Hospitals have become businesses, and thus people’s health has become a commodity. “Decisions about treatments and length of hospital stay are not made solely on medical criteria, but increasingly based on what can be billed profitably. More and more hospitals are being privatized,” notes the Hospital Not Factory Alliance. On the one hand, all sick people suffer from the supposed market constraints and profit logic, on the other hand, however, the employees also suffer: too few staff, too high a workload, psychological pressure, little scope for decision-making on the part of the nursing staff. Interpersonalism, as a central aspect of care work, has been rationalized away, thus abolishing the “care” in “care work.”
Since 2015, the alliance has consisted of civil society organizations such as the Association of Democratic Do ctors (vdää), attac, the Soltau Initiative, the Society for Psychotraumatology, Trauma Therapy and Violence Research (GPTG), trade union actors from ver.di regional sections 03 Baden-Württemberg, Berlin-Brandenburg and North Rhine-Westphalia, as well as members of the party Die Linke.
The alliance describes its own task primarily as informing, educating and stimulating public debate. In addition to numerous articles on the website, the brochure“Facts and arguments on the DRG system and against the commercialization of hospitals” was also produced for free download. According to the composition of the alliance, it wants to have an effect on the governmental political level and the actors there. The goal: “Hospitals should be institutions that provide services of general interest to society, not commercial enterprises. Hospital planning and financing are public tasks that require political planning and control. We need hospital care demand planning that involves all health care stakeholders.”
On the grievance addressed by the alliance, the SOCIUM “Research Center Inequality and Social Policy” of the University of Bremen recently produced a study in 2017 entitled “Medicine in hospitals between patient welfare and economization – doctors and managing directors interviewed”. This shows to what extent the economic interests of hospitals influence medical decisions to the disadvantage of patients. It should be critically noted that only physicians were surveyed for the study and not nursing staff or, for example, auxiliary and cleaning staff, whose poor and stressful working conditions also have an impact on procedures and patients. Moreover, economization and profitability as structural moments are not fundamentally questioned.