{"id":403350,"date":"2026-09-01T12:38:56","date_gmt":"2026-09-01T10:38:56","guid":{"rendered":"https:\/\/communia.de\/project\/health-as-a-commons\/"},"modified":"2026-09-17T22:57:45","modified_gmt":"2026-09-17T20:57:45","slug":"health-as-a-commons","status":"publish","type":"project","link":"https:\/\/communia.de\/en\/project\/health-as-a-commons\/","title":{"rendered":"Health as a commons"},"content":{"rendered":"

[et_pb_section fb_built=”1″ custom_padding_last_edited=”on|tablet” admin_label=”Zitat” _builder_version=”4.27.8″ _module_preset=”default” background_color=”#F0F0F0″ positioning=”none” overflow-x=”hidden” overflow-y=”hidden” custom_margin=”||||false|false” custom_margin_tablet=”||||false|false” custom_margin_phone=”||||false|false” custom_margin_last_edited=”on|tablet” custom_padding=”41px||41px||true|false” custom_padding_tablet=”150px||150px||true|false” custom_padding_phone=”60px||60px||true|false” hover_enabled=”0″ collapsed=”off” global_colors_info=”{}” sticky_enabled=”0″][et_pb_row admin_label=”Quote” _builder_version=”4.27.8″ _module_preset=”default” width=”90%” max_width=”1170px” custom_padding=”70px||70px||true|false” hover_enabled=”0″ global_colors_info=”{}” custom_padding_last_edited=”on|phone” sticky_enabled=”0″ custom_padding_phone=”40px||40px||true|false” custom_padding_tablet=”70px||70px||true|false”][et_pb_column type=”4_4″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_text admin_label=”Zitat” _builder_version=”4.27.8″ _module_preset=”default” text_font=”|700|||||||” text_text_color=”#172938″ text_font_size=”30px” text_line_height=”140%” text_orientation=”center” max_width=”825px” max_width_tablet=”600px” max_width_phone=”600px” max_width_last_edited=”on|tablet” module_alignment=”center” text_font_size_tablet=”26px” text_font_size_phone=”22px” text_font_size_last_edited=”on|tablet” global_colors_info=”{}”]<\/p>\n

Health as a commons: care for everyone<\/strong><\/h1>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row admin_label=”Intro” _builder_version=”4.27.6″ _module_preset=”default” width=”90%” max_width=”1170px” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][et_pb_text admin_label=”Intro” _builder_version=”4.27.8″ _module_preset=”default” text_font=”||||||||” text_text_color=”#172938″ text_line_height=”1.6em” max_width=”900px” max_width_tablet=”600px” max_width_phone=”600px” max_width_last_edited=”on|tablet” module_alignment=”center” text_font_size_tablet=”26px” text_font_size_phone=”22px” text_font_size_last_edited=”on|tablet” global_colors_info=”{}”]<\/p>\n

The German health system is at a turning point, and all of us are feeling it more and more.<\/strong> Whether it is hospital closures, the chronic shortage of nursing staff or hedge-fund investment in medical practices: the economization of health care has left behind structures that fundamentally contradict its stated goal of good care for everyone. Nurses and doctors keep the system running through personal commitment; relatives take on unpaid care work that overwhelms them. At the same time, health is the field in which society\u2019s readiness for structural change has grown the most. communia is entering this field not with yet another reform proposal, but with the ambition of developing a model for health as a commons: one in which good care has top priority, in which the wellbeing of patients, relatives and workers is the highest goal \u2014 and in which health is no longer treated as a commodity.<\/p>\n

<\/p>\n

So far the health policy debate has been shaped by narrow technical politics and short-term reform compromises that mainly mediate between particular interests.<\/strong> communia counters this with a different starting point \u2014 health care shaped by those who need it, carry it and know it: patients, nursing staff, doctors and municipalities.<\/p>\n

