PSI Health Blog

Public sector workers paying for corporate tax cuts

'Public employees are being asked to make a contribution of $750 million towards a $3.6-billion tax cut for large corporations.'

By Larry Brown
National Secretary-Treasurer
National Union of Public and General Employees (NUPGE)

Ottawa (31 March 2010) - The Ontario budget for 2010 wasn’t the worst budget possible – in some ways. There are even many things to admire in it.

But this budget was among the best at making one simple point very clear: in the opinion of many governments these days, if you work for the public, providing important services, you will be expected to contribute some of your wages to the noble cause of corporate tax cuts.

Consider the numbers provided by the government itself:

• Public sector wage freezes will ‘save’ the government $750 million over two years.
• Corporate tax cuts will cost the government $3.6 billion over three years. The budget says about $1 billion of that will go to small business, so by definition the rest will go to large corporations.

Thus, the public’s employees are being asked to make a contribution of $750 million towards a $3.6-billion tax cut for large corporations. All the other talk about the deficit and the need to fight it is all very interesting, but you can’t sensibly talk about a focus on cutting the deficit if at the very same time you are voluntarily cutting your income by billions of dollars.

If the Ontario government didn’t cut corporate taxes, it would be able to pay public sector workers their $750 million and still have almost $3 billion left to fight the deficit. As it is, public sector workers aren’t helping to fight the deficit, they are helping to pay for the corporate tax cut.

'Pure fiction'

There is a fascinating chart in the budget documents about how cutting corporate taxes magically creates more revenue, because all the corporations use their tax cut to rush out and invest, which creates more jobs and more revenue for the government. It’s a lovely work of pure fiction.

After all the cumulative tax cuts for corporations in Canada, we should, if that fairy tale was true, be flooded with investment and new jobs and all the wonderful things that happen when corporations don’t pay their fair share.

Erin Weir, an economist with the United Steelworkers, succinctly put it this way:

“The previous round of corporate tax cuts begun in 2000 has increased after tax profits to record heights without a corresponding rise in business investment. In fact Canada’s ratio of business investment to profit has fallen to an all-time low.”

In other words even when times were good corporate tax cuts simply didn’t lead to new investment; they only resulted in higher corporate profits, which then weren’t taxed. The same story has played out in the federal budget, where public sector employees are going to be called on to contribute $6.8 billion of their wages and jobs to the ongoing corporate tax cuts, which will cost more than $21 billion over the next five years.

Over $100 billion

The Harper corporate tax cuts have already cost us over $100 billion, but allegedly the country needs more; more cuts in taxes for profitable corporations, so federal public employees are being asked to contribute their wages to line the deep pockets of these companies, so the companies in turn can afford the astronomical salaries of their CEO’s.

Federal employees aren’t helping to cut the deficit at all; that’s not where their money is going. It’s going to tax cuts for multinational corporations, plain and simple. How can anyone pretend this is about fighting the deficit when we’re giving away $21 billion in revenue for no good reason?

What is beyond dispute is that the $750 million the Ontario government wants to take out of the pay cheques of its employees is all money that would have been spent in the stores and businesses of Ontario. We know from bitter experience that if public sector wages are cut, public sector workers will spend less in their communities. Fewer houses bought, less furniture sold, fewer restaurant meals purchased, fewer new clothes, fewer cars and CDs and books bought, fewer haircuts, less discretionary spending all round.

All of the private businesses that provide these sundry services in the community will pay the price too. The average wage of public sector employees guarantees they will spend their money close to home, because they don’t earn enough to sock money away in off shore tax havens.

All this is mere fact. The myth is that public sector workers have to sacrifice to fight the deficit; the reality is that public sector employees are being asked to pay for corporate tax cuts.

The National Union of Public and General Employees (NUPGE) is one of Canada's largest labour organizations with over 340,000 members.

Health care reform in the USA

A STEP FORWARD, MUCH WORK LEFT TO DO

STATEMENTS BY PSI AFFILIATES

AFSCME

President Gerald W. McEntee, Vice President of the AFL-CIO

"Tonight's historic vote marks a major milestone in the struggle to break the power of the insurance industry and provide quality, affordable health care for millions of American families. Democrats in the House, with the determined leadership of President Barack Obama and Speaker Nancy Pelosi, demonstrated the courage that is necessary to defeat the special interests and do what is right for the American people.

AFSCME members will remember those who stood with us and those who stood with the insurance industry.... Together, we will not fail. Tonight, we celebrate a monumentally important victory for our country. Tomorrow, we get back to work in the fight to make health care reform happen."

Read more:

A Monumentally Important Victory for Our Country

AFSCME launches ad campaign

SEIU

Anna Burger

SEIU Secretary Treasurer, Vice President Change to Win

"For the child who was denied coverage because she got too sick, too young – tomorrow is a new day for our country. The 5.5 million members of Change to Win, united in their commitment to bring the change our families, our communities and our country needs, earned this victory the old fashioned way: they worked for it. It is because of their passion and their steadfast belief in doing what's right that Congress stood and delivered the change they demanded."

Read more:

Landmark Health Care Bill Signed Into Law

Timeline of the immediate benefits of health insurance reform

AFT

Randi Weingarten,
President, American Federation of Teachers

"We applaud... [the] action by the U.S. House of Representatives that brings us to the cusp of affordable and accessible healthcare and prevents insurance companies from denying coverage to millions of Americans.

The House package will allow 32 million more Americans to receive healthcare coverage... And insurance companies will not be able to deny benefits because of pre-existing conditions or cancel policies because of illness.

While this is not a perfect bill...it makes a significant start at getting costs under control and moves the nation toward the goal of affordable, high-quality healthcare for all Americans."

