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'Free' health-care nightmare
Published: Monday | November 30, 2009
Garth Rattray
It was my opinion that the 'free' health care promised during the Jamaica Labour Party 2007 election campaign was predominantly politicking. No user fees - "unrestricted access to basic health services including primary health care, emergency services, out-patient treatment, diagnostic procedures, surgical operations, hospitalisation, dialysis, radiological services and in-patient medication and supplies" - devoid of requisite financing and medical infrastructure - were bound to have extremely serious consequences.
User fees contributed about 11 per cent to public health care. For 2006/07 they generated $1.7 billion, even though many never paid, and 22.2 per cent of people didn't seek help because (they thought that) they couldn't afford it. The new no-user-fee policy wooed the electorate but stopped any income from that source - an astute political move (given the relatively small income that was collected from user-fees) but a medical nightmare (given the unprecedented rush on our lamentable public-health sector).
No-user-fee promise
The manifesto categorically promised, under "Our Pledge" that the no-user-fee health-care policy would have concomitant improvement of our primary and other health-care facilities, expansion of the emergency medical services, the pursuance of exciting opportunities in health tourism, telemedicine technologies, availability of medical personnel, more intensive public-health management, and centres of excellence among several others. None has materialised.
Recently, an 80-year-old patient of mine was sent home with a haemoglobin of around five Gm/dl (less than half the accepted value) because a major public hospital had no blood-giving drip set to transfuse her. Her frail heart is working overtime, pounding and racing in a futile attempt at using her watered-down blood to keep her alive.
Our primary birthing centre is still stacking pregnant women and mothers two to a bed, and one patient of mine reported seeing a woman give birth while in a wheelchair - her baby literally flew out and bounced off the floor. Where is the promised upgrading and improving of the existing public health-care facilities?
Now, this administration, severely burdened by the reality of a buckling health-care system, is quietly going back on its "no-user-fee" policy by stating that patients in possession of health insurance who access the public system will (perhaps soon) be required to tender them. However, the insurance companies might protest because no user-fees mean no user-fees from anyone. A policy decision to use health insurance to access 'free' health care will single out the health insurance companies, and force them to join taxpayers and the National Health Fund in financing the 'free' health-care system.
Social safety nets
We have been told repeatedly that the social safety nets will not be abandoned. However, as far as I know, we always had social safety nets in Jamaica. Generally, our public health-care system already had a no-user-fee policy for those who could not afford to pay. No one was turned away from any government-run health-care facility. Anyone could access basic health-care without paying, if they were flat broke; and children whose parents could not afford school fees could make arrangements with the public schools for assistance.
It was stated that the announcement of widespread 'freeness' in the health-care sector was to alleviate the suffering of the poor, but it has opened the flood gates and caused oversubscribing of a horribly inadequate system - now, people are still suffering as a result of this political decision (it certainly wasn't a medical one).
Clinging obstinately to this health-care nightmare is overtaxing health-care workers, endangering lives, causing inadequate medical care, long lines at public pharmacies and unpaid, frustrated suppliers. The Government should have continued the pre-existing unwritten policy of allowing those who can afford to pay something to do so, and concentrate on improving the decrepit services.
Garth A. Rattray is a medical doctor with a family practice. Feedback may be sent to garthrattray@gmail.com or columns@gleanerjm.com
'Free' health-care nightmare
Published: Monday | November 30, 2009
Garth Rattray
It was my opinion that the 'free' health care promised during the Jamaica Labour Party 2007 election campaign was predominantly politicking. No user fees - "unrestricted access to basic health services including primary health care, emergency services, out-patient treatment, diagnostic procedures, surgical operations, hospitalisation, dialysis, radiological services and in-patient medication and supplies" - devoid of requisite financing and medical infrastructure - were bound to have extremely serious consequences.
User fees contributed about 11 per cent to public health care. For 2006/07 they generated $1.7 billion, even though many never paid, and 22.2 per cent of people didn't seek help because (they thought that) they couldn't afford it. The new no-user-fee policy wooed the electorate but stopped any income from that source - an astute political move (given the relatively small income that was collected from user-fees) but a medical nightmare (given the unprecedented rush on our lamentable public-health sector).
No-user-fee promise
The manifesto categorically promised, under "Our Pledge" that the no-user-fee health-care policy would have concomitant improvement of our primary and other health-care facilities, expansion of the emergency medical services, the pursuance of exciting opportunities in health tourism, telemedicine technologies, availability of medical personnel, more intensive public-health management, and centres of excellence among several others. None has materialised.
Recently, an 80-year-old patient of mine was sent home with a haemoglobin of around five Gm/dl (less than half the accepted value) because a major public hospital had no blood-giving drip set to transfuse her. Her frail heart is working overtime, pounding and racing in a futile attempt at using her watered-down blood to keep her alive.
Our primary birthing centre is still stacking pregnant women and mothers two to a bed, and one patient of mine reported seeing a woman give birth while in a wheelchair - her baby literally flew out and bounced off the floor. Where is the promised upgrading and improving of the existing public health-care facilities?
Now, this administration, severely burdened by the reality of a buckling health-care system, is quietly going back on its "no-user-fee" policy by stating that patients in possession of health insurance who access the public system will (perhaps soon) be required to tender them. However, the insurance companies might protest because no user-fees mean no user-fees from anyone. A policy decision to use health insurance to access 'free' health care will single out the health insurance companies, and force them to join taxpayers and the National Health Fund in financing the 'free' health-care system.
Social safety nets
We have been told repeatedly that the social safety nets will not be abandoned. However, as far as I know, we always had social safety nets in Jamaica. Generally, our public health-care system already had a no-user-fee policy for those who could not afford to pay. No one was turned away from any government-run health-care facility. Anyone could access basic health-care without paying, if they were flat broke; and children whose parents could not afford school fees could make arrangements with the public schools for assistance.
It was stated that the announcement of widespread 'freeness' in the health-care sector was to alleviate the suffering of the poor, but it has opened the flood gates and caused oversubscribing of a horribly inadequate system - now, people are still suffering as a result of this political decision (it certainly wasn't a medical one).
Clinging obstinately to this health-care nightmare is overtaxing health-care workers, endangering lives, causing inadequate medical care, long lines at public pharmacies and unpaid, frustrated suppliers. The Government should have continued the pre-existing unwritten policy of allowing those who can afford to pay something to do so, and concentrate on improving the decrepit services.
Garth A. Rattray is a medical doctor with a family practice. Feedback may be sent to garthrattray@gmail.com or columns@gleanerjm.com
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