Sick bastards!

In France, what successive governments and the media call « the hospital debt » amounts to more than 30 billion euros(1). This is the figure that Prime Minister Castex gave when he announced in March 2021 a plan « for » the Hospital of 19 billion euros… spread over ten years(2). Nineteen billion to pay off a debt of 30 billion or so does not add up. However, the budget for « Defense » in France, in 2021, is 67 billion, against 15 for Health(3) yet France is spending more and more on its defence, thus joining the « 2% club », i.e. twenty or so countries that devote more than 2% of their GDP to the army(4). But it is the sick that the French state is waging war on, by denying their hospital the means to treat them.

A major political and social lie

Is it reasonable for a state to say that the health of its citizens should be included in the « deficit » or « loss » column of its budget? Simple logic would dictate that the state should be happy to have healthy citizens, and that its subjects, sorry, its citizens should take care of themselves and receive quality medical care. A hospital that treats well allows, to speak in all economic logic, to quickly put back on their feet the citizen-workers, so that they can make the economic machine work at best. But no: even this coldly economic logic does not suit the State, which still considers that the hospital is expensive.

It could be possible that some of the hospital’s expenses are excessive, why not, but this could only be due to corruption, for example. While this possibility cannot be ruled out, it has nothing to do with an alleged « debt » of 30 billion. But the state does claim that its hospitals, which are really ours, are expensive and that they are in debt. So, apart from the few specific cases of possible embezzlement or corruption, the problem lies elsewhere. Let’s face it: the state does not consider the hospital’s high quality care to be a right of its citizens.

This is how successive governments are increasing the hospital’s « debt » by refusing to assume what should be a minimal basis of its regalian functions, namely to do everything possible to ensure that its citizens are in good health. This is not the case. Or rather: this is no longer the case, and the hospital is deteriorating. Very precisely: the political representation we have of it has been affected, to the point that today most of us endorse the notion of « debt » in relation to the Hospital. It is in fact a major political and social lie.

Ugly, dirty, nasty, and on top of that: sick!

How did we get here? We could evoke this ideological propensity of the dominant to make the dominated feel guilty. Thus, Catholicism worked to make the West feel massively guilty when the Church of Rome was powerful and called all those people sinners who were only trying to survive or live. Guilt-tripping is a way of getting people to accept certain despicable policies. Times have changed, and it is now the debt that functions as a guilt trip in the strongest sense: if you are in debt, you are guilty, and therefore France, Belgium, Italy and the vast majority of other European states, which spend more than they harvest and produce, are populated with « guilty » people who live beyond their means.

Why not? Degrowth cannot be accommodated in a race towards « always more ». But if we go back to the Hospital and this one sector of Health, there is no « always more ». There is only « always better for the citizens ». When it comes to public health, there is no question of decreasing! What is needed is decontamination. Not to decontaminate the hospital, but to decontaminate our brains that think in terms of debt about the health of citizens, about our own health!

This « decay of the truth (5)  » did not arrive as one more ideological gimmick, a storytelling(6) intended to make people forget the reality. Not at all. The debt of the public hospital is « in the making », so to speak, in the political theory of the minimal state, due to Robert Nozick, in Anarchy, State and Utopia (7). According to Nozick, the « state of nature » is eminently desirable, but it has nothing to do with Rousseau or anarchy: it is about limiting the role of the state to repression and justice. Care, medication, surgical procedures, all of this is outside the minimum state. The only difficulty is to make the citizens accept that they are all « in the same boat », because in this way  » no one sees the situation as one of domination  » to the point that  » each person thinks that every other person is not a bully but rather someone who would be like him or her, in exactly the same position(8) « .

Our « minimal states » only care about the health of their citizens to make them accept their policies by making them feel guilty via the idea that we are indebting the state through our illnesses, burn-outs or occupational cancers. Sick bastards! The current pandemic reinforces this guilt-tripping, to the point that no political leader proposes to cut the army budget by three quarters and transfer it to the hospital. This common sense measure should be on the agenda of all opposition parties — and yet it would be insufficient, the army budget should be simply wiped out, and the military should finally be used for positive social tasks.

Instead, we are witnessing the breakdown of our health care systems. To top it all off, INSEE (Institut national de la statistique et des études économiques) revealed in early April that there was no longer any excess mortality due to covid-19 since February 2021, in a study that went largely unnoticed(9) this study totally invalidates the extension to the whole of France of the measures of confinement and limitation of movement (i.e. a masked ban on movement, previously reserved for prisoners on parole), curfew and soon internal passport. So: voluntary breakage of the hospital and guilt-tripping of these bastards of patients! Who still doubts this(10)?

Notes et références
  1. Selon le rapport officiel d’avril 2020 « Évaluation de la dette des établissements publics de santé et des modalités de sa reprise » igas.gouv.fr/IMG/pdf/2019–121-rapport_dette_eps‑d.pdf
  2. Voir, par exemple, republicain-lorrain.fr/sante/2021/03/09/comment-seront-repartis-les-19-milliards-d-euros-promis-aux-ehpad-et-aux-hopitaux
  3. Voir le tableau des budgets par ministère budget.gouv.fr/budget-etat/ministere
  4. Voir par exemple bfmtv.com/economie/international/depenses-de-defense-la-france-rejoint-le-club-des-2-a-l-otan_AD-202103160314.html
  5. Selon le titre d’un rapport passionnant de la Rand Corporation, Truth Decay. An Initial Exploration of the Diminishing Role of Facts and Analysis in American Public Life (« Décadence de la vérité. Une première exploration de l’affaiblissement du rôle des faits et analyses dans la vie publique américaine »), publié en 2018 et visible ici : rand.org/pubs/research_reports/RR2314.html
  6. En français, « un scénario fiction pourtant destiné à créer de la vérité »… où le faux devenu non seulement un moment du vrai, mais le vrai enjolivé !
  7. Publié en 1974 et traduit en 1988 aux Presses Universitaires de France, et toujours disponible, 441 pages
  8. Anarchie, État et Utopie, p. 350
  9. Disponible en ligne : insee.fr/fr/statistiques/4923977?sommaire=4487854 (au 13 avril 2021)
  10. Pour prolonger cette réflexion, vous pouvez lire Tout est pour le mieux dans le pire des mondes, coécrit avec Régis Duffour, aux éditions du Cactus inébranlable, 144 pages
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