Read more:

AFT Press release

Fight for America's Future

CNA

Rose Ann DeMoro
Executive Director, National Nurses United, AFL-CIO and California Nurses Association

"Passage of President Obama's healthcare bill proves that Congress can enact comprehensive social legislation in the face of virulent rightwing opposition. Now that we have an insurance bill, can we move on to health care reform?

As an organization of registered nurses, we have an obligation to provide an honest assessment, as nurses must do every hour of every day. The legislation fails to deliver on the promise of a single standard of excellence in care for all and instead makes piecemeal adjustments to the current privatized, for-profit health care behemoth."

Read more:

Diary of a Wimpy Health Care Bill

Chile earthquake: need to invest in public health, support health workers

PSI affiliate Fenpruss asks the new Government to make the rebuilding of hospitals a priority and to reassess the Health Services Network

The Federation’s President stressed that “right now, it’s more important than ever to invest in Public Health”.

After the earthquake and tsunami that affected the southern central region of Chile, the National Federation of Health Service University Professionals (FENPRUSS) has stressed how urgent it is that action be taken quickly to deal with the effects of this disaster.

“During our visits to hospitals in the 8th Region, we saw how very seriously they had been affected. There are also several rural first aid posts that were not only affected by the earthquake and the tsunami, but also by the looting”, stated Claudio González Jara, the President of FENPRUSS.

Experts think it will take three yeas to return to normality, and it is thought that the Government will need to invest $3.600 million to rebuild the hospitals damaged by the earthquake.  

“This”, he added, “will mean having to plan afresh all our professional and health-related activities. Urgent action will have to be taken to deal with the challenges to public health which are to come: gastrointestinal illnesses due to lack of hygiene and water in overcrowded conditions, and mental health problems, with a population afraid of returning to their homes in case of aftershocks, and health workers affected by the constant worry about what may be happening in their homes while they work exhausting shifts”.

Icelanders reject becoming Iceslaves

An astounding 93% of voters reject unfair terms imposed by the governments of the UK and the Netherlands as Iceland takes the lead in following a democratic approach to handling the consequences of the crisis

 

[Please see statement by Ogmundur Jonasson]

On 6 March, 2010, Icelanders did what no one in the world has done yet. Un-fazed by near-freezing weather and drizzle they went to the polls and let their government and the world know they will not be made to shoulder an unfair and unsustainable burden for the reckless policies of greedy private bankers. They made it clear they refuse to be made Iceslaves by the fallout from the Icesave collapse.

They voted on a referendum on whether or not the Icesave bill approved by a narrow majority in Parliament and vetoed by President Olafur Grimsson, should be enacted. The bill would obligate Iceland to accept the terms set by the governments of the UK and the Netherlands for repayment of the "Icesave Loan Agreement."

European union adopts directive to prevent sharps injuries

Carola Fischbach-Pyttel, General Secretary of EPSU

AGREEMENT BETWEEN REPRESENTATIVES OF HEALTH WORKERS AND EMPLOYERS BECOMES LAW

The European Hospital and Healthcare Sector Social Partners - The European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers’ Association (HOSPEEM) welcomed the decision of the European Council which adopted the directive on prevention from sharp injuries in the hospital and healthcare sector today.

The agreement between the European Social Partners in the hospital and healthcare sector signed on 17 July 2009 has become law. Now the European Member States have three years to implement the requirements set out by the directive.

Godfrey Perera, Secretary General of HOSPEEM said that: “the Directive is a fundamental step toward the improvement of health and safety of patients, workers and employers in the hospital and healthcare sector. Indeed, when implemented it will diminish the occurrence of accidents and infections. We are conscious that this problem cannot be eliminated completely, but we are keen to make sure there are appropriate procedures in place to try to reduce the number of injuries by as much as possible. The use of risk assessment, prevention, protection and training procedures will help to achieve this result”.

“This is a major break-through”, Carola Fischbach-Pyttel, General Secretary of EPSU, said: “With this directive EPSU and HOSPEEM have laid an important basis to create the safest possible working environment to prevent workers’ injuries caused by all medical sharps. We stress that a well trained, adequately resourced and secure health service workforce is essential to underpin that objective.”

The text above is a press release by EPSU. For further information, please contact: EPSU: Carola Fischbach-Pyttel +32 2 250 10 91 E-mail: cfischbach@epsu.org

Health workers union prevails in Nova Scotia, Canada

Proving that unions can stop efforts to make workers pay for an economic crisis that was not of their creation, CUPE members were successful in defending their hard-earned right to wage parity and their right to strike.

(see prior coverage: Global Issues tested as strike looms in Nova Scotia)

The Nova Scotia provincial government had argued that the union's wage demands, based on maintaining parity with non-rural areas, was not possible due to budget deficits in the climate created by the current crisis. Karen MacKenzie, president of CUPE Local 2525, which represents basically all primary health-care workers within the hospitals, responded by saying  "he (Premier Dexter) is not going to balance his budget on the backs of Nova Scotia health-care workers. That’s just not happening.”

When the union decided to go on strike, politicians in the Conservative party questioned their right to strike. When their party was in power, they had attempted to pass legislation that would deny health workers that right.

The union was undeterred. Picket lines went up at 6:00 am on 18 January, as had been announced by the union well in advance of the strike deadline.

Global issues tested as strike looms in Nova Scotia, Canada

Health and School Workers Refuse to Pay for the Crisis as they Defend Wage Parity and their Right to Strike 

Karen MacKenzie, president of CUPE Local 2525: "We are not going backwards"

Negotiating Committees for 4,100 hospital workers and more than 3,000 school board workers in Nova Scotia, Canada, have announced a strike deadline of Monday, January 18, 2010. They are represented by CUPE, The Canadian Union of Public Employees, which represents 600 000 public sector workers across Canada. Both groups are already in a legal strike position.

