled.
Politicians are now using this state of affairs as an argument to cut beds and close clinics instead of addressing the problems in the nursing professions that have been known for years and solving them for the benefit of the citizens. The main reason for this undesirable development was the introduction of flat rates per case, which took the place of the daily allowance, which was also not optimal. Put simply, hospitals used to be financed by the length of stay, today by the surgical intervention or treatment.
One extreme has been replaced by the other. At the same time, each side also has something good. Working this out and finding a new, patient-friendly billing system is the imperative and the task of the present and the future.