In order to live in dignity, you need first to live. Nothing takes priority over the right to live. That is why I do not understand how a society could leave someone to die, or to barely survive, because he or she does not have enough money to "buy" that right.
I can imagine not having the money to spend a one-week beach vacation every year, or not having a surplus of money to buy new clothes. And I might imagine not having the money to get an education. But I will never understand how anyone could be deprived of the right to live.
The social system Egyptians live under is a shame to humanity. In the second decade of the third millennium, the poor in this country, and in fact much of its middle class, cannot get acceptable health care.
In 2009, a foreign friend of mine who was living with me had a severe heart attack. After we called a government ambulance, which took a while to come, we kept searching for a hospital that had a free bed in its intensive care unit.
We could not find a single free bed for him, and he died, even though I live in an upper-middle class Cairo neighborhood and was ready to pay any amount of money to save his life.
I do not wish to turn this article into a eulogy, but I feel obliged to point out my personal experience with medical service in Egypt. Since I had a heart attack in 2006 I have had to buy medications that cost LE300 a month in addition to periodical visits to the doctor and X-rays. How many Egyptians can afford that? And how many Egyptians in the present suffer from chronic diseases such as diabetes, hypertension and liver and heart problems? This is a catastrophe.
Our health system is a crime against Egyptians. The state is the criminal, and the capitalists and the orchestrators of the free market are its accomplices. This poor nation and the majority of doctors are the victims.
Over the past 40 years, officials responsible for formulating health policies worked hard to transform medicine from a humanitarian service into a purchasable commodity.
The health system is allocated 4.8 percent of the state budget, which is less than a third of the universal percentage of 15 percent. A quarter of that budget goes to the Ministry of Health to cover salaries, bonuses and allowances for top employees. And another good percentage of that budget is stolen and squandered in different ways, undermining the humanitarian nature of the medical process in favor of market competition.
Since such a tight budget, a good percentage of which is wasted, cannot finance even the most basic medical needs, a considerable sector of patients were forced to switch to the private sector, including clinics, hospitals and polyclinics. Another sector, which may be financially better off, has resorted to the health insurance system provided by professional syndicates or private companies.
On the other hand, doctors who work in the government sector find themselves forced to accept additional jobs in the private sector, which they end up giving most of their time and attention to.
As such, we have patients who cannot find free service and prefer the purchasable commodity, and doctors who do not receive fair pay and turn to the market to make a livelihood – and this is how the forces of supply and demand meet. Those who control this market are the fat capitalists who own the hospitals, polyclinics and big clinics. The young doctors work for them in return for low pay while the patients pay hefty fees.
The top Health Ministry officials who get a good share of the health budget benefit from this oppressive system, which inflates their wallets.
Parties to the alliance between the medical capitalists and senior state officials undoubtedly want the existing system to remain. If the state changes its priorities and withdraws support to the capitalists, slashes salaries paid out to its advisers and top bureaucrats, and raises the health budget to extend proper services to the patient and pay doctors well, it will jeopardize the standing market mechanisms and squeeze the profits of those heartless entrepreneurs.
Since the medical service at public hospitals is in dire conditions, the ongoing partial strike launched by the doctors at these hospitals will not pose a danger to the lives of patients, but rather a danger to the current flawed system.
I am very proud that my country has doctors who are humane. The demands issued by doctors and others working in medical professions will break that vicious circle which renders the right to life a commodity.
The doctors are calling for increasing the health budget to 15 percent of the state budget, increasing the salaries of employees in the field, scrapping the current corrupt administrative system and securing hospitals against the dangers of criminal attacks. Responding to these demands would eliminate the reasons that forced the doctors to abandon the realm of humanitarian service in favor of better-paying market competition.
Some will say that it is selfish of doctors who carry out such an exalted humanitarian job to demand higher salaries and to refrain from helping patients to have a personal demand as such fulfilled. Several of those who reject this logic say that doctors, like everyone, have a right to demand better compensation.
Though correct, I do not like this response. I believe that the demand for better pay is humanitarian and not personal, and that satisfying it would have more benefits for society than for the doctors.
If doctors were better paid by the government to provide free medical care, they would have not resorted to the capitalist market to make a living. In turn, society would be able to hold them accountable for their service. If doctors were properly compensated by the state, they would not be another gear in that evil machine which treats the patient as a client who should be tricked to pay more money to aggrandize profits.
Is that a selfish demand? Not at all. Saving the medical profession from the dangers of having its service sold on the market is essential to restore its humanity.
Imagine the cruelty of a health system that distinguishes between poor and rich patients, with the poor ones being left to die; one whose primary goal is the generation of revenues.
Alternatively, imagine a health system where the revenues of the service providers and the social conditions of the users of the service are not determining factors in the medical equation, a medical system that provides healthcare to all patients regardless of their economic class.
The second system, which regards healthcare as a service rather than a commodity, frees patients from the evils of market mechanisms and neoliberalism.
That is why I support the doctors’ strike, and particularly their just demand for higher salaries and better working conditions.
Translated from Al Masry Al Youm by Dina Zafer.