The CUPE hospital workers are in 33 hospitals in rural Nova Scotia, outside of Halifax. The key outstanding issue for the hospital group is maintaining wage parity with their counterparts in Halifax, something they have had for 10 years now. 

The school board workers are in eight school boards, also outside of Halifax. For the school board group, the issue is a contract offer that’s inferior to ones that have been given to other workers in the sector.

And a group of 3,500 long term and community care workers are not far behind them, facing similar issues in bargaining.

PSI leader Ogmundur Jonasson leads democratic opposition in Iceland

Ogmundur Jonasson --a member of the Parliament of Iceland and of the Executive Boards of PSI and EPSU --, continues to successfully lead the opposition to the unfair treatment of Iceland by the governments of the UK and the Netherlands. Today, the movement he leads succeeded in getting the President of Iceland to refuse to sign legislation that would impose onerous conditions on his country's population.

Acting on behalf of powerful financial concerns, the governments of the UK and the Netherlands have used the IMF and EU to pressure Icelanders to shoulder the burden the price of the decisions of the executives of Landsbanki and foreign investors (see story below from the Financial Times) . 

Jonasson, who resigned his post as Health Minister over his views on the Icesave agreement, has stated that "the British and Dutch are using the IMF and the EU as weapons to force the country to accept more debt than it is responsible for." 

UK: UNISON opposes new attack on the NHS

In a new move to weaken the UK's National Health System and shift resources towards privatized health care, the government of England is introducing so called "personal health budgets."

(For details, see "Warning issued on impact of patient control over budgets," by clicking "continue reading" below).

UNISON, a PSI affiliate which represents NHS health workers, vigorously opposes the move. Karen Jennings, UNISON's head of health warns that the policy "would take money out of the NHS and divert it to private firms."

The commercialization of health care would have devastating effects. As Ms Jennings warned last year in a joint statement by the European Federation of Public Service Unions (EPSU) and the European Hospital and Healthcare Employers Association (HOSPEEM): "We cannot let market forces run healthcare systems or we will end up with a two-tier system of healthcare delivery....the universal principles of healthcare solidarity are the starting point and not the internal market."

(see story dated 9 June, 2009 by clicking "continue reading" below)

$400 vs the cost of health care

NUPGE's national secretary-treasurer looks at the long-term impact on government revenues and public services of the Harper government's new Tax-Free Savings Accounts (TFSAs). 'How are you going to buy your own health care with $400?' he asks.

By Larry Brown

National Secretary-Treasurer
National Union of Public and General Employees (NUPGE)

Ottawa (30 Nov. 2009) - Everyone knows the Conservative government doesn’t like taxes.  Prime Minister Harper has even been quoted as saying, “I don't believe that any taxes are good taxes.”

Yet while almost every Canadian grumbles about taxes, most people know that if they don’t pay taxes they are going to have to give up things like public health care, toll-free roads, safe food and education – all of these and thousands more vital services come from our taxes.

Tax cuts are a way for conservative governments to ‘Govern from the grave.’ A government that wants to weaken the public sector can cut taxes and then saddle the next government with inadequate income to provide any improvement in public services.

Most people now understand that for all the tax cuts they have supposedly seen – the never-ending parade of tax cuts over the last couple of decades – they have not really benefited personally at all. Almost every personal tax cut favours the already wealthy. If personal tax cuts were so great we’d all be rich. They don’t work that way, though.

Brazilian government organizes conference to promote universal health systems

Health for all

In the face of the continued challenge of global policies aimed at the commercialization, privatization and fragmentation of health care and health promotion, and the new challenges posed by the economic crisis, the Ministry of Health of Brazil has launched an iniative to bring together all those around the world commited to universal access to health care and social security.

The first step will be the holding of the first world conference on the development of universal health and social security systems. The conference is scheduled for the 22nd to the 26th of March 2010 in Brazilia.

AFSCME's Plan: Health Care for America

AFSCME members have urged fundamental changes in America’s health care system. At recent International Union Conventions, AFSCME members have developed a health care reform blueprint and an Rx for the Health Care Crisis. In the broadest sense, there are five basic elements to our plan:

SEIU: Public Health Insurance Option is Needed For US Health Reform

PLEASE, SENATE FINANCE DEMOCRATS:STOP HIDING BEHIND REPUBLICANS

ANNA BURGER, Secreary-Treasurer SEIU

In just a few hours, the Senate Finance Committee has an opportunity to pick up where the House of Representatives and Senate HELP Committee began, and include in their bill a strong public health insurance option. Only one thing stands in their way: themselves.

Since the beginning of this debate, President Obama and Senator Baucus have done everything possible to keep Republicans at the table. It turns out -- not surprisingly -- the majority of Republicans don’t care about changing our healthcare system. They’re content to do the bidding of Big Insurance by spreading half-truths to score political points.

So it’s time for Democrats to make a decision: Are you going to vote to support a public plan, which has the vast support of Democrats, and I might add, of the majority of Americans?  Are you going to stand up for the change the people voted for in November? Or are you going to cower before the Republican minority?

Let’s look at exactly what a public health insurance option would do: 

AFT: Where we stand … healthcare reform

Randi Weingarten, President, American Federation of Teachers

The time to reform our healthcare system is now. Many Americans are uninsured or struggle to pay the soaring costs of healthcare. Reform is key to regaining economic strength, especially in these difficult times.

Rising healthcare costs strain family budgets, burden businesses of all sizes, squeeze state and federal budgets, and are delaying America’s economic recovery. Reform can enhance choice and competition in care, while also helping to create jobs, spur innovation, and make an important and timely investment in America.

