On death

My friend Tom wrote:

“The Georgetown University Hospital comprises several medical towers interconnected. The CCC Building is where the Pediatric Inpatient floor is.
On the fourth floor on a wall by the elevators there is a beautiful, large quilt encased in glass. Next to it there is a large picture of a young woman. Her expression is of a friendly, intelligent, serene, very nice looking woman. Below the picture it says:
Sandra D. Teague, Physical and Occupational Therapist.
19 June 1970- September 11, 2001

Sandra had been working at GUH for three years after graduating from her University degree. She had decided to take a vacation to Hawaii and was on the American Airlines Flight 77 to fly to Los Angeles and from there on to the islands. Flight 77 was highjacked and crushed into the Pentagon, just a couple of miles, across the river from Georgetown, in Arlington, Virginia.
The quilt was especially made in memory of Sandra "With sorrow and a deep sense of loss..." It has woven in its center a red square representing warmth and love. Surrounding this there are different colors signifying the passages of happiness and also setbacks in life.
Believe me, I have stopped many times to look at this beautiful quilt and read the words written about Sandra. She was one of the many innocent victims of the criminal attacks of September 11, as well as those of Madrid and London.
You can say that I am not a good Christian because one should forgive but never forget. I know I will never forgive.”


One piece of the evolution of man is the evidence of (certain) care for the dead. Of the many findings of the paleoarcheological site of Atapuerca the Pit of the Bones (“La sima de los huesos”) claims a major interest: it is bthe first evidence of some activity or behaviour related to dead humans. This means some consideration of transcendence beyond death: that there is something besides the body. You may call it soul or just remembrance.
The fossils found in the Pit of the Bones are dated some 300.000 years b.p.t (before present time). That is how old are memorial practices.
The quilt you mentioned is what is called a cenotaph: a memorial for a dead person elsewhere the actual tomb. Death, being tragic or just early, elicits deep feelings, old ones. And beautiful words.

The Bard said, with the voice of Mark Antony at Julius Caesar death:

“O mighty Caesar! dost thou lie so low?
Are all thy conquests, glories, triumphs, spoils,
Shrunk to this little measure? Fare thee well.
I know not, gentlemen, what you intend,
Who else must be let blood, who else is rank:
If I myself, there is no hour so fit
As Caesar's death hour, nor no instrument
Of half that worth as those your swords, made rich
With the most noble blood of all this world.
I do beseech ye, if you bear me hard,
Now, whilst your purpled hands do reek and smoke,
Fulfil your pleasure. Live a thousand years,
I shall not find myself so apt to die:
No place will please me so, no mean of death,
As here by Caesar, and by you cut off,
The choice and master spirits of this age.”

(Julius Caesar, Act three, Scene I)

March 11th- On terror and Politics

Reaching the second anniversary of the M-11 (2004) massacre in Madrid commuter trains I watch with certain despair the attitudes of the Spanish opposition party, the Popular Party.

In the memorial celebrations held in the park area designated as Memorial for the Absent there have been cries and shouts demanding a “full investigation” on the grounds that the truth of what happened is not fully known. A convoluted theory of conspiracies has been proposed after the claims of putting the blame on the Basque independents ETA terrorist had proved wrong.
The whole point is that the attacks were so closed to the general elections that the reason for them was to generate a change in the electorate against the incumbent PP government. This was actually what happened, but everybody believes that the reason for the switch vote was precisely the way the aftermath of the attacks was handled by the PP government. To think otherwise would put too much foresight in the terrorist minds.
Previous experience, such as the 9/11 New York City WTC Twin Towers catastrophe and the London bombs of July 7, 2005 afterwards, produced a rally around the standing government. In fact both instances somehow reinforced the standing of both GW Bush and Tony Blair. Why would in Spain happen differently?

