El Salvador: Anti-Privatization Victory

September 25, 2007

San Salvador—El Salvador’s nine-month health care workers’ strike against the privatization of the public health system came to an end on June 13. Union leaders and government representatives reached an agreement that halts the privatization of the nation’s health system. Representatives of the Doctors’ Association met previously with World Bank officials in Washington and managed to reverse a privatization clause imposed under a loan earmarked for modernizing the public health system.

As part of the agreement, a commission made up of medical professionals along with government, union and civil society representatives will follow up on reforms to El Salvador’s health care system. The commission is the first inclusive attempt at health reforms. And the entire membership of both the health care workers’ union and the medical professionals’ union will be reinstated under previous contracts, restoring labor stability, salaries and seniority. Workers fired or on strike since last September will also return to their jobs. While the agreement reincorporates all workers immediately, 160 will be reviewed on an individual basis, because of charges against them for strike related activity.

The government has sought to undermine union organization by reassigning some workers—mainly union leaders—to new hospitals or to the Ministry of Health. Within one week of signing the agreement Mauricio Ramos Falla, the Social Security Institute’s director, threatened to “demote” doctors and strikers in positions of authority in the hospital and mentioned new contracts. Both threats are in strict violation of the agreement signed.

By weakening the unions the government could possibly pave the way for privatization. The unions and medical associations expect the government will continue to seek privatization through the commission on health care reforms. But besides stopping the privatization, the nine-month strike educated the public on the drawbacks to privatizing the country’s public services, so it is unlikely such a strategy would succeed.

Tony Saca, the president of El Salvador’s private business association, is the intellectual author of President Francisco Flores’ health care privatization proposal. Saca is currently the favorite to win the right-wing Nationalist Republican Alliance (ARENA) presidential nomination for the 2004 elections. The opposition Farabundo Martí National Liberation Front (FMLN), which gained substantial ground in the recent mayoral and legislative elections, leads the polls to win next year’s presidential election. Anti-privatization has become a salient part of the FMLN’s platform, which is surely an asset in a country where—according to a recent poll by the Jesuit University—80% of Salvadorans oppose health care privatization.

Leslie Schuld is the director and co-founder of the Center for Exchange and Solidarity (CIS), http://www.cis-elsalvador.org, in El Salvador.


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