The AFT strongly supports healthcare reform that will guarantee high-quality, affordable healthcare for all. Successful reform will:

Your money or your life: health care should not be for sale

 

User fees for health care are a life or death issue for millions of people in poor countries. Too poor to pay, women and children are paying with their lives.

For those who do pay, over 100 million are pushed into poverty each year. User fees for health care continue to exist in most poor countries despite rarely contributing more than 5% of running costs for health services. This month will witness a global opportunity for world leaders to really make a difference to poor people by backing the expansion of free health care in a number of countries.

On 23rd September 2009 world leaders will meet at the United Nations General Assembly in New York for a high-level event on health. On the table is a proposal to support at least seven developing countries to fully implement free care for women and children or to expand free health services to all.

The Privatization of Health Care

El Sector Privado en la Salud  (Para la version en espanol, pulse aqui.)

The following is a guest post by
Rodrigo Ml. López García
General Secretary of the National Association of Nursing Professionals

It is extremely unpleasant to see how public systems are collapsing under the dishonest rhetoric of those who have convinced whole societies that this public service is expensive, that because of its cost it cannot, and should not be publicly shared, and that even less should it be universally accessible. An objectionable idea has been introduced, and those of us with health education know that in no country do cost cuts bring good health, but in all populations where good quality healthcare is implemented, this good healthcare in itself brings economy.


The globalizing trends of an economy that moves capital around, and sets up business on every corner, have been the driving force behind the closures and the disappearance of the social concepts of healthcare. The world banking system has prescribed a lethal dose to make whole systems break down, and to bring on the throes of death in others, all of them public, of course.


Nobody can fail to appreciate that public services are supported by the social investment based on taxes paid by the people themselves, and that it is for the State to manage this in a logical way, striving for equity in the assignment of budgets, always endeavouring to provide an adequate service, on competitive terms, but above all responding to the needs of the population.
It is a painful sight to see all the ruses that are used to discredit public health services, tending only to point out weaknesses and risks, while failing to mention (concealing) the true strengths and opportunities offered by public services.


In my country, Costa Rica, I can assure you that in the 65 years that the public health system has been running, it has been through many different stages, during which its consolidation as a universal service offering equity and solidarity meant that the people of Costa Rica could, according to the figures, enjoy standards of health comparable only to those in developed countries.

However, attacks under neoliberal policies, by corrupt politicians who are ruining the Costa Rican state, importing the sinister policies imposed by the international banking system, have caused a deterioration in the healthcare processes of prevention, promotion and cure, producing a reduction in healthcare coverage and in treatment of pathologies which had been overcome many years ago, but are now re-emerging.


What is often made to look good are the less-than-transparent private healthcare systems, the very same ones that sell at inaccessible prices the healthcare they offer, of course to a niche market that can still afford it. However, these “showcases for privatisation” are so inefficient that, when one of their clients experiences complications and uses up the money destined for his/her care, the private services coordinate the patient’s transfer back to the public health service, so that the latter, using funds from the whole of the population, can resolve the inefficacy originating in those brilliant private hospitals.


At the same time, the healthcare budget is constantly reduced, from one period to the next. Out of convenience, this funding is never described as what it really is, SOCIAL INVESTMENT: rather it is termed “public expenditure”, producing the normal human reaction to the concept of spending (reduction of capital). The funding is never set in the context of the benefits provided, instilling very directly in people the idea that the public system is dysfunctional, and that it means low quality healthcare, at a high cost for everyone.


The modern trend is very evident in this country: low investment in the budget will mean that the public health service CANNOT cover the needs and demands of a growing population, the new trends towards specialized healthcare, and any programmes for a new strategy in the face of Costa Rica’s current epidemiological profile.


There are some ongoing agendas which can only bring about a terrible, crude, situation: among these are the Free Trade Agreements with countries like the USA, one which is about to be set up with the E.U., and soon another one with China. It is as if those in government understand very little about the true needs of our citizens – logical, as they all belong to the high echelons of the bourgeoisie, know nothing about poverty or need, and have never experienced it, and they have even less knowledge of the aspirations for a better world which are held by those at the bottom of the pile (essentially the vast majority of people).


The privatization that is so much talked about with regard to our public health service is a way of privatizing a fundamental human right, will break with ideas put into practice by our grandparents, and, far from whatever historical values we wish to defend, will radically change conditions of access for future generations.


WHY THE INSISTENCE ON PRIVATISATION? – WHAT IS THE HURRY? I think the answers are obvious, but if we want a full-length portrait of this policy, we need go no further than the countries of the Southern Cone which are in dire straits because of the clumsy privatisation programmes imposed less than twenty years ago by the international financial institutions.


It is my belief that when evaluating the inefficiency of health privatisation programmes already ongoing in Costa Rica, and the health privatisation agenda in countries crushed under this capitalist trend, we, the workers, must redouble our efforts in this struggle.


A struggle based only on the convictions of the workers of Social Security Healthcare in Costa Rica could be undone in days: it must include those who are the most affected, the service users. The defence of our quality, highly inclusive, public services, is a matter that should be shared with those whose lives are deeply involved with this fundamental component of Social Security in Costa Rica, the population.


In this way, we can develop the ability to say NO to this process, which is a product of those who, in their crazy race towards commercialisation, have prevented our societies from acquiring better health, and currently have the whole world in turmoil due to the economic crisis that they have produced.


Many thanks, friends.


Rodrigo Ml. López García.


General Secretary
National Association of Nursing Professionals of Costa Rica

(Asociación Nacional de Profesionales en Enfermería Costa Rica).