Obviously the conspiracy claims are just a smoke curtain to stave off the responsibilities of the then-acting government, that of the Popular Party. It’s just peculiar that the main advocate of the conspiracy theory happens to be the former Minister of Interior, Mr Acebes, who could be easily charged with negligence for not preventing the attacks. Should the attacks had taken place in any other inter-elections period, then opposition parties would had demanded an inquiry on the responsibilities of the Interior Ministry and surely asked for his resignation. The immediate elections took care of that and the Spanish people, by voting against the PP, sacked them.

The Popular Party have not digested yet their defeat and, worse, by acting as it has, seems that the undemocratic roots of the Spanish Right are still present and active.

But I believe that it’s just their top leaders, still shocked and entangled in their own contradictions. If they do not change, the electorate will tell them in the next elections. Watch for it.

La defensa de la cultura

Si son temps dolents per a la lírica, potser que siguin tan dolents per l’assaig, ni que sigui aquest petitet weblog. En qualsevol cas, la defensa de la llibertat d’expressió sempre mereix un esforç.

Fa uns anys en una presentació professional sobre el transport de malalts i les dotacions de recursos vaig fer servir una imatge, una diapositiva, per a il·lustrar una dita popular comuna a les nostres contrades: aquella que fa referència la decisió d’apropar Mahoma a la muntanya. A la imatge es veia un home amb un turbant caminant cap a una muntanya antropomòrfica, amb cara i ulls, que el mirava amb sorpresa.

La dita fa referència a una anècdota, totalment apòcrifa, atribuïda al profeta al confrontar-se amb la realització de miracles, o amb la fortalesa de la fe “que mou muntanyes”. Si mai es va pretendre amb l’anècdota qüestionar les capacitats demiúrgiques de Mahoma, des de una cultura cristiana que, en canvi, fa un gran ressò dels miracles de Jesús, l’intent és errat, puix que a la cultura i a la religió musulmana el rol dels miracles és molt reduït.

En tot cas, a mi personalment la paràbola de Mahoma i la muntanya més aviat em sembla un paradigma de la racionalitat. Del possibilisme enfrontat a la dificultat inútil. I pel que fa al transport de malalt la realitat que sempre és més eficaç portar malalts als hospitals que portar els hospitals a la gent.

El cert és que, ara, en aquest començament de segle, no faria servir ni la diapositiva ni l’anècdota per a il·lustrar un argument per tal de no ofendre sensibilitats.

Més o menys per la mateixa època es va estrenar una pel·lícula sobre Mahoma: “Mahoma, el missatger de Deu”, o, amb el seu títol original en anglés: “The messanger”. A la pel·lícula, una coproducció britànica-libanesa, en cap moment apareix el profeta, per respecta a les creences islàmiques i per exprés disseny del director, Moustapha Akkad, musulmà ell mateix. Això no va evitar fortes crítiques per part d’islamistes i, fins i tot, una revidicació de la destrucció del film per part de d’un grup radical de Musulmans Negres (“Black Muslims”) que van protagonitzar un greu incident a Washington D.C. al març de 1977, quan van ocupar uns edificis a la capital del Estats Units i segrestar un grup de persones, amb el resultat d’uns quants morts.

No vaig veure la pel·licula, però si els cartells publicitaris i, ignorant de la importància de que la imatge de Mahoma no ha d’existir, d’alguna forma se’m va quedar l’idea de que Mahoma devia semblar-se a Antony Quinn.

Per contra, la profusió de pel·lícules sobre Jesucrist i l’abundantíssima imagineria cristiana, configuren un Crist que sembla un hippy amb la cara de
Willem Dafoe si el veu Scorsesse, o John Caviziel si el veu Mel Gibson.

La cultura occidental, si és que tal cosa existeix de forma individualitzada, inclou un notable pes de les imatges. No es que una imatge valgui per mil paraules sinó que les imatges configuren, donen forma a la realitat.

Uns quants segles d’eurocentrisme, els imperis espanyol, francés o britanic, i ara nordamericà, també europeu en el seu origen cultural generen dificultats per a entendre un món, com ara es diu, globalitzat i una barreja de cultures.

