The minister and Sofia's choice


By Ronald Rocha*

Public health is handed over to a supporter of compulsory euthanasia or a strange age eugenics, recalling cultures that relegated old and incapable people to death.

Under “normal conditions of temperature and pressure” – an environment with a “standard atmosphere” – ministerial replacements are commonplace acts, although they have nothing natural or chemical-physical. They even go beyond what is constitutionally foreseen as the legal prerogative of the “chief” in governments within the democratic regime, including restrictive ones with strong autocratic components, as in Brazil. Often, they impose themselves as adjustments in administrative details and in the arrangements required by governance in the relationship between situationist or allied segments, especially in the dance of pragmatic needs and the correlation of forces.

As a rule, every politician – as it should be seen any professional or technician who occupies the first echelon in the Esplanada Brasiliense – knows very well that he can be fired ad nutum, that is, by unilateral, exclusive, unjustified and unappealable will of the contracting party. In Administrative Law, such prerogative extends to any competent authority. However, the spontaneity meticulously exhibited through words and gestures at the official ceremony in Planalto, last Friday, suggests that there is, among the smiles, compliments, hugs and affectionate greetings, “much more [..] our poor philosophy," as Hamlet rambled.

In fact, the simple comparison between Mandetta's declarations, in his farewell, and Nelson Teich's, when he made his debut in public affairs, exposes a disagreement in bourgeois thought, which generated not heartbeats, but between heads in the extreme right in general and also in the Bolsonaro government. Said the exonerated: “Nothing has greater significance than the defense of life, SUS and science; stand on these pillars.” He replied the nominee's voice, very brief, timid, almost babbling: "We discuss health and economy is very bad, because they do not compete with each other, they are complementary." The two, in another situation, perhaps could have signed the same phrases that they verbalized studiedly: in addition to never having given evidence of a specific attachment to conceptual meanings, since they are pragmatic politicians, they have always adopted ultraliberal dogmas.

However, at that moment and in the course of contamination, the first – despite his previous desires, commitments and ideations linked to private interests in the field of medicine, which allocated him to the National Congress and the Federal Government – ​​was literally forced to intertwine his arms with public health and to invest in health planning supported by state agencies. Thus, he had to temporarily store in some trunk his conceptions beyond the famous “Hippocratic oath”, as read at graduation ceremonies in academic institutions and reiterated in professional councils.

The novice and insecure minister – who now, with his ribcage inflated by the coveted investiture, declared himself faithful to the presidential thought and thrown into the most important function of his life – will not experience great aporias and dilemmas. Giving a lecture at the Institute of Oncology, as administrator of policies aimed at the “public health system”, he based himself on the controversial principle of “efficiency” to clarify that he would not hesitate to condemn an ​​elderly person “at the end of life” to treat “an adolescent You have your whole life ahead of you.” Therefore, public health is handed over to a supporter of compulsory euthanasia or a strange age eugenics, recalling some cultures that relegated the elderly and incapable to death, but without the rites that honored ancestral sacrifices as socially “necessary”.

The case in focus does not refer to a “Sophie's Choice”, pressed by unavoidable external forces, which cannot even appeal to the Kantian “categorical imperative” to guide itself. It is a rational political line of the manager who aims to direct actions “to invest”, as he meridianly clarified. If it were to counter-reform the social security system, the argument would be the opposite, repeating the words of Paulo Guedes to exhaustion: the elderly can work forever, being vagrancy a rest at the end of their working capacity. It so happens that the plot is no longer the doctor's, but the president-owner of the Grupo Clínicas Oncológicas Integradas (COI) and the business consultant-lobbyist linked to his Teich Health Care, since the Bolsonaro campaign with a special interest in health policies, certainly not to defend or strengthen the SUS.

To whom it may concern, the Linked in from the COI Institute prefers to say “About Us” in English: “Patient care in the specialties of Medical Oncology and Genetic Counseling for Familial Cancer”. Furthermore, the official website illustrates a monopoly-financial conglomerate with 67 oncology, hematology, radiotherapy, medullary transplantation and complementary care clinics, located in 11 member states of the Federation and linked internationally. It also reveals the typical marketing jargon in vogue, especially written to hide, through vague formulas, the real character and industrial purposes of capital: “Missão” worthy of “Innovating, educating and producing information for Brazilian society”; “Vision” of “Being a scientific leader”; “Values” based on “Entrepreneurship, Excellence, Empathy, Sustainability”.