Challenging the Myths about Private Health Care

[ Un desafio a los mitos sobre el sector privado en la salud - Resumen en espanol abajo ]

The last resource available to a poor person who has nothing, is the use of his or her healthy body to toil and obtain the basic resources necessary for survival. Without health, they truly have nothing. That concept, which I often heard from Dr. Francis Omaswa, captures the indispensable nature of health. But beyond it being a necessary requirement for personal and national productivity, we all know how much good health is also a central component for enjoying a good quality of life.

This basic understanding of the centrality of health is the reason why, during the 20th century, societies channeled considerable resources to the creation of public health systems that could make primary health care and prevention policies universally accessible. The impressive gains in overall health and life expectancy experienced over the last 100 years, was due in great part to the expansion and improvement of publicly-run health systems.

Yet, for over two decades, we have experienced a relentless drive to promote the growth of the private health care sector and transform health care from a basic human right, into a service for sale. Privatization policies have been promoted by the World Bank and other International Financial Institutions, donors like USAID and the UK's DFID and political and economic forces in developed countries.

To create a favorable political climate, they have weakened public health systems by starving them of necessary funds, relentlessly engaged in a campaign to discredit them and to create myths about the superiority of private health services.

A new and very timely policy paper  "Blind Optimism" by Oxfam exposes those myths and provides evidence that "making public services work is the only proven route to achieving universal and equitable health care." Recognizing that "public provision is lacking or very weak in many countries" it states that "making it work requires determined political leadership, adequate investment, evidence based policies and popular support."

The report reviews the policies through which the World Bank worked to "improve the policy environment for public-private partnerships in health" and supported "private sector-led solutions." Also reviewed are the activites of powerful private sector companies and the "promotion of commercialization and privatization of health-care services in the General Agreement on Trade in Services (GATS) negotiations and in an array of bilateral trade agreements."

The report's review of the evidence to support the main arguments used to promote the private provision of health care, yields a powerful indictment of private sector involvement. Privatization has failed to produce improvements in efficiency, effectiveness, quality, accessibility for the poorest nor accountability through competition.

The OXFAM study comes in the heels of the report by the WHO's Commission for the Social Determinants of Health, which conducted a three year investigation. In addition to confirming the importance of economic and social factors, the report (download)  concluded that worldwide, publicly financed and delivered services continue to dominate in higher performing and more redistribute health care systems.

PSI and OXFAM share the same perspective regarding the primacy of health as a human right, the importance of preserving health services in the public domain and the central role of health workers. We highly recommend their study and its findings.

Download:  "Blind Optimism" Oxfam briefing paper 125

The Financial Crisis and Global Health

[ La Crisis Financiera y la Salud Global - Resumen en espanol abajo ]

As the Global Financial Crisis looms large and a structural economic crisis unfolds in its heels, concerns are naturally rising about their impact on health policies and our ability to deal with the already daunting health challenges facing the world.

With a slowing of economic activities, increased unemployment, decreased government revenue and increased pressures on public institutions, resources for public health systems may diminish, just when they are most needed.

As pointed out in a report just released by the World Health Organization (WHO), "a grave human crisis is already happening" in many countries, which "may get even worse as they are affected by the downturn, and through causes which are not of their own making."

The WHO report, entitled "The Financial Crisis and Global Health ", was issued after a High Level Consultation in Geneva in January 2009. Amongst the important issues it raises, are:

1. Better health is also dependent on social and economic determinants of health. These will suffer under the current crisis.

2. It is important to sustain support for prevention.

3. Strategies to mitigate the crisis can also be seen as opportunities to promote reforms based on a primary health care  approach.

Under "Mitigating the health impact of the financial crisis," it offers WHO support for efforts to:

1. Make health as visible as possible, as an entitlement to which people have a basic right

2. Take in account the needs of vulnerable populations.

3. Make the health response transformative, promoting a greater focus on social justice.

The report deals with other important issues, such as increasing the health impact of public spending, increasing the effectiveness of health sector spending and protecting aid for health.

The WHO response is encouraging. In the end, however, much will depend on what the union movement and our political allies do to promote enforceable policies in our countries and to confront the policies of international financial institutions and other global entities.

The crisis will be deep and long lasting. Thus, it is crucial that we develop long term responses to prevent the implementation of policies which would have a negative impact on health systems. As suggested by the authors of the report, we should turn the crisis into an opportunity to expose and reverse harmful policies, reset national and international priorities and make much needed advances towards making health care effective and universally accessible.

To download the WHO report, click here.

La Crisis Financiera y la salud a nivel global  

A medida que la crisis financiera global se profundiza y abre el paso a una crisis economica structural, surgen los inevitable preocupaciones sobre su impacto sobre las politicas de salud, y sobre nuestra capacidad de remontar los ya de por si difíciles desafíos que el mundo encara.

A medida que las actividades economicas se desaceleran , crece el desempleo, se reducen los ingresos gubernamentales y aumentan las presiones sobre las instituciones publicas, existe el peligro de que se reduzcan  los recursos para la salud. Esto, precisamente cuando serán mas necesarios.

De acuerdo a un reporte recien emitido por la Organizacion Mundial de la Salud, “existe ya una grave crisis humanitaria” en muchos paises, la cual “puede empeorar a medida que les afecte la desaceleracion economica, debido a causas que ellos no provocaron.”

El reporte de la OMS, entitulado “La Crisis Financiera y la Salud Global” fue diseminado despues de una consulta de alto nivel realizada en Ginebra en Enero del 2009.  Entre los puntos mas destacados, señala:

1. La salud depende tambien de determinantes economicos y sociales que se veran afectados negativamente por la crisis.

2. Es importante mantener los apoyos a las politicas de prevencion.

3. Las estrategias para mitigar la crisis pueden ser tambien oportunidades para promover reformas basadas en la provisión de servicios primarios de salud.