Les dificultats creixen quan sobre de les cultures s’instal·len concepcions religioses i, d’elles, les més integristes.

De l’actual situació i conflicte al voltant de les imatges de Mahoma publicades fa quatre mesos a Dinamarca és fàcil extreure les implicacions religioses. No és cap novetat que els clergues, col·loquialment els capellans, facin de les creences motiu per al conflicte amb ànim de reclutar adeptes. Quan es diu que els occidentals hem fet de la tolerància i del laïcisme un pilar de les llibertats, sembla que no se’n recordem de totes les guerres i conflictes de religió que ocupen les pàgines de la història de Europa. Des de les croades, quan un monjo boix cridant “Deus volt”, Deu ho vol, va rossegar reis, papes i munions de gent a la conquesta destructora de l’actual Palestina, fins als “Tercios de Flandes” o els conquistadors d’Amèrica imposant a cops d’espasa i de crucifix una religió com a suport psicològic i social del poder. També els clergues van ser instrumentals i protagonistes reclamant una atenció que altrament no aconseguien.

Quan ara els clergues islàmics de Dinamarca son capaços d’organitzar un enrenou que, si pot ser justificable des de la indignació per manca de respecte a una religió, malament pot justificar els aldarulls, les destruccions i les morts, torno a pensar el deia el meu amic Agustí: “Rotllos de capellanots”.

La defensa de la cultura va per altres camins.

Mi jeta, "my spittin image", ma guele, la meva cara

"L'estatut"

La semana pasada celebramos en Catalunya el final del Ramadán. Este sábado por la mañana me he encontrado en el mercado con la esposa de Carod-Rovira. Luego me he ido al congreso. No al de los diputados, no: es un congreso sobre redes de comunicación locales y lo que me interesaba era el WiFi por si podemos instalarlo en mi barrio.

Ayer tarde un paisano comentaba que a “l’estatut” se sobran algunos “et” y algunos “ut”. En catalán se dice cuando un asunto está completo que tiene todos los “et” y “ut” del aniguo lenguaje jurídico. Sobre todo le sobra el “ut” de estatut: a él lo que le mola el “l’estat”, por Estat Català, la agrupación a la que pertenecía su padre, un notario de Tarragona que tuvo que exilarse a Francia en el 39. Ahora espera recuperar alguno de sus papeles del archivo de Salamanca.

Se me ha despegado el “teletac” del parabrisas. Lo he vuelto a pegar con pegamento instantáneo. Es ese achiperre que permite el pago telemático de los peajes en las autopistas. Aquí no puedo recorrer ni un centímetro de autovía sin pagar.

Igual todo eso: Ramadán, Carod, WiFi, Estat Català, Teletac... suena raro o lejano, pero forma parte de mi entorno diario.

Este blog se escribe en los tres idiomas en los que trabajo habitualmente. Puedo conversar en cinco y entiendo hasta ocho, pero no es un mérito: es una necesidad. En todos los sitios donde he trabajado había más de una lengua oficial. Me parece que eso es lo habitual en el mundo.
También creo que el nacionalismo se cura viajando y los provincianismos me entristecen.

Me apura el griterío sobre el estatuto de Cataluña. No lo acabo de entender. Al fin y al cabo se están siguiendo las percepciones legales para modificar una ley que, para los catalanes, se ha quedado estrecha. Y la voluntad representada por el 90% de un parlamento democráticamente elegido no se puede ignorar. Entre otras cosas porque los elegimos para que legislaran. Para eso elegimos también al parlamento español, aunque a lo mejor fuera sólo para despedir a Aznar.

Que legislen. Que parlamenten. Que “parlin” que es como se dice hablar en catalán.
Claro que hay que hablar de dinero y, naturalmente, no va a ser del dinero de los extremeños o los canarios. Tendrá que ser del dinero de los catalanes. Y para eso hay que reordenar la financiación.

