Kryzys zdrowotny w Polsce w okresie pandemii – wnioski - głos w dyskusji zainicjowanej przez NIK

W okres pandemii ludność Polski weszła w stanie recesji zdrowotnej. W pracy poddano pod dyskusję związek dysfunkcji realizowanego od początku XXI wieku rynkowego systemu zdrowotnego ze spowalnianiem od 2002 r. i zahamowaniem od 2015 r. przewidywanej długości życia oraz ze wzrostem wskaźników umieralności. Marginalizacja zdrowia publicznego, niedostatki promocji zdrowia, profilaktyki chorób i opieki zdrowotnej doprowadziły jeszcze przed pandemią do wzrostu zachorowalności i umieralności z powodu chorób, którym można skutecznie zapobiegać, zwłaszcza związanych ze spożywaniem alkoholu i tych o podłożu infekcyjnym. Te same uwarunkowania przyczyniły się do nasilenia katastrofy zdrowotnej w okresie pandemii, mierzonej spadkiem przewidywanej długości życia o dwa lata i nadmierną umieralnością. Oba te wskaźniki należały do jednych z najgorszych w krajach należących do Organizacji Współpracy Gospodarczej i Rozwoju, w przeciwieństwie do wskaźników w krajach skandynawskich. W okresie pandemii pojawiły się poważne wątpliwości co do funkcjonowania krajowego przywództwa w dziedzinie zdrowia publicznego. W pracy zestawiono autorskie propozycje pilnych badań i analiz oraz tematów do otwartej, interdyscyplinarnej debaty na ten temat.

Before the pandemic COVID-19, the Polish population was in a state of health recession. The paper discusses the relationship between the dysfunction of the market health system implemented at the beginning of the 21st century and the stalling (since 2002), and then freezing (since 2015) of the increase in life expectancy in Poland. Public health marginalization, shortcomings in health promotion, disease prevention and health care led to an increase in morbidity and mortality from effectively preventable diseases before the pandemic, especially alcohol-related and infections-related diseases. The same conditions contributed to the exacerbation of the health disaster during the pandemic, as measured by a 2-year decline in life expectancy and excessive mortality. Both of these indicators were among the worst in the OECD countries, in contrast to the Scandinavian states. During the pandemic, serious doubts arose as to the functioning of national leadership in the field of public health. The work presents original, and thus subjective, proposals for urgent research and analysis as well as topics for an open, interdisciplinary debate. According to the author, the following issues cannot be taboo in such a discussion: Does the neoliberal, dysfunctional health system undermine the health of the Polish population? Will the dramatic experiences of the pre-pandemic health recession and the current health disaster help shift the market-oriented health system to the service of the common good? How does neoliberal newspeak affect social awareness and actions taken in the field of health? The epidemiological situation observed in recent years in Poland and the unacceptably high excessive mortality rate during a pandemic should be a reason for immediate action in the field of public health and other public policies. Without this, further economic and social development of the country will be impossible. For example, the Government should ensure national leadership in the field of public health by establishing and locating the institution of the Government Plenipotentiary for Public Health, specifying the Plenipotentiary’s tasks, including the administration of the Public Health Fund to prevent and deal with such destructive phenomena as the COVID-19 pandemic. and epidemics of non-communicable diseases. Only as a result of an open, multifaceted discussion can we expect a reliable assessment of the health situation of Polish women and Poles in recent decades and the development of good solutions for the future. Efforts of state authorities, public institutions, the health establishment, scientific and professional communities, as well as the entire society, to reorganize the health system, should be accompanied by recollections, self-reflection and a sense of moral obligation towards the victims of recession and health disaster, as well as reflection on the a human being’s ontological status in the health system.