La respuesta de la OMS es alentadora. Sin embargo, mucho dependerá de lo que haga el movimiento sindical y nuestros aliados políticos para promover políticas obligatorias en nuestros paises, en vez de recomendaciones globales, asi como de nuestra efectividad al confrontar las políticas de las instituciones financieras internacionales como el FMI y el Banco Mundial. 

La crisis será  profunda y duradera. Es crucial que diseñemos respuestas de largo plazo para impedir que se tomen pasos que tengan un impacto negativo sobre los sistemas de salud. Como sugieren los autores del reporte, debemos convertir la crisis en una oportunidad para exponer y revertir las políticas dañinas del pasado, reorientar la prioridades nacionales e internacionales y avanzar hacia la meta de convertir la salud en un derecho, accesible a todos.

Para descargar el reporte de la OMS  pulse aqui.

Quality health services and protection of health workers in the Americas

PSI Interamericas health network meets to organize implementation of PSI’s strategic plan

From the 13^th to the 15^th of August, 2008, leaders of health workers unions from the American continent engaged in three days of discussion and planning.

Departing from their national perspectives and sharing elements of a regional and global vision, they developed a common perspective about the global challenges they face and the best strategies to confront them. 

The 81 unionists from 16 countries -from Canada and the United States to Argentina and Chile, including the Caribbean, Central and South America-, forged a consensus on how to develop programs to:

1. Protect health workers from occupationa hazards like hepatitis B, AIDS, needlestick injuries and workplace violence.
   
2. Join forces to advance in their efforts to achieve quality health services in their very diverse countries
3. Address the challenge posed by increasing flows of migration of health workers.
4. Advance towards achieving the principles of decent work and protecting trade union rights

During the meeting in Sao Paolo, Brazil, they were joined by representatives of the Spanish UGT and TEHY, the Finnish nurses organization, both of which are PSI affiliates.  The UGT has programs of collaboration on health workers migration with several Latin American unions. TEHY provided critical support for the meeting.

 Participants recognized the importance of forming alliances with organizations of patients and their families, with other unions and with political non-governmental organizations. In addition to presentations by participants, they heard guest presentations from the Alianza Social Continental and the Central Sindical Americana. 

A plan of action was  developed. Groups of affiliates interested in participating in the various programs were identified and coordinators were elected.

In order to implement the plan, it was decided to strengthen sub-regional networks and to improve their means of communications, including bulletins, websites and other electronic media. 

It was a very intense and fruitful three days of work. The diversity of national realities and language differences were overcome by an identity of purpose and the commonalities in workplace experience. 

The main resolutions, as well as power point presentations and some of the documents discussed can be found here:

Summary and resolutions

http://healthblog.world-psi.org/psi-interamericas-health-.html

Power point presentations

http://healthblog.world-psi.org/presentations-at-the-psi-.html

Health is determined by social and economic conditions

"(The) toxic combination of bad policies, economics, and politics is, in large measure responsible for the fact that a majority of people in the world do not enjoy the good health that is biologically possible,"

This is the central message of  a very significant report recently released by the WHO's "Commission on social determinants of health."

The report is entitled "Closing the gap in a generation: Health equity through action on the social determinants of health," and it is available in six languages at:

 

http://www.who.int/social_determinants/final_report/en/index.html

The result of three years of research, the report offers a comprehensive view on the key determinants of health that supports and validates principles that the labor movement has been promoting all throughout our history, such as:

"Employment and working conditions have powerful effects on health equity. When these are good, they can provide financial security, social status, personal development, social relations and self-esteem, and protection from physical and psychosocial illness."

"...inequities in health arise because of the circumstances in which people grow, live, work, and age, and the systems put in place to deal with illness. The conditions in which people live and die are, in turn, shaped by political, social, and economic forces....

The commission offers three principles of action to improve the health of the world's population:

1) Improve the conditions of daily life – the circumstances in which people are born, grow, live, work, and age.

 

2) Tackle the inequitable distribution of power, money, and resources – the structural drivers of those conditions of daily life – globally, nationally, and locally.

 

3) Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in the social determinants of health, and raise public awareness

about the social determinants of health.

 

I invite you to examine the report and use its contents to advance our views. WHO will now make the report available to Member States which will determine how the health agency is to respond. But, as always, it will take action by trade unions, political and grassroots organizations to ensure that the concepts of the report are publicized widely and that policy makers take steps to implement its recommendations.  

Korean health workers victory

One of the greatest pleasures of working for PSI as health officer, is to meet and work with the committed union activists and leaders of our affiliates. Earlier this year, I met the leaders of an incredibly dynamic  union when I attended the 10th anniversary celebration of the KHMU, in Seoul, South Korea.

The Korean Health and Medical Workers union was formed under extremely difficult condition, when the country was still under a repressive military regime. As conditions improved, ten years ago, they became an industrial union and have been fighting persistently to improve the conditions of their members, the quality of care patients receive and the political conditions of their country.

After the recent elections, when a new conservative president got elected, and his party won a decisive majority in Parliament, prospects looked grim. But the KHMU did not relent.

In April, they began negotiations for a new national collective bargaining agreement, and in spite of facing an seemingly unfavorable climate, began to mobilize their members. Then, in June, massive demonstrations broke out against the policies of the new government, with much of the focus being the Free Trade Agreement with the United States. Public demonstrations reached up to 1 million participants.

In July, the KHMU organized their members for a strike starting on 23 July in protest of the commercialisation of medical facilities and the use of American beef in patients' meals, while calling for a 10.2 percent pay raise and the hiring of more personnel. They also demanded the government to scrap plans to privatise the medical insurance system, to improve staffing and provide better wages and working conditions.