Para que el año que viene volvamos a celebrar el Ramadán, porque a este país le hacen falta inmigrantes. Para que la mujer de Carod pueda seguir yendo al mercado sin escolta. Para promover las telecomunicaciones locales. Y para redimir el molesto peaje de nuestras autopistas. Para que nadie se tire de los pelos porque el notario recupere las cartas de su madre. También para dar apoyos a la lengua catalana, que la emplean más ciudadanos europeos que el danés, el sueco o el checo.

Financiación y nación suenan casi igual en castellano. En catalán no. Por eso van separadas en el estatut. Pero, al cabo, son lo mismo.

Safari to Cabañeros

Cabañeros is the newest National Park in Spain. A hunting private property, it was acquired by the Defence department to be used as a shooting range for the Air Force. Environmentalists (in Spain called “ecologists”) went ballistic and the public uproar forced the government to declare the area protected land first and later, as the natural riches became more evident, was declared National Park some ten years ago.

Cabañeros took its name from the “cabanas”, the thatched dwellings its inhabitants back a couple of hundred years ago used. Part of the Montes de Toledo mountain range, is in the Ciudad Real province, in Central Spain and is highly representative of the central Spanish high plain, the “Meseta”.

To get there I drove all the way from Catalonia through the expressway to Valencia and Madrid but, on reaching Alarcón, some 100 miles before the nation’s capital, I took a country road, actually an excellent two lane “Redia” road practically deserted, on through Los Yebenes, a very beautiful wide valley of “dehesa” land, as the large tracts of land in the Southern half of Spain are called: grazing expanses interspersed with Spanish oaks “encinas”. In some fenced areas you could see cattle and also “toros bravos”, the Spanish semi-wild bulls used in the “corridas”, the bullfights, quietly grazing away.

It was sundown when I reached Retuerto del Bullaque, a small village North of Cabañeros and one of the gates to the park. I settled down in a “hostal”, had a light supper (soup and fried eggs) and went to bed early, being a Saturday, just to catch a few blinks at the Barça football game on the TV.

Up at six, I hit the road at 6.30 luckily to stumble with one of the park rangers 4 wheel drive passing through. I followed it for a few miles to what I was thinking was going to be the park’s gate. Suddenly it turned left without signalling and entered a short dirt track to stop at a chain fence. I followed suit and as the guy was unlocking the chain I asked him if that was the park’s entry.

Well it was and it wasn’t. As I was about to find out, the visits to the park are limited to 96 persons a day, and the visits are only allowed with a guide and by previous reservation. This peculiar number was actually 100: 96 visitors and 4 guides, half in the morning and half in the afternoon, in four 4WD vehicles each through one of the park entries.

Fortunately they had room for me, so I left my car and hopped in the 4WD. This was a large semi-truck contraption, a German made Mercedes Unimog, with large windows, that held ten passengers and a driver. It took off immediately and drove haltingly through a narrow and bumpy dirt track. Still pitch dark, the vehicle lights showed ghostly threads of fog between the trees.

The ranger guide, a rather talkative fellow, went on explaining the trees and bushes, and the aromas of the bushes and bush flowers: rosemary, “jara” (“rockrose”), honeysuckle, lavender, and so on.

Some half hour later the vehicle stopped and turned the lights off in the middle of what look like a rather ample expanse. We were in “La Raña” and we were going to participate in one special event: the “berrea” of the deer. The annual bellowing contest between male deer in the range.

As the first lights began to clear the night’s shadows and one could hardly distinguish dark dots that were not bushes or rocks but living things, then and there began the concert of “berridos”, bellowing away the deer’s love song. Fantastic!

Roe deer, fallow deer by the dozens. And then as the daylight allowed, you could see families of wild boar, a couple of foxes and a whole bunch of different birds, the black vulture with its 10 ft. wingspan the most spectacular.

Later on we went to a cliff to get to see imperial eagles, one of the few remaining families in Southern Europe.

Well, that was some safari!.