The greater significance of the ministerial change goes beyond a simple change of ministers, with their declarations, trajectories and social ties. Although such issues are relevant, the most important is located at the level of doctrinal, ideological and political conceptions, reflecting, as Engels recalled in his Letter to Joseph Bloch, dated 22/9/1890, “the reproduction of real life”. It has become commonplace to say, with different combinations of more or less similar words and with different intentions, that there is no conflict between health and the economy. If such a statement inhabited the level of Platonic entelechies, in the condition of abstract universality, it would be foolishness of a lesser degree. However, the subject refers to universal-concrete, that is, health policy in a pandemic situation and the reproduction of capital in a phase of social distancing. If the equation were in line with reality, why would the situationists, starting with Bolsonaro, Mandetta and Teich himself, be talking and repeating the same truism all the time?

It is known that the most unsuspected institutions of sowing rumors against the imperialist powers and the world order recognize that the Planet is in recession and that the fall in 2020 will be equivalent to the so-called Crash 1929 or later. They even say that the GDP in Brazil will be around 5 to 6% negative. Even more serious: the crash occurs in the middle of Phase B or Depression of the Fourth Long Wave in capitalism, following the qualification pioneered by Kondratieff in 1926. That is why now, under the overwhelming pressure of the Coronavirus, everyone has remembered public health in capitalist countries, that is to say, of the health policy carried out by the bourgeois State, the collective power of capital that not only represses the “positive possibility of emancipation”, but also needs to guarantee the minimum conditions for the workforce to maintain and reproduce itself .

It turns out that such a long-term strategic objective is fundamental not only to save labor without which capital would not exist as a social relationship, but also indispensable to the maintenance of hegemony, “legitimizing” the existence of public institutions, laws and coercion. , as noted by Gramsci. However, a good part of the individual capitalists and some of their fractions, dissatisfied with the media policies and in the compulsive pursuit of hasty profit, especially those who do not have working capital and other resources to make the crossing, press for a return to work at any price. , as they lack public support. This is how demagogic discourses such as: life goes on; business continues; everyone needs to work; the State cannot support parasites; and so on.

In fact, the pandemic, demanding social distancing practices in the world and in Brazil, interfered with the economic process of production and mercantile circulation, which for six years had already lame in its slow, zigzag recovery, with comings and goings. The evils that affect the multitudes, notably the modern world of work and the popular classes, are clear and aggravated by the insufficiency of government measures, which move away from ma non trope of the neoclassical bull. However, the blow most felt by the ruling class, the main target of government concerns, is located exactly at the poles where Marx's critique located – including for knowledge available to the bourgeoisie itself, in yet another Hegelian irony of history – the basic antagonism of production and reproduction of capital: social work, affected by the necessary distance between people and by growing unemployment, versus the form of private appropriation, hampered by the fragile realization of surplus value in trade.

Therefore, Covid-19 interferes, directly and obviously, in the current accumulation process, affecting the bourgeoisie and the proletariat as people and as classes, since they weakly impregnate goods with their will to buy and sell, be it labor force to produce value, or goods in general to survive and materialize profits. Such a process has a determination dense enough to be reflected in the environment of businessmen and political society in the condition of schism between a certain conservative humanism, which looking to the future defends the fight against viral genocide, and social Darwinism, which is only concerned with immediate profits and bets on what it believes to be a “hen of 10”. After all, the market “spins…, spins…,” as the late Henrique Discepolo's tango refers to the worldly indifference. Furthermore, the deaths by the millions would still keep the surviving unemployed in the queues, available to the aggressive"Véio da Havan” and “Tristonho do Madero”. This is what the absolute alignment between the new minister and the self-coup president represents, especially in a context of a triple crisis, recessive, pandemic and institutional.

*Ronald Rocha is a sociologist. Director of the Sérgio Miranda Institute (Isem).

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