Summary of ¿De tod@s para tod@s? - Sanidad

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00:00:00 - 01:00:00

The video discusses the pros and cons of private healthcare versus public healthcare systems. It argues that Spain needs to make a political decision to switch to a more equitable model, in which allocating resources between different sectors is key. It also suggests that healthcare professionals need to be better organized and managed, and that the country should invest in more doctors and nurses.

00:00:00 The video discusses the health system in Spain, which is seen as being successful by some. Some of the consequences of this success, however, come from the system's reliance on success. It is a success system if it is intrinsic and has good costs, and we always have to compare ourselves with what other countries spend on health care. Spain's situation is relatively good, but the problem is that health care is being cut back in response to the economic crisis. This is causing dissatisfaction among professionals and worrying citizens. We can't forget that health is an important social glue in times of transition, and we are currently in a transitional phase. We started off on a relatively positive note when we were one of the few countries in the world with a good expectancy of life and good health care. But if we look at things from a global perspective, our situation in health care is much better. We rank high in life expectancy, have universal and free health care with low costs, and are moving towards a more market-based system. However, Spain's health care system is suffering from budget cuts, and it is becoming increasingly similar to the system in the United States. This is causing dissatisfaction among professionals and worry among citizens. We need to remember that money isn't the only issue
00:05:00 The video discusses the difficulties of implementing a model of health care that is more efficient and affordable for all, as models are often more expensive in some cases and less efficient in others. The main point is that health care funding is not sufficient to cover the costs of this model. This has been the case for a long time and probably goes back to the early 1990s. Over the past decade, we have identified that this model of success requires changes. We need more order and better government. This organization has a 10-year-old document that is still very relevant to improving government in public health sectors especially. Since the economic situation requires it, the government has been forced to take measures that have been applied quickly and without much thought. These measures have been reductions in health services that have been applied linearly, without taking into account the people who will be most affected. I say that these measures are reducing services without counting anyone. They are reducing them indiscriminately, without taking into account whether services can be maintained in this way. So, as a carpenter would do with a short, sharp knife, cutting where necessary but not taking into account whether he's taking fat, he can do the same with health care but without taking into account
00:10:00 The video discusses the situation of universal health coverage, and how, in the current system, only a restricted group of citizens who are social security insured beneficiaries receive care. It also discusses the impact of financial barriers to accessing health care on the poor, and the change in healthcare copayment policy for workers in Spain. The video concludes with a discussion of the principle of universality, which is not being upheld for those without papers. This has a negative impact on nurses, as they are powerless to intervene when people with no papers are refused treatment.
00:15:00 The video discusses the issue of health care and how to deal with patients who never receive the treatment they need. It points out that, due to the increasing number of patients and the lack of resources, hospitals are often unable to provide the same level of care to all patients. The solution, according to the speaker, is for the government to give health care responsibilities to the professionals who are best suited to provide it, rather than simply handing it off to a bureaucratic hierarchy or reducing the number of staff. This would require a change in the way the health care system is run, from a hierarchical, top down model to a more horizontal, transversal one.
00:20:00 The Canadian Agency for Drugs and Technologies in Sanitarias (CADTS) is campaigning to improve diabetes care by encouraging people to get screened and treated early. CADTS found that by reducing the number of blood tests patients undergo, they were able to save over a million Canadian dollars a year. CADTS is asking for the government to create a single, unified state agency with high levels of transparency and no political interference in order to better manage healthcare.
00:25:00 The video discusses how hospital managers are chosen in Spain, and how the role of politics in health care has become overwhelming in recent years. The main points are that there is a lack of expertise in politics when it comes to running hospitals, and that there is no political oversight of health care systems. The main concern is that hospitals are being built at a faster rate than they can handle, and that the care of patients is not being prioritized.
00:30:00 This video opens with a discussion of health care in Spain, where many centres are opening up. The need for the service was debatable, as there would have to be a case-by-case examination to see if it was more important to prioritize it or not. From my perspective, sometimes it followed demagogical maneuvers, such as women in this town giving birth in their own village, 10 km away, becoming a tragedy and a few months later and with the same ideology, many of these institutions are being transferred to for-profit entities throughout 2009. The new hospital, with a population of 240,000, treated 337 births and 3,307 emergency admissions in 2009 as a comparison. The hospital in the town of Majadahonda, level 1, treated 70,000 residents and had 739 births in the same year. Overall, we are very satisfied with the hospital, and there is a great variety of private/public partnerships in place, such as in Catalonia where a longstanding tradition is to have private sector participation in healthcare delivery through foundations or public sector health companies that provide more flexibility to health centers. Recent models involve private companies taking over management of health services from public sector entities, with a pay-for-performance scheme in place in which the private
00:35:00 The video discusses the increase in absenteeism in Spain over the past two years, from 4.3 percent to 67 percent. It cites a study that found that, in systems with private healthcare, the primary goal is profit, not health. Public systems, in which the goal is health, are more efficient and better for patients.
00:40:00 The video discusses how hospitals are becoming more like businesses, with hospitals favoring profit over providing quality care. This is done by reducing the amount of money that is spent on health care by cutting back on things like specialized care. This reduces the quality of care that patients receive. One example is the difference between two types of hospitals: level 1 and level 2. Level 1 hospitals are simpler and don't have the many specialized services level 2 hospitals have. Level 1 hospitals are usually run by private companies, while level 2 hospitals are the large, private hospitals. When a patient enters either type of hospital, the doctor is put in the position of having to choose between providing the best care for the patient or following company policy. This can be a difficult decision, as it is not always clear what is best for the patient medically. When making decisions based on clinical and scientific criteria, as well as long-term outcomes, it often costs more, but the patient stays with the hospital. This is something that was recently reported in the media, as from the management of a hospital in Valencia, Spain, doctors were reminded that if they had to transfer a patient to another private hospital, they should do so instead of a public hospital. There are studies that
00:45:00 The video discusses the importance of having a doctor available to treat stroke patients, and the various factors that can affect the quality of care received. It also points out the importance of properly funding health care in order to provide the best possible care for patients.
00:50:00 There is a great pressure on all medical officials to do research in order to be competitive. However, the research could have a more nefarious purpose, such as tax collection. This could happen in the teaching profession, too. I've lived in a hospital that went from being a private institution to one with an ulterior motive of profit at some point. We began to feel discontent among the hospital's managers because they didn't appreciate the time we spent as doctors. They preferred that we be in a "productivity-oriented process" right away. The teaching profession is an element of a productively-oriented system because, in the end, your own students are who hire you and your patients. However, this is not what is seen and, as a result, those who are rewarded are those who are quick to return or make a lot of money. There is no evidence that private provision is more efficient in fact, any reasonably observant person would sit here next to me and say that, economically, it is more efficient to run and provide service between the administration and I, who provide or provide and profit. The one who provides services and a third party for profit is the one who I, in an instant, called a paraphrase of the title, "you
00:55:00 The video discusses the risks and benefits of private health care versus public health care systems. It argues that Spain needs to make a political decision to switch to a more "stable" model, in which allocating resources equitably between different sectors is key. It also suggests that healthcare professionals need to be better organized and managed, and that the country should invest in more doctors and nurses.

01:00:00 - 01:05:00

The video discusses the need for Spaniards to come together and agree on a model system for healthcare that has been agreed upon for 30 years, and which also needs to be rebuilt. The main issue at the moment is that we can finance it either better or worse. If we want to have a system that works well, we need to have an agreement on the same type of system, be it public or private, among all the different groups of people involved.