In the afternoon I took a walk through the “El boquerón del Estena”, a narrow canyon along the Estena river on the promise I could see some otters swimming but by midday wild animals tend to keep themselves out of sight. A nice walk though.

The next day I went to the Cuenca mountains to visit “La ciudad encantada”, that very popular and peculiar wind eroded landscape and crossed the “Montes Universales” to visit the Cuervo river source, also a spectacular neck of the woods, on to Albarracín and, some 400 km later, back home. But that’ll be some other day story.

COMENÇAMENT DE CURS MULTICOLOR

Enguany encara es notarà més la varietat ètnica dels alumnes a les escoles. Del fenomen immigratori dels darrers anys, l’increment ha estat progressiu. Uns seran nens arribats de l’estranger, des de fora de les muralles Shengen, i un bon grapat nascuts aquí, de pares immigrants.

L’any 2004, el darrer del que tenim xifres, els fills de pares immigrants nascuts a Catalunya arriben al 16%. Així doncs ja sabem els que començaran escola al 2007. A tots els efectes, benvinguts siguin.

La qüestió però, te algunes peculiaritats. No tots els nenes aniran a escola, tot i que, al nostre context legal, és obligatori. I no es repartiran entre totes les escoles, si no que es concentraran en unes, mentre que d’altres a penes en tindran.

La coherència, cohesió, estabilitat de la nostra societat, del nostre país, passa per una presa de consciència de les realitats. Els nous ciutadans s’han d’integrar. Això es bo per a tothom. I la integració comença des del primer moment, al nàixer, i continua amb la incorporació a la societat que, per als nens, és començar a anar a escola.

Integrar es posar tots els mitjans per a evitar la marginació, l’exclusió o la separació dels membres de la societat. Els que han vingut, els que han nascut aquí, no marxaran. Estan aquí per a quedar-se. I no podem cometre l’error d’ignorar-los.

Els infants han d’anar a escola. Però alguns col•lectius, podríem dir “ètnies” o cultures, això no ho tenen clar. Alguns àrabs, alguns xinesos, algunes gitanos, no creuen que els seus fills hagin d’anar a escola. Alguns musulmans retiren les seves noies del sistema educatiu tan bon punt arriben a la pubertat. Amb tot el degut respecte a la diversitat, ara per ara i aquí, el millor passaport per al futur dels joves, dels menors, es l’escolarització. I és també el seu dret.

Així s’ha d’explicar als pares, i tots plegats estem obligats a vigilar-ho i, si s’escau, denunciar-ho.

Algunes escoles dificulten l’admissió d’alumnes que pertanyen a minories o son estrangers de naixement o origen. Les escoles privades poden fer el que vulguin, però si son subvencionades i, per tant, publiques estan obligades a admetre la seva quota d’immigrants.

Així s’ha d’explicar als pares dels altres, i tots plegats també estem obligats a vigilar-ho i, si s’escau, denunciar-ho.

Per que tots plegats no ens podem permetre el luxe ni la desgracia de generar “ghettos” ni nuclis d’exclusió. Ni que els infants, els menors, perdin les seves oportunitats d’integrar-se, conviure i desenvolupar-se lliures a la nostra societat.

Al cap i a la fi, l’única qüestió es tenir ben clar que som, que vol dir “nosaltres”. Som i serem, si som tots.

