The drive to destroy public health care in Romania marks a new stage in the program of social counterrevolution embarked upon by the Romanian ruling elite at the behest of the European Union and the International Monetary Fund. The new reforms will lead to the privatization of hospitals and the introduction of private insurance for most medical services.
The previous attempt to enforce the privatization of health care in 2012 became the rallying point for popular opposition against the government’s austerity program. The protests to defend health care turned into mass demonstrations against the government. A subsequent strike by miners in Valea Jiului threatened to break out of the control of the trade unions; it eventually forced the conservative Prime Minister Emil Boc to resign.
The new government of Victor Ponta, formed by the Social Democrats with their junior coalition partners, the National Liberals, relies on the support of the mass media and the social democrats’ organic ties with the union bureaucracy to carry through the same program.
The trade unions that allowed for every attack on workers since the restoration of capitalism to go unchallenged are playing a central role in the carve-up of the country’s health system. A leading figure in this process is Vasile Astarastoaie.
Astarastoaie, leader of the College of Physicians of Romania, has, since the autumn of 2012, taken the lead in bringing together various organisations and trade unions in the Coalition of Healthcare Professionals. Astarastoaie, a career bureaucrat and founder of 6 NGOs (non-governmental organizations), has been dubbed in the press as the “orchestra man” for holding as many as seven government paid posts at the same time.
He has been involved in regional and national politics for 25 years, and directly participated in drafting the legislation to privatize health care, as part of the Presidential Commission for Health Care.
The union coalition, which was formed in July 2013, was to function as a propaganda organ to demoralize workers’ resistance and serve as a lever to obtain benefits from the government for the bureaucratic layers Astarastoie represents. Numerous closed-door discussions with state representatives yielded nothing more than the promise that members of the coalition will be represented in the government commissions, and that the boards of directors of hospitals would be the first targeted for privatization.
At the same time, the coalition plays a crucial role in maintaining the veil of silence and misinformation imposed by the government and the media. They have organized only toothless forms of protest and promoted demands that are purely economic or are related to “professional dignity”. They thereby hide the true extent of the reforms from both the public and their own members.
One of their most vocal demands has been doubling salaries of junior doctors, which they have consistently used as a smokescreen for their lack of opposition to the new legislation. The cynicism of this maneuver was underscored by one of the leaders of the Sanitas trade union, who said that auxiliary medical personnel have agreed to give up on their own demands, in favor of the demand (which will never be realized) for doubling junior doctors’ pay.
Junior doctors are amongst the most oppressed sections of workers in hospitals and are not included in any trade union, making them a potentially difficult source of opposition. They are employed with temporary contracts and gain as little as 200 euros a month, many of them being forced to pay around 225 euros for a one-room flat in the major university cities or to live in student dorms. There are reports that many junior doctors participated in the anti-austerity demonstrations of 2012.
Astarastoaie promoted a dubious NGO, “The Association of Junior Doctors”, with no real base, in an attempt to bring junior doctors behind the coalition.
Opposition to the laws is growing, as workers begin to see the real extent of the attacks. Despite the blackout imposed by the coalition on the scale of the attacks, there are already 57,000 signatures for a petition proposing a general strike. The trade unions are actively involved in preventing it, however.
Any opposition will necessarily take the form of a rebellion against the trade unions. Fearing a backlash from workers for its association with Astarastoie, the Sanitas union, the largest component of the Coalition of Healthcare Professionals, was forced to mimic some sort of opposition.
On October 16, Sanitas offered to hold separate talks with the government, even though the union has participated, as part of the coalition, in every round of negotiations. The union came out with a statement claiming to oppose what they now call “an underhand privatization of hospitals” and demanding a “specific salary regulation for all health employees”.
Sanitas is only searching for a way to sell the reforms to workers and is in fact committed to expand performance pay, one of the key components of the government’s plans.
The WSWS asked Marius Sepi, the Sanitas vice president and a leading member of the Social Democratic Party up to 2011, to clarify the union’s statements. Sepi explained that, while the union “does not agree with changing the status of hospitals”, as the government “pilot project” demands, Sanitas “does not oppose it” and “have not asked for its withdrawal”.
Instead the union is waiting “for further clarification” from the government that could “convince them”. On the salary law, Sepi insisted that “there should be no misunderstanding, that Sanitas did not want performance-based salaries”.
He explained that the union proposes “a law for all employees, which includes the government’s project on staff revenues”. Complaining that it is mostly doctors who will be affected by performance pay, he said that he would like it to be extended to the entire hospital staff.
As the Social Democrats and the unions are coming into conflict with the working class, the upper middle-class layers represented by pseudo-left organizations are moving rapidly to the right. CriticAtac is a protest group linked to the union bureaucracy and the “left” academia around the Social Democratic Party that customarily employs a left or even Marxist sounding phraseology.
While the group has aligned itself completely to the union-run campaign of misinformation, their latest article on the subject directly expresses all the pent-up hostility of these social layers for the working class. The article is signed by Viorel Rotila, the president of the union Sanitary Federation Solidarity of Romania.
The article’s theme is that the problems of the health care system are caused by the working population, who expect health care to be a social right: “because health care was one of the last bastions of the communist mentality and a large portion of citizens is still attached to it, politicians were obviously interested in maintaining this slogan”. Observing that “health care costs” are rising, Rotila makes the case for private insurances and also reiterates his union’s demand for performance pay.
The Socialist Alliance Party, a Stalinist party aligned with the German Left Party, did not issue an official statement regarding the health care question. Asked by the WSWS on their position, the president of the party, Constantin Rotaru, said that, although he was not entirely familiar with the demands of the trade unions, his party is completely in solidarity with the actions of the coalition.
He said that he would add to them the demand that the state should provide free insurance, while insisting that “his party has nothing against private clinics”, a demand entirely in line with the government’s privatization package.