Transforming healthcare: necessary but difficultBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2842 (Published 25 April 2014) Cite this as: BMJ 2014;348:g2842
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None of the changes proposed in health care serves if we don't accept that all people, in relation to health, are equals. The term equity doesn't adjust correctly in health. Biological, social and economic basic conditions for all people must be the same in order to maintain their health.
With globalization, personal health management requires the implementation of new radical changes in our society, and those are not possible in many countries because we are living in a profoundly conservative society. In Colombia, for instance, it is governed by competing interest groups, who, from ancient times, have legitimated their own businesses, trades, benefits, advantages, and opinions. Common people don't believe in any official sector of our society. Throughout Colombian history several episodes of big corruption have been detected and the health sector is no exception. Several health institutions and corporations are seen by people as vehicles for corruption.
Please we cannot violate natural laws. To maintain a good body and mind condition we must live in optimal conditions and the state must guarantee them, to all people, without any political, ethnic, social or genetic distinction. To be healthy and wise is urgent to introduce in our country: fundamental and extreme changes in views, habits, life conditions, and institutions are needed. For those changes to occur it's necessary to modify dogmas, paradigms, hierarchies, inertia and the social orthodoxy that have stifled initiative and suppressed creativity in health care dynamics. The only key to success is to improve the people 's living standards, employment, salary wages, education, food production, housing, and environmental conditions.
Not one of the proposed reforms that are now been studied by our governing leaders goes to the bottom of the true problem of health care in Colombia. All promote the same obsolete, unhealthy and ineffective culture planned at the top without considering real people necessities. The spirit of the health care proposals that really motivate their respective proponents is only monetary – financial. The main preoccupations for all of them is how to move effectively the official money destined for our health care system, by introducing changes favorable to the same businessmen, arrogant leaders, traders, private pharmacological companies and other institutions; and how to adapt the system to a new contemporary form on many levels, mainly in the administrative and the aesthetic fields by the introduction of those classic electronic devices that are changing all the world such as computers, mobile phones, and powerful tools of the world wide web.
The world is crossing an important historical divide. There is a massive popular discontent with all proposals for reforming health care in Colombia, because they are only transitory and cosmetic but not fundamental. They don't allow the dismantling of the existing failing, caducous, and moribund system. They don't allow it to be cleaned, purified, and renewed. People need revolutionary reforms for modernizing, humanizing, and saving our health care system. Those reforms are possible only if people have the necessary good living conditions. People need changes that catapult their health care system to a new phase in many directions, to a new version with a contemporary shape.
Competing interests: No competing interests