Death by the Mississippi

My last entry hoped for a prompt and effective aid reaching the victims of the hurricane Katrina. Very unfortunately that was not to be.
From this side of the Atlantic we have been watching in disbelief the unfolding of a tragedy that only the well informed could foresee: how bad a hurricane can be, the orographical situation of the Gulf coast and that of New Orleans specifically, the social situation of the population in Southern Louisiana and Mississippi states and least of all, the striking difference between the United States enormous might and resources and their ability to provide effective aid to the victims of a major natural disaster.
My, and I would dare say, most people culture of naturals disasters comes from the disaster movies. Most movies deal with the rescue that follows the disaster and the heroics around it. Thus it seems incredible that now it took more than 5 days to get help to the refugees in New Orleans Superdome and a whole week to restore some sort of law and order.
That New Orleans is below sea level is well known. It is even mentioned in touristic brochures. That the levees would or not hold in case of a water surge must be a consideration continuously present when building levees.
The song by Don McLean about the demise of Buddy Holly “The day the music died…” talked about a levee that was dry.
So bye-bye, miss american pie.
Drove my chevy to the levee,
But the levee was dry.
And them good old boys were drinkin’ whiskey and rye
Singin’, "this’ll be the day that I die.
"this’ll be the day that I die."
Dry to rhyme with “die” and “rye”
The first time I heard it, new to the South, I had to ask what a levee was. I have not been across any levee ever since, until last Sunday when I watched on the satellite TV a diagram depicting a cut of New Orleans and the differences in levels of lake Pontchartrain and the Mississippi river with the ground level of the city.
So the flood was predictable.
The Census Bureau said that 12.7% of Americans were living below the poverty threshold in 2004. The three states with the highest poverty rates were Mississippi, New Mexico and Louisiana.
That poverty includes lack of all kinds of resources, and thus that of transport, could easily bring to the conclusion that even though an order of evacuation was in effect, a good whole lot of people would stay behind. And that most would be poor and handicapped. With a large number of people, poor, abandoned to their fate in an empty city, looting, violence and lawlessness were also foreseeable. It’s all right to get people out of harm’s way but law enforcers should stay put, shouldn’t they? Someone has to mind the shop.
As for why it took so long to get rescue efforts underway is a question meriting a federal investigation. Fingers may point to a variety of directions but mine points straight to GW Bush and his pathetic appearances in the media more than three days after the magnitude of the catastrophe was quite obvious.
I would not take issue with the comments of Rev. Jesse Jackson and some members of the Black Democratic Caucus as to whether race was o was not a matter in this terrible mess. Misery has many faces. Sometimes that of comments. But this time around won’t be Weapons of Mass Destruction to blame, nor could anyone justify the invasion of Cuba on the grounds that two million Cubans were blowing in the wind at the tail of Katrina which wouldn’t be any more preposterous.
Still, a Spanish TV crew showed how three consecutive police cars with white officers refused to evacuate two black persons that were walking by them on one of the highways overpasses. Then another police car came by with black officers that carried them away. So there.
When I see water I think of Navy. Seeing the flurry of helicopters flying around over New Orleans downtown skyline I cannot but to wonder that shouldn’t be easier to get there by boat? The LC’s that landed in Omaha beach at Normandy or Guadalcanal are not around anymore?. Flood waters are shallow alright, but there should be plenty of low draught vessels or dinghies to navigate a flooded city.
The same with the levee breaches they try to plug up with helicopters carrying sand and cement blocks. Wouldn’t it be easier to pull a couple of large loaded barges and scuttle them right there? With all due respect for the Army Corps of Engineers… isn’t there a Navy one?
Let’s hope that this nightmare will pass and that restoration of cities, towns and peoples’ lives will get underway effectively, and the dead can get not only rest but recognition.
Sunday, 04 September 2005

Katrina

Somewhere along the line the National Hurricane Service should stop using Russian names for hurricanes... Last year Ivan, and now Katrina seem to have created quite a disaster.
This year is full of natural disasters, from tsunamis to hurricanes. If you click Katrina on Google right out it comes an almost forgotten rock'n roll band "Katrina and the waves".... Katrina and the tsunami....
Pity the victims and let's hope aid is forthcoming and effective. Although it looks like we are all going to be victims of rising oil prices...

August, 30/2005

MAL DE MUCHOS: EPIDEMIA

A finales del verano de 1966, con mi flamante título de licenciado en el bolsillo, me hice cargo de una substitución por vacaciones en un consultorio del Seguro. El consultorio ocupaba un pequeño edificio destartalado entre dos enormes e innominadas naves industriales en la Avenida Icaria. Por entonces el Poble Nou de Barcelona, que ahora ocupa la Villa Olímpica, era un suburbio industrial polvoriento y dejado de la mano de Dios y de la de los concejales de urbanismo.

