Political science to save health care and the global model

By Alessio Cortiana

October 18Dear Director,
Health is a right, not a benefit, and not a service. An observation on which there should be consensus, but it seems that this is no longer the case, witnessing a (perhaps) inevitable secularization of human rights and their perception, in the era of “peak Gaussian” capitalism.

However, law is a traditional form of man abandoning the lion-like state of the wolf-man for the good of society, as Hobbes well reminds us, heir to the long tradition of overcoming the materialist view of the natural order of things and, by extension, of law.

Given this further consideration, we understand how, on the one hand, chronic diseases and their associated individual and collective costs are increasing and, on the other hand, the trend towards capitalist management based on the highly arbitrary nominal value of money in our societies. , Huber and colleagues1 They propose a revision of the traditional definition of health as “a state of complete physical, mental and social well-being and not exclusively the absence of disease or infirmity” contained in the 1948 Constitution of the World Health Organization. In fact, they propose a new definition that conceives of health as “the capacity for adaptation and the capacity for self-government in Facing social, physical and emotional challenges.

Therefore, whether health at the conceptual level is a traditional right to be guaranteed or we view it as an innate ability, it is ensured through the provision of services.

Providing services means managing production processes, and the concept of government is closely linked to the tasks of executive power, which is nothing but the ability to enforce laws, i.e. customs among men in a complex society. To enforce laws, you must have the ability to do so. Power, or the ability to force, that is, the ability to act, corresponds to the ability to do so through the monopoly of information or material and economic power.

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Therefore, to ensure health, whatever conceptual theoretical definition we want to give it, we must have the ability to manage useful resources to implement the set of actions necessary to maintain states of well-being or adaptive capacities, and to act on the determinants of health.

This long-standing theoretical hypothesis answers one question in this time of prolonged crisis: How do we ensure health for all and how do we do so by maintaining a comprehensive management model? Through power analysis.

Power is analyzed through political science, as Lasswell and Kaplan remind us2It can be considered the science of power. Therefore, to ensure overall health and order, it is safe to assume that more political science applied to health is needed to further ensure health outcomes.

We are witnessing a historical and social phase in the development of medical scientific thought that is rightly inclined towards a system based exclusively on literary evidence. This system interacts with the financial system from which the economic resources for health care management are derived. Both systems rely primarily on data monitoring. However, data is simply an organized set of numbers to give a representation of reality. However, if we stop at the judicial analysis of the number of statements, neglecting to include them in a social, and therefore political, context, we can really guarantee health safety as “not good”, but a case of law. Or innate in humans?

To ensure health, we should not rely entirely on epidemiology, biostatistics, econometrics, health economics, and peer-reviewed clinics, but we should also look to the “human” rate, which represents the balance of capacity to act and thus exercise power. . Therefore, more than ever, we need to include political science, with its skills, disciplinary scientific characteristics, and methods, in health care management.

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In this sense, it is essential that political scientists also begin to engage with health care, and encourage applied political science studies, because without political science, which must be researched by those in programming roles, but also proposed by those who theorize it, it is difficult to To continue to ensure health.

Alessio Cortiana
PhD student in public health
College of Medicine and Surgery
University of Milano-Bicocca

NB
1 BMJ 2011;343:d4163 How should we define health?, M. Huber et al.
2
Morgenthau, H. (1952). power and society; A framework for political inquiry. Written by Harold D. Lasswell and Abraham Kaplan. (New Haven: Yale University Press. 1950. p. xxiv, 295. $4.00.). American Political Science Review, 46(1), 230-234. doi:10.2307/1950772

October 18, 2023
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