Is this a health plan?

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By THIAGO BLOSS DE ARAÚJO*

Prevent Senior sees the interests of capital above life

The comparison between the inhuman medical experiments of Nazi-Fascism and those carried out by Prevent Senior with patients infected with Covid-19 is not entirely exaggerated. Undoubtedly, there is a rationality of the past that is still symptomatically reproduced in the present. However, there is another element of this barbarism that deserves attention, mainly because it is part of the essence of health plans.

Last Sunday, the program Fantastic interviewed some of the doctors involved in the Prevent Senior scandal who were coerced into administering the ineffective “covid kit” to patients hospitalized for the disease, with the explicit aim of proving the supposed effectiveness of the medication. It was a biological and social experiment, which responded directly to the political and economic interests of the Brazilian bourgeoisie.

Under such an inhuman circumstance – permeated by countless forms of harassment and threats – the doctors reported something that goes beyond any limit of sadism: the company imposed as a goal the vacating of ICU beds within two weeks, even if it was through inducing the death of patients. That is, according to the reports, physicians were advised to reduce the oxygenation level of hospitalized patients, even if such a procedure would lead to death. According to the doctors' lawyer, the thought that guided such actions was: “death is also high”.

In this sense, there is no doubt about the similarity between the company's rationale and that of the Nazi concentration camps. In his famous book Is this a man?, Primo Levi gave a dense account of the period in which he was a prisoner of the Auschwitz concentration camp. Even if in the preface the Italian author expresses the intention of “providing documents for a serene study of certain aspects of the human soul” ¹, certainly one of his greatest feats was to reveal how much the operating principle of that extermination camp operated, right down to the last moments. consequences, the instrumental rationality of the great capitalist corporations of his time. This is confirmed in countless passages, among which, I quote: “the essential thing for the administration of the Camp is not that precisely the most useless people are eliminated, but that vacancies appear soon in a predetermined percentage”². More current, impossible.

However, during the interview on the Rede Globo program, another absurd circumstance was revealed that was little studied, namely, the hard work routine that those doctors from the health plan were submitted to. According to his report, the company set the goal of treating 60 patients in 5 hours on duty, which on average required them to have a consultation within 12 minutes. Despite the obvious absurdity, what the report never questioned is the fact that such an exhausting and precarious routine is part of the daily lives of health workers who work with health plans and health insurance companies. If the induction of patients to death reveals a circumstantial similarity with the rationality of the Nazi concentration camps, the precarious work of professionals in this sector reveals that this rationality is the essence of health plans. The principle of everything is the general equivalent, the universal fungibility of workers and their patients. Hence the insistence of Frankfurtian philosophers that Auschwitz was the limitless realization of capital.

Currently, one of the first entry points for newly graduated health professionals is assistance through operators and health plans. Usually, these spaces serve professionals to guarantee some kind of income while building their professional career. However, there is a price to be paid: long routines of poorly paid and precarious work. For example, Psychology professionals who work in health plan clinics, in general, must carry out psychological care in just 30 minutes. During this time, it is still the professional's duty to fill in the patient's evolution form and, depending on the case, the care form to be sent to the health plan. All this half-hour work can cost between 4 and 7 reais for the psychologist. That is, in just one hour, the Psychology professional must attend to two patients, make two evolutions, fill out two insurance forms and, for such work, he will receive from 8 to 14 reais.

Not to mention the fact that such plans receive any type of demand: people with depression, psychoses, sexual violence, eating disorders, children with learning difficulties, suicidal behavior, etc. Without minimally dignified working conditions and without specialized health planning, such clinics take on the appearance of open-air asylums. This is the current condition of physical and mental health care under oligopoly capitalism. This is the result of reducing health to one more commodity to be speculated on the market.

It is always important to remember that the privatization of universal and free services offered by the Unified Health System (SUS) has always been a goal of Temer, Bolsonaro and his ministers, including former health minister Luiz Henrique Mandetta, who is a defender of the end of the gratuity of the SUS and the granting of Basic Health Units (UBS) to the private sector. Despite all the issues that the SUS is currently experiencing, arising mainly from its public underfunding, its principles of universality, integrality and equity are contradictory to the privatist logic and defend a type of community health, agreed and not market-based. Nothing more necessary in a country where the hungry population disputes the remains of animal bones.

In this sense, the current Prevent Senior scandal reveals both the absurdity to which the promiscuous association of health entrepreneurs with the denialist interests of the federal government can reach, and the future of public health policy in the country if the privatist plan advances. It will be a hecatomb for the workers and for the population.

In summary, if there is one thing that the inhumane management of human beings denounced by the Covid CPI has revealed to us, it is that such logic is not an exception, but the rule for health plans. The rationality of the death camps used in the management of ICU beds made explicit something deeper and more natural: the use of the same rationality on private health workers. The logic of efficiency at minimum cost – which the federal government wants to implement in the SUS – was the principle of Auschwitz. This is the same logic narrated by Primo Levi, when he witnessed the death of his colleagues from hunger or exhaustion as a result of overwork.

From this perspective, what we call a health plan ultimately becomes a death plan, death management. Hence, Levi is again accurate and current when he states that “when the unspoken dogma becomes the major premise of a syllogism, then, as the last link in the chain, there is the Extermination Camp” ³. Maybe it's past time to call things by their true name...

* Thiago Bloss de Araújo is a doctoral student at the School of Philosophy, Letters and Human Sciences at UNIFESP.

Notes


[1] Cousin Levi. Is this a man?. Translated by Luigi Del Rei. Rio de Janeiro: Rocco, 1988, p. 7.

[2] ibidem, p.190.

[3] ibidem, p.7.

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