Healthcare has been hijacked by corporations.

Much has been said and written about the weaknesses of the current Minister of Health, Ana Paula Martins. It has been repeatedly stated that the problems in healthcare are structural, stem from the past, and cannot be solved solely with money, but also with good management and greater efficiency. But we rarely look at another dimension of this problem: the sector's corporations that prevent any kind of reform and always emerge unscathed from any crisis, any death. No one ever resigns from those responsible. Why is that?

The Público newspaper reported this week that a group of over 1,000 temporary doctors is preparing to paralyze the emergency services of the National Health Service. The headline is exactly that, blunt and direct. The reason for such a threat is related to the Government's intention to regulate the hiring of temporary doctors and reduce the hourly rate they are currently paid.

Now, doctors working on a freelance basis can receive between 20 and 61 euros per hour, depending on their specialty and the hospital where they work. This means that, in a 24-hour shift, they can take home 1,464 euros. To achieve maximum tax efficiency, many of these doctors have formed companies, some as sole proprietors, others by bringing together several professionals who respond to the needs of various hospitals.

When we question where the money we put into healthcare every year is being spent – ​​and that's almost 18 billion euros a year – part of the answer lies here: according to Sábado magazine, by August of this year the State had already spent 230 million euros on temporary workers. One company alone billed something like 56 million euros in the last 16 years.

Of course, these temporary workers are not happy with the Government's decision. How could they be? The Government is preparing to ruin their business. Therefore, they threaten, "without fear or hesitation," to paralyze the country's emergency services because they feel, poor things, "ostracized" and "excluded from decisions." Besides this decision being of questionable legality – since when can a company go on strike? – these doctors who took the Hippocratic Oath seem to not care about the human lives that may be lost. As long as they are not the ones who lose money.

While those working on temporary contracts are blackmailing the State at the expense of people's health, the president of the National Federation of Doctors, Joana Bordalo e Sá, is on television shouting that healthcare is not a business. This is the same Joana Bordalo e Sá who also makes threats and blackmails if the Government goes ahead with the centralization of emergency services, forcing doctors, poor things, to travel up to 25 kilometers to provide services in other hospitals.

The monster, in reality, was created by the State itself. In the case of temporary workers, it began with José Sócrates and grew gigantic over the years, to the point that, at this moment, the National Health Service is completely dependent on temporary doctors to function. Not only has no Minister of Health managed to stop this runaway train of misguided incentives, but, on the contrary, they have all been feeding it with more and more money to survive in office and try to buy some social peace. The result is clear: doctors preferred to leave the State's payroll, created companies to pay less taxes, and now have the State in their hands.

This capture of healthcare, not by private entities – as left-wing parties like to claim – but by the healthcare professionals themselves, is far more profound and dramatic. As long as the State does not end the power of the Medical Association in determining the number of positions for various specialties and does not have the courage to confront this small but significant power head-on, no problem will be solved by simply throwing money around.

Does Ana Paula Martins currently have the political authority to confront these corporations? She has less and less. But if she wants to leave a mark on the portfolio she holds, here are two good examples of health reforms that could, in the medium term, solve many of the problems we face today. She's more politically damaged than she already is, and that would be difficult. And it would be a fitting farewell to the government.