Why don't neoliberals love public health?

[Updated in the text July 27].

“... I think this is an important question at issue!”

the former director-general for the Swedish National Institute of Public Health Gunnar Ågren writes in the last blogposting from his time at the National Institute of Public Health.

He thinks the first cut-off point is about whether you shall look upon health as a human right or as a commodity. If you see health as a human right this also implies an obligation to see so all get this right through common measures.

Unfortunately it becomes more and more common with a market-thinking around health where we buy more or less qualified achievements to improve our health in the same way as we, depending on income, can choose to buy shoes or shirts of different qualities and prize-levels.

The second cut-off point is about the view on the market and its ability to solve basic distribution problems and thus health problems too.

This is not a new discussion. Already in the childhood of industrialism dogmatic market advocates were inconsistent with prohibitions against child workers, industrial welfare (safety) and sanitary reforms because this would disturb the supply of labor.

Luckily there were sensible politicians, often influenced by a pressure from below, realizing that protecting laws and a better hygiene in fact was something that promoted both social and economic development.

Unfortunately the blind faith in market forces has come back in today's more globalized world, even though it has gotten a certain blow the last weeks (the financial crisis).

The National Institute of Public Health (in Sweden) is seen as a trade barrier or disturbing element in the market Ågren says.

Reform politics [today] is sometimes synonymous with lifting welfare and protection legislation away.

There is a blind faith in that (parts of) the market wealth shall trickle down on the poor and sick too.

As has become clear for instance by data presented in the Marmot Commission report there is no indication that this theory is right.

On the contrary the evidences for the opposite connection is valid.

Basic welfare, a good education system, basal health care and a good public health means that more people can work, leads to that the productivity increases and the international competitiveness increases.

The third and last cut-off point is about the individual contra the society and the state. A row of health risks lies beyond the individual's control and possibility to take responsibility for. Air pollution, poverty and income inequality are only a few examples on health risks lying beyond the individual's control.

The Institute of Public Health has been seen as something implying guardianship from authorities and something that deprives people from their possibilities taking responsibility for their own life and health.

My comment: But – this institute has never forced any individual to anything?? Maybe forced public authorities? Just come with advices to individuals to which they can take whatever attitude they want?

Ågren continues: Of course the ones representing the public health interest have nothing against that people are taking responsibility, on the contrary, this is praiseworthy (fantastic and something great) but there are limitations in possibilities for taking responsibility for the health.

My comment: Yes, there are things lying beyond individuals' possibilities, but there are also a lot of things we CAN do!!! Something I think Ågren agrees to too. As the Institute does.

And I also wonder, why are some people paralyzed in these respect? And why are some don't caring and taking all sorts of risks, even enormous, challenging risks? However I have my ideas about this.

What can we do about this? What shall we do about this? Shall we do something about this?

I don't think any of those attitudes are irreversible though. We aren't born in this way. We CAN recover from this (but sometimes with a lot of hard work and struggles - and pain). But the best would be if we could prevent them in the first place, by treating our kids with greatest respect! Listen to them and meet them respectfully.

In reality the break through for democracy in Sweden largely was about that representatives for non-governmental movements conquered seats in parliamentary congregations on local, regional and national levels and forced through social protection legislation, a restrictive alcohol policy, ban on child labor, basic industrial safety – mostly in opposition to those in power who used to refer to the individual's freedom because they in their privileged position didn't have any greater needs for protection laws.

How well said! How many with money and power in this world havent' been interested in NOT loosing their power position, even though they retorically speak about freedom? What would actual freedom be? Freedom of choice etc. be?

Ågren thinks that this antagonism still holds.

Just as well as there shall be individual freedom there shall also be rights to create a loyal society with the democracy as tool where people don't have to become exposed to unnecessary health risks and where all have the same rights to best possible health.

There is still a lot to do. Our era's great health risk is the unequal distribution of power, nature resources, access to health care, education, money and influence/ascendency, something we see globally AND in our own country and that deprive many human beings from many healthy years that could be used to pet cats, see grandchildren, read good books, grow roses or why not fight for social justice.

Yes, can all people do this in this world? Do all people have those choices? Does it always have with their lack of responsible taking to do? Or with things beyond the possibilities that are presented for them in the society where they live? Can all people do this in our own western societies ether? Who can and who can not, and why?

Ågren retired last fall and here is his farewell speech (in Swedish).

And here a blogposting by Ågren on "The Globalization Board – a neoliberal think tank.” About the Globalization Board.

Also read the article "Equality of What?" by the British researchers Richard Wilkinson and Kate Pickett and Paul Krugman in "Why markets can't cure healt Care."