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15 years after The Death Of Mr Lăzărescu, Romania’s healthcare system is still ailing

18 August 2020

A touchstone of the Romanian New Wave, The Death of Mr Lăzărescu turns 15 this year. Director Cristi Piuiu’s film recounts, in real-time, the final hours of an ageing, impoverished man, complete with all the stylistic choices — handheld cameras, long takes, and semi-improvised dialogue — and thematic concerns that came to define the movement.

After being transported from one hospital to another, passed between doctors and facing moral judgements on his excessive drinking, Mr Lăzărescu eventually succumbs to his illness while waiting to be operated on. A disturbingly realistic depiction of a preventable tragedy, The Death of Mr Lăzărescu is a stark warning of the human costs of societal failures. But the events of 2020, as well as developments in Romania over the past decade, have shown how little the film’s warning was heeded — conspiring to make the movie resonate even more strongly today than it did back in 2005.

The Death of Mr Lăzărescu is a stark warning of the human costs of societal failures. But the events of 2020 have shown how little the film’s warning was heeded

With economical but effective characterisation, Puiu illustrates the personal flaws of the hospital workers who attend to Lăzărescu over the course of his late-night odyssey. There is a suggestion that many of these people are complicit in the protagonist’s eventual death, but it’s also clear that their occasional displays of callousness, pride, and indecision, wouldn’t have such tragic consequences, if the institution they’re part of wasn’t so over-stretched and under-funded. If an antagonist can be identified in The Death of Mr Lăzărescu, it’s most likely the Romanian healthcare service itself, or perhaps the forces that have left it in such a desperate state.

Early in the film, Lăzărescu hears a report on the radio about a major bus crash in the centre of Bucharest. This accident soon comes to play a pivotal role in the story, as the local hospitals he is taken to find themselves unable to cope with the numbers of injured victims. When it comes to making a decision as to whom to treat, the older man’s apparent alcoholism makes him less worthy than these younger, more innocent patients. But in the country’s capital, should an incident like this have overwhelmed facilities to such an extent, and forced this kind of choice upon its doctors? And if this was the impact of a traffic accident, how would the healthcare system cope with, say, a pandemic?

Around the same time that Puiu was demonstrating how much it was possible to achieve artistically with limited resources, along with Cristian Mungiu, Radu Muntean, and a handful of other Romanian filmmakers, the country itself was starting to see a major economic recovery. New foreign investment led to significant GDP growth and drastically reduced unemployment, with many economists Iabelling Romania “the Tiger of Eastern Europe”. In 2007, the year that Mungiu’s 4 Months, 3 Weeks, and 2 Days won the Palme d’Or at Cannes, confirming the Romanian New Wave as a cultural force to be reckoned with, the country’s accession to the European Union was finalised. Yet, ironically, this would prove to be a key factor preventing Romanian healthcare standards from improving any further.

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An estimated 43,000 doctors left the country over the course of the next decade, seeking better salaries and working conditions in the UK, France, and other more prosperous EU nations. The Eurozone crisis that came in the wake of 2008’s global recession accelerated this mass exodus, eventually leading to 26,000 doctor positions being unfilled nationally. Despite a recent effort to retain medical professionals by doubling wages across the sector, Romania has placed in the bottom four in the European Health Consumer Index, ranking EU member states every year from 2015 to 2019. According to the World Health Organisation’s 2019 rankings of national health systems by performance, the country is 99th in the world, behind Nauru and Benin.

Not everyone in Romania has had to suffer like Lăzărescu, however. Unofficially, those with means have always been able to circumvent the country’s supposedly egalitarian universal healthcare system in one way or another. A culture of bribing doctors for better care, dating back to Ceaușescu’s “Golden Age”, still clings on. And almost a decade on from a controversial proposal to fully privatise the health sector back in 2011, which led to large-scale protests and the eventual resignation of prime minister Emil Boc, less extreme reforms were introduced in early 2019. The private health insurance market has since been allowed to grow significantly, with a major increase in the numbers of mostly middle- and high-income people taking out private policies. For the rest of the country’s rapidly-ageing population, however, the prospects are bleak.

A still from The Death of Mr Lăzărescu

A still from The Death of Mr Lăzărescu

Recent figures show that Romania’s Covid-19 death rate per capita was just outside Europe’s top 10. It has perhaps not been struck with quite the same force as other nations, but its degraded health service has definitely struggled to cope. And in Romania, just as in the rest of the world, the pandemic has exposed some uncomfortable truths about who our institutions work for, and which people bear the brunt of their failures.

As socially relevant as his film might have been, Piuiu has denied any intent to make a political statement. This proved to be true of most of the other leading lights of the Romanian New Wave, and this strict adherence to objectivity has seen their status in the film world diminished over the past decade or so. But the impact of their earlier work is tough to deny. More than anything else, Piuiu and his contemporaries represented a search for a new sense of morality, austerely observing human behaviour to get at some deeper truth. Reacting against both the propaganda of the Communist era and the inhumane market logic of late capitalism, they suggested a type of filmmaking that could question its own role in perpetuating a social order, just as Europe’s neo-liberal consensus was starting to show signs of strain. Without providing any easy answers, the story of Mr Lăzărescu continues to serve as a reminder of how social status can determine every element of a person’s life, including their chances of survival.

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