Since 2011 People throughout Greece have been forced to fight for and self-organize their health care. Faced with a newly imposed payment for every doctor and hospital visit and in the context of a terrible economic crisis, people found they were no longer able get treatment or purchase medicine. Some even spoke of having to choose between food and medicine to survive. As with many other areas in Greek life, people came together in assemblies and decided to use both direct action and self-organization so as to survive. Some neighborhood assemblies and local communities regularly organize blockades of the cashiers in clinics so that people who need care do not have to pay. Other assemblies, generally initiated by doctors, came together to organize all volunteer health clinics. There are now over sixty medical clinics through Greece, forty-eight of which are definitely self-organized and called Solidarity Clinics, the remaining twelve are organized by the church and the movements are not clear on the internal forms of organization. These clinics provide most all services people need on a day-to-day basis from general medicine, obstetrics, pediatrics, dental care, psychology and psychiatry and many other services. They also run free pharmacies, also based in volunteer and donation based goods and services.
I spoke with Ilektra Bethymouti, a psychologist and participant in the initial group who organized the first Solidarity Clinic in Thessaloniki, about the national assembly of Solidarity Clinics that took place in the end of November. She began by sharing the surprise that all of the assembly participants had at discovering that there were no longer thirty Solidarity Clinics in Greece, as they had all thought, but sixty, and the number seems to keep rising. She also immediately raised the new challenge posed by the government, and one of the reasons for the national assembly.
“There are many things coming up – we have more clinics now, we have about 50, this is one of the things that came out of the big assembly we just had. At the same time they are changing the law about the health system – and the question is what are we going to do about it.
According to the new law the people who currently do not have social security are supposed to have access to the public health system – this is something new, everyone having access, but at the same time this is something that the hospitals do not seem to know and they are not helping or accepting people. At the last national assembly we had last weekend of the 60 solidarity clinics 26 decided to come together and organized what we named the Observatory. We decided we must discover what is happening with the hospitals, to investigate, and see if they are accepting unemployed people and people without social security, and if not, why. There are some criteria that they are supposed to base accepting people on, but until now there are a huge number of people who have not been able to go. The law has already been passed but it is not being complied with yet. It seems that doctors in the hospitals are not informed of this new law.
When they passed the law a few months ago a number of the Solidarity Clinics began to think together and question whether it was a good idea to continue with our Solidarity Clinics as a whole or just for immigrants. Because we had no idea what our identity was going to be if there was access to health care for people. We have now all decided to continue since we do not know how the situation is going to resolve itself and that there is still need, so we must continue.”
The change in the law with regard to health care is incredibly confusing, and intentionally so. On the one hand it is presented as a solution to the current crisis, in allegedly creating access to health care for all (a crisis of course made by the policies of the government). On the other hand, this new health care system is modeled on the German system, so is not at all free or accessible for all services and needs. As Ilektra explained,
“At the same time they are going to give health care for the majority – still not for everyone – but it is going to be a heath care system that is more expensive, more like the German system. It is going to be privatized in that each type of health care will have a cap, so for example if you have surgery and need four days to recuperate, but are only allowed 3 by the new system for financial reasons, then you only get 3 days of coverage or the hospital will have a deficit. Imagine – the doctor’s salary could depend on these things. At the same time there is “access” they are putting a price on the services and you might not be able to get what you need.
It is devious on all levels. It seems like they are offering public health but they are taking something back. The government is fixing the prices with the hospitals and private sector, and together are going to fix the prices. So whatever need you have is going to have a fixed price and you cannot receive more than that, even if you need it. Some of the doctors are protesting, but the new law is really complicated. In our Solidarity Clinic for example we had to make many new groups to study this new law to try and understand what it is and what they are going to do. It is really hard and we had to study a lot. And still so many people don’t know about it.”
One of the other challenges that has arisen is around the type of care that is and will be provided. The Solidarity Clinics are creating a new vision – based in practice – of health care and health in general. They are organized by medical professionals, patients and the wider community. The vast majority use horizontal forms of organization, have regular assemblies where all can participate, and try and break down the division between professional and person serviced. They do not accept any money from the state, nor do they have a relationship to the state. All money comes from non-affiliated donations. The Solidarity Clinics are autonomous from all political groups and parties.
We believe in and want self-organization because what we are achieving with self-organization is something more than giving a service, what we are organizing amongst ourselves is something new. We self-organize the Solidarity Clinics with horizontal assemblies – assemblies take place in each specialization, within the entire clinic and then nationally. This is a new experience and we want to continue with it.
What self-organization gives us is the opportunity to achieve what we call a different health care, a different sort of health and that is what we have achieved up until now. For example in our clinic we have a group for alternative health care and we are trying to change the relationship between medical expert and those who don’t know their rights or have the same expertise. We are trying to change these sorts of relationships and are doing so in ways that are very concrete. That is to say we are finding ways together with self-organization and this changes the idea of expert, of health care, of how we organize amongst doctors and with pharmaceuticals. And we have so many more questions that we have not answered yet, but we want to work on them together and can. This is much different than if you have a public heath care system only with its pros and cons.”
It is unclear what Syriza will do if elected with regard to the Solidarity Clinics, as well as other self-organized projects, such as recuperated workplaces and I hope they will, as with sectors of the Venezuelan government with the Communal Councils and Communes, encourage such developments of power from below. Indeed, I hope those who work in the self-organized clinics and workplaces will continue to organize and push hard to ensure these results.
Ilektra Bethymouti is a psychologist, therapist and trainer. She is actively involved in socio-political initiatives for the rights of citizens in the area of (mental) health. She is a member of the Solidarity Social Practice Clinic (www.kiathess.gr), and the Hellenic Observatory For Rights In The Field Of Mental Health, (http://mentalhealthhellenicobservatory.wordpress.com), in Thesaloniki, Greece.
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