The government and employers responded with threats, but were forced into the negotiation table. The KHMU proceeded to rally their members and hold public demonstrations.

Finally in 28 August, after 4 months, the Hospital Employers’ Association signed a National Collective Agreement. The contents of the agreement are amazing under any country's conditions, with gains that go beyond improved wages and safer workplaces, but which include unprecedented recognition of the rights of women health  workers (like paid menstruation holidays) and for the patients they treat.

Here is the KHMU’s description of the results:

The main contents of the agreement as follows:

·         4~5 percent of wage increase.

• Industrial Minimum Wage should be increased to 950,000 won (around 930 USD) per a month.
• Wage increase rate for irregular workers should be higher than that of regular workers.
• Meat with doubt of mad cow disease should be banned in hospitals.
• Fresh agro-livestock products should be provided in hospitals.
• Supplement of the staffing for hospital should be made.
• Joint cooperation to improve the medical evaluation system which government is in charge of.
• The Charter of Patient Rights and the National Health Insurance System should be more actively publicized by hospitals.
• Menstruation holiday should be paid.
• Mechanism and tools to eliminate workplace violence should be introduced and strengthened.

·         The National Labor-Management Council should be immediately held.

Encuentro interamericano de sindicatos del sector salud

“Has hecho volar banderas en mi corazón,” dijo la compañera Carolina de Chile en respuesta a la presentación del compañero Colombiano Manoel Rozental durante el segundo día del encuentro interamericano de sindicatos del sector salud de la ISP.

 

Indudablemente que el primer efecto del intercambio de experiencias, información, ideas y propuestas por parte de dirigentes sindicales de todo el continente es emocional e inspirador.

 

El escapar la ardua realidad cotidiana para reunirse con 81 compañeros y compañeras de 16 países de todo el continente, desde Canadá y Estados Unidos a Argentina y Chile, pasando por el Caribe, Centro América y todo Sudamérica, y el descubrir los lugares comunes, la identidad de convicciones y objetivos, es refrescante y tiene un efecto inspirador y alimenta las sinergias.

 

Mas el resultado mas importante ha sido la identificación de los retos comunes y de tareas conjuntas. Las deliberaciones realizadas durante tres días, del 13 al 15 de Agosto, en Sao Paolo, Brazil, han dado como fruto la creación de consensos entre los participantes.

 

Partiendo de perspectivas nacionales y de elementos de una visión continental y global se fue creando una perspectiva común acerca de la realidad global que enfrentamos.

 

Se debatieron propuestas de ejes fundamentales para la acción conjunta, incluyendo programas de actividades para proteger al personal de salud de los riesgos a su salud y seguridad en los centros de trabajo, para luchar por los servicios de salud de calidad y para hacer realidad los principios del trabajo decente. Se discutió también como extender y profundizar el trabajo para resolver problemas comunes, como el impacto de la migración del personal de salud y la defensa de los derechos sindicales.

 

Los participantes reconocieron la importancia de formar alianzas con los usuarios de los servicios de salud, con otros sindicatos y con federaciones como la CSA, con organizaciones sociales como la Alianza Social Continental y, con organizaciones no gubernamentales y políticas.

 

Se decidió fortalecer las redes sub-regionales y los medios de comunicación como los boletines regionales y sub-regionales, las paginas de red y otros medios electrónicos y se eligieron coordinadores para dichas tareas.

El encuentro recibió el apoyo de TEHY, la organización de enfermeras de Finlandia y dos de sus dirigentes participaron en las deliberaciones, asi como dos representantes de la UGT de Espana, con quienes existen programas conjuntos sobre el tema de migración del personal de salud.

 

Fué un programa de trabajo apretado pero fructífero. La diversidad de realidades nacionales y de idioma fue sobrepuesta por la identidad de aspiraciones. Ondeo una sola bandera en el corazón de los participantes: la bandera de la defensa de los intereses del personal de salud y de los intereses de la población del continente, de cuya salud y bienestar cada uno de ellos decidieron responsabilizarse cuando se incorporaron a las instituciones publicas de salud.

Implementing PSI's Strategic Plan for the health sector

Preparations under way for health network meetings

During three intense days of discussions, members of PSI’s Health Services Task Force, who represent health workers unions in 24 sub-regions, generated a large number of proposals for our strategic plan for the health sector and a list of tasks necessary for its implementation.

As promised, we have compiled those proposals and the tasks identified, globally and by region, in a single document, which can be accessed through this link:

Download psi_strategy_for_health_sector.doc

Since the meeting, we have been busy organizing the implementation of our 5 year plan:

1) Two weeks after the Health Services Task Force meeting, the strategic plan was presented to PSI staff from headquarters and all regional and sub-regional offices. This took place on 27 May, during the staff Annual Coordination meeting. A rich discussion ensued about how to best implement the plan.

2) We have met with some of our colleagues at the WHO, ILO and other organizations, to plan the implementation of some of the joint programs which will contribute to our strategic plan, like the hepatitis B immunization and the safe injection campaigns.

3) We have been gathering materials and making preparations for our regional network meetings.

Network meetings will take place as follows:

13-15 August       Interamericas health network meeting –

                        Sao Paolo

14-15 September  W. Africa health network meeting –

                        Accra, Ghana

1-3 October        Oceania network meeting -

                        tba

3 – 5 November   Southern cone health network meeting -

                        Paraguay

2- 5 December    African regional network meeting -

                        Tunisia

A Strategic Plan for the Health Sector

Health Services Task Force meets in Geneva on 12-14 May, 2008

When one works with 231 unions representing health workers in all corners of the world, it is easy to lose sight of our commonalities.

The health workers unions affiliated to PSI operate in countries that are separated by more than vast distances. Our members speak different languages and work and live under different economic, social and political conditions.

