Conference Agenda

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Session Overview
RN16_11b_P: Making Publics and Building Solidarities in 21th Century Public Health
Friday, 01/Sep/2017:
4:00pm - 5:30pm

Session Chair: Ekaterina Borozdina, European University at St.Petersburg
Session Chair: Olga Zvonareva, Maastricht University
Location: PC.2.9
PANTEION University of Social & Political Sciences 136 Syggrou Avenue 17671 Athens, Greece Building: C, Level: 2.

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Between reflexive patients and reflected health care systems: the case of patient and public involvement

Dino Numerato

Faculty of Social Sciences, Charles University, Prague, Czech Republic

This paper analyses the role of patient and public involvement (PPI) in the politics of health care in the Czech Republic. By understanding PPI both as a bottom-up civic engagement and top-down initiative stimulated by public policies, the analysis is focused on the dynamics between engaged citizens and health care system. In this regard, the capacity of PPI to transform, redirect and reorient health care is critically examined. In order to understand the PPI´s impact, the paper discusses the internal heterogeneity of PPI. Furthermore, the paper identifies different scenarios that emerge due to the impact of PPI on the Czech health care system. Different health care (re-)configurations caused by the PPI are situated on the scale between the transformation and reproduction of the health care system. The analysis is theoretically framed by the concept of reflexivity; the focus is given to the dynamics between reflexive patients on the one hand and critically reflected and potentially reflexive representatives of the health care system on the other hand. A particular attention is given to the role of digital media in these processes. The data that underpin the analysis are drawn on the qualitative study carried out both online and offline of the patient and public involvement in the Czech Republic as part of the project “Civic engagement and the politics of health care”. More specifically, a critical discursive analysis of primary and secondary documents is complemented with semi-structured interviews with citizens and policy-makers.

Europe and transplant tourism

David Matas

Canadian Bar Association, Canada

The focus of the presentation would be transplant tourism from Europe, using travel to China as a case study. The rise of transplant tourism into China coincided with a shift in China from socialism to capitalism. The Government of China, as part of this shift, withdrew funds from the health system. This funding gap was filled in large measure by the sale of organs, often to transplant tourists, sourced from prisoners sentenced to death and prisoners of conscience.

Globally, humanity was not defended against this abuse. Outside of China, organ trafficking prohibitions were largely territorial nature, and did not apply to transplant tourism. The Council of Europe Convention against Trafficking in Human Organs opened for signature in March 2015, the European Parliament 2013 resolution on organ harvesting in China and its 2015 declaration on investigating organ transplant practices in China address the abuse.

The inclination of health professionals to focus on the health of their patients has come up against the need for concern about organ sources. The question of compulsory reporting by health professionals to health authorities of international transplant tourism is a particular area of tension. As well, the issue of organ transplant abuse in China gets tangled up with larger questions of China European relationships.

The presentation would consider the answers of pan-European institutions to these questions and the response of a sampling of European countries. The conclusion would be that subjectivities make resolution of the conflict between capitalism and solidarity in this area difficult to achieve.

Solidarity and cost management: Swiss citizens’ reasons for priorities regarding health insurance coverage

Mélinée Schindler1, Marion Danis2, Samia Hurst3

1Département de Sociologie, Université de Genève, Switzerland; 2National Institutes of Health, United States; 3Institut éthique histoire et humaintités, Université de Genève, Switzerland

Approaches to priority setting for scarce resources have shifted to public deliberation as trade-offs become more difficult. We report qualitative results of public deliberation in Switzerland, a country with high health care costs, an individual health insurance mandate, and a strong tradition of direct democracy with frequent votes related to health care.

We adapted the Choosing Healthplans All Together (CHAT) tool, an exercise developed to transform complex health care allocation decisions into easily understandable choices, for use in Switzerland. We conducted focus groups in twelve Swiss cities, recruiting from a range of socio-economic backgrounds in the three language regions.

Participants developed strategic arguments based on the importance of basic coverage for all, and of cost-benefit evaluation. They also expressed arguments relying on a principle of solidarity, in particular the importance of protection for vulnerable groups, and on the importance of medical care. They struggled with the place of personal responsibility in coverage decisions. In commenting on the exercise, participants found the degree of consensus despite differing opinions surprising and valuable.

The Swiss population is particularly attentive to the costs of health care and means of reducing these costs. Swiss citizens are capable of making trade-offs and setting priorities for complex health issues.

The impact of social networks on the level of health literacy among Polish elderly, in the context of their area of residence (urban/rural). The SKSPOL study.

Zofia Antonina Slonska, Agnieszka Borowiec, Anita Ewa Aranowska

the Cardinal Wyszyński Institute of Cardiology, Poland

In accordance with the statistical prognosis the process of Polish population aging will be constantly accompanied by a dynamic growth of the old-age dependency ratio. It means, that along with the aging process, we can expect, both at the individual and the societal level, the intensification of the problemmes related to coping with worsening health and social dependency. One of the action, which can contribute to the prevention of the threats is the empowerment of the elderly through activation and education of their social networks in supporting them in rising their health literacy . To perform this task a deepen knowledge on relationships between social networks and health literacy in different contexts is needed. The aim of the presentation is to show the newly identified categories of social networks and then to assess them in terms of their impact on the health literacy of older people in urban and rural area in Poland. The analyzed data come from the study, which at the turn of 2016 and 2017 was carried out by the Institute of Cardiology, Warsaw in the representative sample of 750 elders aged 65-84 years. Data were collected by the standardized questionnaire, using PAPI.

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