[stop-imf] Alert: Help Stop Healthcare Privatization in El Salvador

[Robert Weissman]

From:
Armando Flores
Executive Director
Center for the Defense of Consumers


San Salvador, October 2002


Dear Friends:

=09In this era of neoliberal reforms promoted by the international
financial institutions, Salvadoran society is living through one of its
worst economic, political and social crises.  The peace accords signed
in 1992 with the mediation of the United Nations no longer guarantee the
democratic functioning of public institutions, and once again the
policies of the right-wing ARENA (Nationalist Republican Alliance)
government are forcing us into a social and political confrontation.

=09Having held power for 13 years, the ARENA governments have already
privatized financial services, telecommunications, electric energy, and
pension systems.  They are now pushing privatization processes in ports
and airports, and more importantly, in public health services.

=09In the specific case of health care, President Francisco Flores
promised during his inaugual speech to initiate a sector reform together
with Salvadoran physicians.  For this purpose, he named a Health Care
Reform Council with the broad-based participation of different groups,
and in December, 2000, the Council submitted to him the Proposal for the
Integral Reform of Health Care.

Contrary to the terms of the proposal, the Salvadoran government then
undertook a reform based on de facto privatization, demonstrating its
intention to contract private firms for the purpose of providing food,
security and laundry services to public hospitals.  Moreover, the
government has begun to contract medical and paramedical services in
certain parts of the country.

=09In addition, since 1999, the Ministry of Public Health has authorized
the charging of high fees for medical services provided in certain
hospitals that are part of the national public hospital network.

=09Together, these developments have provoked a growing resistance
movement among doctors and workers in the health care sector who fear
the dangerous implications of this approach for the safety of the
population.  The last conflict exploded last September.  The
government=92s lack of willingness to dialogue or compromise on the
question of further privatization of health care has caused a situation
in which most public hospitals are now on strike, providing only
emergency services.

=09This movement in defense of health care is increasingly supported by
community, peasant, union, women=92s, health care, environmental,
consumer, and human rights organizations and by the general population.
The October 16th demonstration in San Salvador, which attracted the
participation of 25,000 people,  was the most recent display of this suppor=
t.

=09In spite of widespread expression of popular opposition, on that same
day, President Flores sent to Congress a package of proposed legislation
for the establishment of a new health care system based on the
privatization and concession of services and allowing the unregulated
commercialization of health care for Salvadorans by both national and
foreign companies.

=09Popular pressure, however, had its effect on the Salvadoran Congress,
which approved on the 17th of October the "Decree of State Guarantees
for Health Care and Social Security."  In compliance with the
Constitution of the Republic, which expressly states "The health of the
population of the Republic constitutes a public good; the State and
citizens are obliged to care for its conservation and restoration," the
decree prohibits any form of health care privatization,

=09A range of Salvadoran social organizations, commited to participatory
democracy and peace with social justice, are concerned about the
direction the country could take should the President veto the Decree,
as he has vetoed other decrees passed by the opposition Congress.

=09We believe that the decree passed by the Congress represents the
opportunity the country needs to begin to resolve in structural way the
problem of health services.  For this reason, in keeping with your
humanistic spirit and in solidarity with people struggling for true
democracy with social justice, we ask your support for our resistance.
Please send letters of support for the approval of the "Decree of State
Guarantees for Health Care and Social Security,"  requesting that the
President of the Republic ratify its content as soon as possible.

=09These letters should be sent to:
=09:
President of the Republic:
casapres@casapres.gob.sv
=09Fax (503) 243 99 47

=09Congress of El Salvador:
=09Comision_medio_ambiente@asamblea.gob.sv
Fax (503) 281 95 23

With copies to the Colegio M=E9dico de El Salvador:
concolmed@telesal.net
Fax (503) 260 0324

In solidarity, from civil society in El Salvador,

Armando Flores
Executive Director
Center for the Defense of Consumers


Licenciado Francisco Flores
Presidente de El Salvador
Casa Presidencial
San Salvador, El Salvador, C.A.
Presente.

Se=F1or Presidente:

=09We are respectfully writing to you in order to communicate the serious
concern we have felt as we monitor the crisis of the health sector in
your country.  The crisis indicates profound structural problems that
influence conditions of access and quality of public healthh care
services for the Salvadoran population.

=09We believe, Mr. President, that the only reasonable solution to the
worsening conflict at public health centers is the creation of
opportunities for dialogue and understanding among the parties. As their
objective, these opportunities should have the creation of a new
national agreement in defense of health care that would explicitly
prohibit the privatization and concession of health care services in any fo=
rm.

In the formulation of a national agreement, the "Decreto de Garant=EDa
Estatal de la Salud y la Seguridad Social" appoved by the Legislative
Assembly of El Salvador this past 17th of October and which we applaud,
constitutes an important element.  On this basis, Mr. President, we
respectfully request that you ratify the approval of this decree, and
make it the law of the land.  This step would establish the conditions
necessay to end the doctors=92 and health care workers=92 strike, to
initiate a dialogue that would allow the definition and implementation
of a consensual health care reform that would guarantee full and
equitable access to health services for the Salvadoran population.

In order to proceed in this direction, and taking into account the
worthy objective expressed in your inaugural address regarding the
undertaking of a health sector reform together with physicians, we
respectfully request that you withdraw from consideration by the
Legislature the proposed reform called "Democratization of the Health
System."  This proposal threatens the social stability of the country
and puts at risk the democratic path that El Salvador has been following.

Mr. President: we will be attentive to the advances that could be
produced by this dialogue and we hope soon to have positive and
encouraging news that will contribute to peace and to the stregthening
of democracy in your country.


=09Very truly yours,