Wed | Dec 7, 2016

Editorial: Health care in emergency room

Published:Saturday | November 29, 2014 | 12:00 AM

There are some hard choices to be made by the current administration about free health care. And the sooner the discussion begins, the quicker Jamaica can move towards achieving a resolution to the current untenable situation that exists in the public health-care system where user fees were abolished in 2008.

We are advocating an urgent review of the ?free? health-care system against the background of reports about a shambolic service where equipment is obsolete or malfunctioning, where facilities are stretched to the maximum and personnel find it difficult to cope with the growing demands for service, and patient waits run into many hours.

As if all those negatives are not stressful enough, this newspaper reported that a medical doctor serving in rural St Ann is appealing to the utility companies for relief from high water rates and electricity bills. The medic called on the private sector to do its part to boost the public-sector efforts to provide health care to citizens. Perhaps it is an opportune time to see how the private and public sectors can work together to address gaps in affordability and delivery of health care.

The truth is that without private-sector assistance, things would be much worse, particularly in areas of health and education. We cannot overlook the investment in research and development that has been made by the private sector. And were it not for private-sector input through various charitable foundations, organisations and persons of goodwill, who organise medical missions and donations, where would the health sector be today?

NEED TO FIND WORKABLE SOLUTION

The discussions need to be framed around the need to find a workable solution that will see the poor, uninsured Jamaican accessing dignified health care, and those who are insured and well-off paying for the services they need. Where governments provide free health care, such systems have to be financially sustainable. Free health care must rely on tax-funded public-sector resources. In Jamaica?s situation, the public spend on health, in real terms, has been steadily eroded over the last few years.

Politicians would perhaps like to perpetuate the myth of ?free? health care, but the quality and efficiency of the current system that obtains in the more than 30 public hospitals and clinics across the island are greatly compromised. A limited range of services is available, and simple medical tests cannot be done at many facilities because of a lack of equipment and supplies. Surgeries are often postponed for many months, even years. Sick people have died on hospital floors while waiting for attention. This is why the discussion is urgent and needs to be practical and dispassionate.

Sick people need health care. Sadly, many sick people cannot afford to pay for their health care, and have no health insurance. Many people cannot see a private doctor and will only seek help when there is a medical emergency. So routine maintenance like dental and vision care are largely ignored because of an absence of resources.

As the cost of medical care increases, the poor and uninsured will face a greater crisis in accessing care. And even healthy people who have private insurance will face hefty medical bills in the event that they get ill.

Policymakers need to engage in a national debate to explore the linkages between a healthy nation and a progressive one, while ensuring a safety net for the minority. A healthy Jamaican has the potential to become a wealthy Jamaican. There are clearly economic and cultural benefits from developing a clear, unequivocal health-care policy.