We are publishing: Health as a Public Good – A Concept for Socially Organised Primary Care

We at the Poliklinik Syndikat demonstrate every day that multimodal, solidarity-based and sustainable healthcare – which takes the social determinants of health into account – need not remain a utopian ideal! We are establishing care centres that provide integrated bio-psycho-social support to people whilst also addressing structural issues.

However, there is still much to be done to ensure that non-profit, interprofessional healthcare centres become the norm rather than the exception.

Together with communia e. V., we are therefore now publishing: “Health as a Common Good – A Concept for Socialised Primary Care”

These reflections on the reorientation of outpatient healthcare in Germany have emerged from discussions between activists from our organisation (specifically our ‘Utopia Working Group’) and from communia e. V. As a think tank, communia e. V. develops strategies for a democratic economy. We are united by the conviction that good healthcare can only be achieved where it is guided by the common good, organised democratically and geared towards people’s real needs.

We see this paper as a basis for discussion and an invitation to work together to further develop ideas on what a socialised, public-interest-oriented healthcare system might look like.

After decades of neoliberal restructuring, the German healthcare system is under immense pressure: privatisation, economisation and staff shortages have taken their toll. At the same time, demographic change and growing social inequality are exacerbating the situation across society as a whole. Many people experience their everyday lives as precarious, whilst major transformations – whether ecological, social or economic – tend to provoke fear rather than confidence. There is often a lack of a positive vision that unites people and provides direction. This concept paper proposes a concrete building block for a rapidly implementable and socially oriented transformation of outpatient care. The core element of this is the establishment of primary care centres (PVZ) under the umbrella of public-law institutions (AöR) – the AöRs ‘Gemeingut Gesundheit’.

The idea of socialisation – understood as an alternative to private ownership of healthcare facilities and as a means of democratisation – serves as a guiding principle here: socialisation regards health as a collective responsibility and reframes the question of how care must be organised so that it benefits everyone. This is not merely a matter of structural reforms, but of a fundamental reorientation – a reclaiming of social infrastructures.

This concept outlines a concrete vision of how primary healthcare can be conceived and organised from a progressive perspective. It brings together practical experience from solidarity-based health centres as well as perspectives from various healthcare professions. The vision developed here deliberately navigates the tension between realpolitik and utopia. For change arises in the space between aspiration and reality.

From a health sciences perspective, it is clear that people live healthier lives when they are embedded in social contexts characterised by trust, participation and mutual care. Solidarity-based primary care can help to create such spaces – places where medical, social and preventive services come together and where a sense of community can be experienced. In this sense, new, collectively organised care structures are more than just models of care: they are building blocks of a democratic society and can counter the rise of exclusion and isolation. With the concept of ‘Health as a Common Good’, we aim to help broaden the scope of what is conceivable. We invite you to examine, develop further, critique and implement the ideas presented here together with us. The future of healthcare is open. It is up to us to shape it as a common good.

As long as privatisation and the marketisation of healthcare dominate the sector and political decision-makers do nothing to change this, a healthcare system based on solidarity and sustainability will remain a labour of love, and the Poliklinik Syndicate, amongst others, will continue to lead the way in this regard.

Link to the concept paper