<\/p>\n

To that end we are producing comprehensive analyses of how the marketization of the health sector \u2014 from the case-based payment system through private hospital groups to the health insurance funds \u2014 can be structurally redesigned. We are also deepening our cooperation with local actors such as the Poliklinik Syndikat, supporting the development of tangible and directly transferable real-world laboratories for democratic health care. We develop starting points in the here and now \u2014 in the dynamic trade-union movements, in municipalities and in the broader political debate.<\/p>\n

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Current studies and publications<\/strong><\/h2>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ make_equal=”on” _builder_version=”4.27.6″ _module_preset=”default” width=”90%” max_width=”1170px” animation_style=”slide” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_blurb title=”Concept paper: Health as a commons” url=”https:\/\/communia.de\/wp-content\/uploads\/Gemeingut_Gesundheit_RZ_Ansichtsdatei.pdf” url_new_window=”on” image=”https:\/\/communia.de\/wp-content\/uploads\/Gemeingut_Gesundheit_RZ_Ansichtsdatei-pdf.jpg” _builder_version=”4.27.8″ _module_preset=”693327c9-5893-415a-ad5d-76bc4e454b25″ header_level=”h3″ link_option_url=”https:\/\/communia.de\/wp-content\/uploads\/Gemeingut_Gesundheit_RZ_Ansichtsdatei.pdf” link_option_url_new_window=”on” global_colors_info=”{}”]<\/p>\n

The concept paper designs an outpatient health care system oriented towards the common good rather than towards returns. At its core are primary care centers (Prim\u00e4rversorgungszentren, PVZ) that bring general medicine, psychotherapy, community health nursing and social work together interprofessionally under one roof, do neighbourhood work and research their own care mandate participatively. As their institutional form we propose municipal public-law institutions (Anstalten \u00f6ffentlichen Rechts) called \u201cGemeingut Gesundheit\u201d: formally in public ownership, democratically administered by employees, patients, the municipality and the public health service \u2014 and thereby structurally protected against re-privatization. A joint paper by communia and the Poliklinik Syndikat, July 2026.<\/p>\n

<\/p>\n

Read the concept paper<\/a> (in German)<\/p>\n

[\/et_pb_blurb][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.27.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_blurb title=”Partner: Poliklinik Syndikat e.\u202fV.” url=”https:\/\/www.poliklinik-syndikat.org” url_new_window=”on” _builder_version=”4.27.8″ _module_preset=”693327c9-5893-415a-ad5d-76bc4e454b25″ header_level=”h3″ link_option_url=”https:\/\/www.poliklinik-syndikat.org” link_option_url_new_window=”on” global_colors_info=”{}”]<\/p>\n

Poliklinik Syndikat e. V. brings together projects that build and run solidarity-based, interprofessional health centers across Germany \u2014 among them the Poliklinik Veddel in Hamburg and the Stadtteil-Gesundheitszentrum Neuk\u00f6lln in Berlin. They are the practice that \u201cGemeingut Gesundheit\u201d builds on: several years of experience with interprofessional care, community organizing and participatory needs assessment in the neighbourhood.<\/p>\n

<\/p>\n

Visit the Poliklinik Syndikat<\/a><\/p>\n

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What does that look like in practice?<\/strong><\/h2>\n

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Fig. 1 \u2013 Structural model of a primary care center (PVZ).<\/strong> General medicine, psychotherapy, social work and community health nursing under one roof, complemented by a community room, childcare and outreach work in the neighbourhood.<\/p>\n

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Fig. 2 \u2013 Governance of the \u201cGemeingut Gesundheit\u201d public-law institution.<\/strong> The administrative board is filled in equal parts by the municipality, the public health service, the joint employees\u2019 council, the joint patients\u2019 council and the health conference.<\/p>\n

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Luise Butzer<\/a>, Vincent Janz<\/a> and Lukas Warning<\/a><\/p>\n

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since 2026<\/p>\n

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Health as a commons: care for everyoneThe German health system is at a turning point, and all of us are feeling it more and more. 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