Deman­ding Healt­h­ca­re for All: Act One

Foto: Flickr

The pro­blems that face us are many. It’s hard to know whe­re to start. When we first came toge­ther, it see­med impos­si­ble to find a place to begin.

For tho­se of us that are refu­gees or undo­cu­men­ted, the abi­li­ty to even live in Ber­lin is alre­ady a con­stant strugg­le as hou­sing opti­ons are limi­ted and expen­si­ve. Health care is per­mit­ted only for emer­gen­ci­es, making ever­y­day life dif­fi­cult as one has to con­stant­ly worry about stay­ing healt­hy. The labor mar­ket – despi­te being the basis for life – is restric­ted, for­cing some to get dan­ge­rous and pre­ca­rious jobs in order to exist and to main­tain some sen­se of inde­pen­dence. Edu­ca­ti­on, the oppor­tu­ni­ty to bet­ter one’s living con­di­ti­ons and one’s under­stan­ding of our world (and a foun­da­ti­on for demo­cra­cy), is blo­cked, restric­ting the capa­ci­ty to chan­ge one’s life through this path. Through it all, the thre­at of depor­ta­ti­on hangs in the shadows, to the degree that fear defi­nes the ever­y­day life of tho­se who live on the bor­ders and mar­gins of «lega­li­ty.»

Access to the city, to muni­ci­pal ser­vices, is full of obsta­cles that crea­te a city of divi­si­ons. Despi­te having crossed a bor­der, for tho­se of us that are undo­cu­men­ted or refu­gees, Ber­lin is still a city of bor­ders and par­ti­ti­ons, restric­ting our every move­ment and our every dream.

How to move for­ward, whe­re to begin in order break through the­se bor­ders and limi­ta­ti­ons? We asked our­sel­ves this many times, and after much deba­te, we deci­ded to begin with deve­lo­ping a stra­te­gy to allow access to the health care sys­tem. This deci­si­on was dri­ven by the voices of tho­se who­se access to medi­cal tre­at­ment is denied or severely limi­ted.

We’re not poli­ti­ci­ans, we’re not tech­no­crats. But we’re the ever­y­day peop­le upon which our demo­cra­cy stands. We want to make chan­ges, not hope that “someo­ne” will make them at some point for us.

Based on the expe­ri­en­ces of peop­le in our group we began asking around. We tal­ked to our neigh­bors and our soci­al net­works, try­ing to find out how they expe­ri­ence access to health care. After this, we loo­ked up what the laws are, we loo­ked up what other peop­le in other cities did, and then we pro­po­sed some ide­as to tho­se affec­ted by the gaps and bor­ders of our city what they think would work for them. We deba­ted the pro­po­sals, we inter­ro­ga­ted them, modi­fied them, throw some away even. But at the end of this deba­te, we got a demand.

Our first demand was this:

We want an anony­mous health card to be pro­vi­ded by the city of Ber­lin. This health card has to be anony­mous in order to ensu­re the safe­ty of tho­se being threa­tened by depor­ta­ti­on. The ser­vice offe­red by this card has to be the same like every other health insuran­ce (Regel­ver­sor­gung), and we oppo­se any kind of limi­ta­ti­on to the tre­at­ments avail­ab­le.

That also means that the card should cover both men­tal and phy­si­cal health.

This card should be avail­ab­le upon arri­val to Ber­lin to anyo­ne that needs it, regard­less of sta­tus – that means refu­gees, undo­cu­men­ted peop­le, folks from other parts of Euro­pe that lack coverage, even locals who’ve «fal­len through the cracks«of avail­ab­le cover­ages.

Medi­cal­ly infor­med trans­la­tors should be avail­ab­le upon request, becau­se other­wi­se the ser­vice remains vir­tual­ly inac­ces­si­ble.

Wha­te­ver ser­vice is pro­vi­ded should be pro­vi­ded to the ful­lest. A com­mon com­p­laint of tho­se we tal­ked to was that health care pro­vi­ders left the impres­si­on of par­ti­al, or dis­in­te­rested ser­vice. Asi­de from lan­guage as a pos­si­ble bar­ri­er in this con­text, struc­tu­ral racism is a likely dri­ving force behind such pro­blems.

This means that health care pro­vi­ders should be trai­ned to pro­per­ly and sen­si­tively tre­at all peop­le, regard­less of whe­re they think they’re from. In order to ensu­re this, a com­p­laint-based sys­tem should be enforced.

But, sim­ply com­ing up with the solu­ti­on doesn’t mean the government will take it. We have to build poli­ti­cal pres­su­re…