In spite of those differences, there is much that unites us. Spending three days engaged in a thoughtful exchange of  perspectives, experiences and proposals with the members of the PSI health services task force, was a powerful reminder of how much we have in common. The members of the task force represent health workers unions in all of the 24 sub-regions of PSI and it is chaired by Karen Jennings, UNISON's Head of Health.

Listening to the discussions, I found it striking to hear how similar are the challenges we are all facing. The variations are more quantitative in nature, rather than qualitative. Specific conditions may be different, but we are all trying to achieve similar goals and we face similar obstacles.

Our members spend their days at workplaces which are organized similarly to achieve the common purpose of saving lives, healing the sick, alleviating suffering and helping our fellow human beings achieve the best possible standard of health.

Our unions share a common goal of protecting health workers and promoting the terms of employment and working conditions that best allow them to fulfill their mission.

We are also engaged in promoting well equipped and better designed health systems, so that health workers have the tools necessary to adequately care for their patients.

One way or another, this commonality of purpose was evident in the discussions we engaged in for three days in Geneva. It may be one reason why the participants remained engaged and active in the deliberations in spite of a packed three day agenda, and after having travelled over long distances and across time zones.

I was impressed with the incredibly high intellectual and human caliber of the union leaders assembled at the meeting.

Beyond the specific proposals advanced and discussed in order to identify the elements for a strategic plan, I left the meeting inspired by the evident commitment and insight of the members of the task force.

Having travelled to some of the sub-regions, I know that we have many such competent leaders all around the world. The task force members and PSI's sub-regional staff, will facilitate their assembling over the next few months at sub-regional and regional meetings, to put some flesh on the outline of a strategic plan that was developed at the task force meeting (click link to see: "The Tasks ahead for the HSTF" )

WHAT IS AT STAKE

The challenge we face is the concerted promotion of policies aimed at commercializing health care.  Their aim is to shift health care provision from public health systems into the hands of fragmented for-profit privately-owned facilities. They would eliminate the concept of health as a human right and turn it into a service for sale.

While we face great challenges, this is also a time of opportunity. Our global federation of public employee unions (20 million strong, 7 million in the health sector), is in a strong position to defend health systems from efforts to weaken or dismantle them.

PSI is determined to confront those efforts and successfully defend the gains we made during the last century. Whether under the slogan of our colleagues in Korea "lives before money" or that of some of our colleagues in the United States "people before profits,"  our unions are engaged in a struggle that will determine what kind of society we, our children and future generations will live in.

More than ever, after spending three days with the kind of leaders assembled at the HSTF, I remain convinced we will succeed in our efforts.

**************************************************************

The meeting presentations can be found here:

HSTF 2008 presentations

The meeting documents are available in this page:

HSTF meeting documents

For what is next, see also:

"The Tasks ahead for the HSTF" )

The tasks ahead for PSI's HSTF

Deliberations and conclusions of the Health Services Task Force at its meeting of 12-14 May, 2008

The HSTF meeting began with a discussion of the challenges we face in our countries and around the world. Over the three following days, strategies and specific programs of activities were considered and the meeting concluded with the outline and central elements of a strategic plan.

Those proposals will be discussed, adapted and concretized at regional and sub-regional meetings that will be held over the next few months. Through this process, we will strengthen our existing sub-regional networks and help create them where they are yet to exist.

Our sub-regional networks will develop concrete strategies intended to support national efforts to achieve quality health services, protect health workers from workplace hazards and secure decent terms of employment and working conditions.

The PSI secretariat will support and coordinate these efforts, provide campaign tools, training and materials, and set up the necessary communication vehicles.

Over time, we will gradually create web-based tool kits, and a resource site which will be a repository of best practices for the provision of effective quality health services as well as of the most effective strategies used by our affiliates to achieve them.

At the close of the meeting, a summary was made of our conclusions and the tasks that lie ahead

Download 6_conclusions_tasks.ppt

In the coming days, we will lay out a plan for the completion of those tasks on a realistic timeline, extending over the period between PSI congresses.

All in all, this year meeting of the task force signified a small but significant step in the direction of becoming a dynamic and effective global federation of health worker unions.

 

 

 

The meeting presentations can be found here:

HSTF 2008 presentations

The meeting documents are available in this page:

HSTF meeting documents

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A proposal for a Quality Health Services Campaign

The Quality Health Services Campaign:

A work-place strategy to protect health workers, strengthen our unions and achieve quality health services. 
In the last 20 years, progress towards establishing health as a basic human right attainable by all has been seriously undermined by the advance of neo-liberal policies.
The introduction of market mechanisms into public health and the increase in private sector involvement has led to decreased access to health services for vast sectors of the population, increases in medical costs and a generalized deterioration of services for many. Access to quality health care is becoming increasingly dependent on socio-economic status and geographical location.
For health workers, the commercialization of health services has meant lower wages, job insecurity, greater workloads and worsening working conditions. Through the prism of market mentality, they are seen as a burden, a recurrent cost, rather than the essential element in the provision of health care. This has led to difficulties in recruitment, training and retention of health workers leading to global shortage. The WHO estimates the current shortage of health workers at 4.3 million.

Continue reading "The Quality Health Services Campaign''

PSI Health Policy

"Global trends in the Health Services and PSI policy”

by Dr. Jorge R. Mancillas

Health is a fundamental human right. This is the guiding principles behind the daily activities of the seven million nurses, doctors, laboratory technicians, radiologists, ambulance drivers, cleaners and other ancillary health workers who are members of the 231 health care workers unions in 154 countries which are affiliated to Public Services International, the global federation of public employees unions and associations.

continue reading "Global trends in the Health Services and PSI policy”