Al consultorio se accedía por una estrecha escalera que ocupaban los pacientes que hacían cola, que acababa en una puerta detrás de la cual se abría una única dependencia con una mesa y un par de sillas y una camilla por todo mobiliario. En una de las paredes mugrientas campeaba un letrero que decía “LA TENSIÓN SE TOMA LOS MIÉRCOLES”.

Al cabo de haber atendido unos cuantos pacientes, se presenta un amable anciano con aspecto de haber trabajado mucho y cobrado poco en su vida quien, tras saludar y con un mal contenido disimulo, depositó una moneda de un duro en un extremo de la mesa.

Yo miré la moneda, miré al anciano, miré a la enfermera que me auxiliaba. Volví a mirar a la moneda, al anciano y de nuevo a la enfermera que con un gesto rápido me indicó: “Cójala”. Y acercándose al abuelo anunció con voz clara y fuerte: “Venga que le voy a tomar la tensión”. Cuando terminó su lío de arremangar brazos, esfingomanómentro, fonendoscopio y palmaditas y el abuelo se había despedido y encaminaba la puerta, me dice en voz queda: “Es que hoy no es miércoles!”.

Acababa yo de descubrir el copago por atención sanitaria.

El copago es una fantasía que en realidad representa “re-pago”. La asistencia la pagamos entre todos. Con el copago obligamos a los que están enfermos a pagarla otra vez, encima.

No creo yo que el euro por visita vaya a superar en cutrez la aventura del duro y la tensión arterial, ni que vaya a resolver ni la financiación ni disuadir el uso multitudinario de los servicios asistenciales.

La salud no es gratis. Cuesta mucho dinero. La sanidad, la asistencia sanitaria buena, es cara. Como la carne en el mercado: la hay más barata, pero ya no es tan buena.

La revista “The Economist” dedicaba hace unos meses un extenso reportaje a la salud de las naciones, especial y naturalmente desde el prisma de la economía de la salud. Con unos titulares sugestivos como “Lección de anatomía”, “Enfermedades de desgaste”, “Tratamiento de los síntomas” o “Nuevas medicinas” se repasaban las dificultades que tienen los diferentes estados del mundo occidental y los diferentes sistemas sanitarios para afrontar los crecientes costos de la asistencia sanitaria. El reportaje en realidad resumia el informe de la OCDE del mes de mayo 2004 “Hacia unos sistemas sanitarios de alto rendimiento”. Que en muchos países se compruebe que la cosa no marcha no es un consuelo: es una epidemia

Una visión economicista de la salud o, si se quiere, de la asistencia sanitaria siempre será parcial y desenfocada. Aplicar la doctrina del mercado a la salud es un mal negocio. Entre otras cosas porque hacer de la salud un negocio es un mal rollo.

De lo que se trata es conseguir un mejor rendimiento, en términos de salud, del sistema sanitario. Si sólo miramos a reducir consumos o gastos, probablemente reduciremos también el producto final que es la salud de la gente. Para mejorar el rendimiento lo más probable es que haya que invertir más en salud, en asistencia sanitaria. Y por cierto, en España estamos a la cola de los 17 países de OCDE en inversión sanitaria. Tan mal que por detrás no nos queda ni Portugal.

Probablemente nuestro sistema ya ha cumplido su ciclo y necesita una reconducción profunda. Eso que los modernillos llaman “reengineering”, reconstrucción. No sólo es el modelo lo que falla con todas sus artificiosidades de niveles primarios, secundarios y terciarios asistenciales, fueras y dentros, propios y ajenos, privados y públicos, oficiales y alternativos, sino el sistema, sus principios, su idea y su financiación.

Si no saben como hacerlo que nos lo pregunten a los que lo hemos estudiado.