Martin Blachier, public health specialist, spoke a lot on TV sets during the health crisis. He publishes
Méga-gâchis: secret history of the pandemic
(Éditions du Cerf, March 2022).
FIGAROVOX.- On March 14, the majority of health restrictions were lifted. Are you happy about it? Is this consistent, when we are experiencing a rebound in the epidemic?
Martin BLACHIER.-
I think that's what had to be done.
By chance, this is the moment when there is an epidemic rebound, but this was expected.
And there will be other twists.
Unfortunately, we are not able to stop the spread of this virus because the immunity acquired with the current vaccine is limited in terms of transmission and the variants are able to partially circumvent it.
If the virus continues to circulate, we cannot live with restrictive barrier measures over the long term.
It is necessary to continue the current vaccination strategy in the oldest, who have a less efficient immune system, by regular vaccination reminders in order to ensure their good protection.
But we cannot eternally immerse the entire population in the pandemic.
Do you think that the government had a more political than health management of the crisis?
No, that was not the case, with the exception of the phase linked to the vaccination pass at the very end of 2021. What could have hindered crisis management for the government were the claims and positions of professional corporations.
Each trade has played its interests, without asking too much the question of the collective.
In France, we have lost the sense of transmission.
Result: caregivers are unhappy because the health system has failed to reinvent itself to the rhythm of changes in society.
Martin Blachier
The pandemic has revealed the French interpersonality of some great influential doctors;
those who do more politics than medicine or science.
This prevents a new talented generation from emerging and transforming the system in depth and this is regrettable.
In France, we have lost the sense of transmission.
Result: caregivers are unhappy because the health system has failed to reinvent itself to the rhythm of changes in society.
We stuck to the old reflexes of the great barons of medicine.
You write that the younger generations have been sacrificed.
The pandemic is, in my opinion, the first indicator of future issues related to the aging of the population.
The Covid-19 has mainly had serious consequences on the elderly populations.
But this population considered itself discriminated against when health policy targeted it.
We therefore preferred to lock students at home, close all universities for a year and a half, stigmatize children - the so-called engine of the epidemic - instead of simply admitting that age is a factor of vulnerability. .
We must learn to raise awareness of vulnerability and accept targeted strategies in order to spare as much as possible the non-vulnerable population which must build its future.
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I thought, half wrongly, that President Emmanuel Macron represented this generational renewal and that he was going to seize the situation to save our young people.
It was not the case.
However, Jean-François Delfraissy had himself recommended this approach from 2020. The political risk was too high, I imagine.
Do you understand the reproaches that were made to you, to you and to many of your colleagues, while you occupied the television sets enormously?
I am an epidemiologist, independent, I am not accountable to anyone for what I do with my time, as long as I manage to pay my teams.
The criticism that I could level at some of my colleagues is precisely their corporatism: a doctor from the hospital came to speak for the hospital, a general practitioner came to speak for the general practitioners, a biologist came to defend the PCR tests, etc.
Finally, people's interest was quite absent from medical discourse.
Health professionals have a tendency to talk to themselves.
What consequences has the management of the pandemic had on the world of medicine?
We discovered the bankruptcy of the public hospital.
Regional Health Agencies have been heavily singled out.
But if the administration has its faults, those who killed the public hospital are often certain doctors themselves!
For example, healthcare teams often want to leave because the management is bad and retrograde.
Battles to retain beds are usually internal power struggles where a mandarin's weight is measured by the number of beds in his service.
Because it must be said, France puts a lot of money into its health system and in particular for its hospital.
But the general logic of the system is to encourage the consumption of care.
Indeed, the total free associated with structures of care remunerated by the activity leads inexorably to consume a lot.
France is the OECD country where the inhabitants have the greatest propensity to consume care.
The French will have to rationalize their consumption of care.
Martin Blachier
To remedy this, the French will have to rationalize their consumption of care.
If you look at the figures, France is the OECD country where the inhabitants have the greatest propensity to consume care.
Why ?
If you are a freelance doctor, you earn your living according to the number of consultations and acts that you do in your office.
In the hospital, it is according to the number of stays that you bring money into your service.
Doctors therefore push for the consumption of care.
Not to mention that they have always been fiercely opposed to delegating some of the acts to other health professionals such as pharmacists, nurses or other paramedics.
But today, with the arrival of new complex and expensive therapies and the aging of the population, the State can no longer keep up.
If we do not want to completely lose the quality of care and its freeness, it is absolutely necessary that the politicians take up these issues by taking stock of the health crisis and by approaching the existing problems differently than with a checkbook and a opening of the numerus clausus.
Méga-gâchis
, Martin Blachier, editions of Cerf, March 2022, €18.00.
Editions du Cerf