Devon Dick | Bruce Golding vindicated
Recently, 2019 Nobel Prize winners in economics, Abhijit Banerjee, Esther Duflo and Michael Kremer, studied global poverty. Among their findings was that providing free healthcare to the general population makes a significant difference. For example, in one location, only 18 per cent of parents gave their children deworming pills for parasitic infections when they had to pay for them even though the heavily subsidised price was less than US$1. But, 75 per cent gave their kids the pills when the pills were free ( Gleaner, October 15). As a result, The World Health Organization recommends that medicine be distributed free in areas with high rates of parasitic worm infections.
Additionally, these erudite economists gleaned that mobile vaccination clinics in India dramatically increased the immunisation rates compared to traditional static health centres. That is not rocket science.
In 2008, former Prime Minister Bruce Golding implemented a no-user-fee policy applicable to all public health facilities. This policy known as ‘free healthcare’ meant that Jamaicans no longer had to pay for consultations with doctors, diagnostic services, hospital admissions, surgeries, medications, physiotherapy, ambulance, maternal services, etc. Some saw the free healthcare as an election gimmick to win votes. Now, eminent economists have conclusively discovered that free healthcare makes a significant difference. This means Bruce Golding has been vindicated.
The Nobel Prize winners engaged in rigorous research. They revolutionised developmental economics by pioneering field experiments that generated practical insights into how people, who are poor, respond to educational and healthcare programmes which were meant to uplift them out of poverty. These economists were not armchair theorists, but they spent time with persons who were poor to ascertain why and how they make their choices.
This research conducted by Diether Beuermann and Camilo Pecha Garzon confirmed work done by others, including the 2017 IDB working paper which examined the impact of free healthcare on health status and labour supply in Jamaica. The study found that the free healthcare policy reduced both the likelihood of suffering illnesses with associated lost workdays and the number of lost days due to ill health by 28.6 per cent and 34 per cent, respectively. This positive effect of free universal public healthcare for persons without health insurance is not unique to Jamaica. By 2013, around 30 countries had implemented this policy, which has helped overall health status and labour market productivity.
Free health in Jamaica meant that the 32 per cent of the population in the lower-income bracket, who said they did not go to a doctor when unwell because they could not afford the visit, could now go. Access was offered to more Jamaicans.
The Noble Prize winners also debunked certain theories. For example, their work in rural Kenya and India found that providing more textbooks, school meals and teachers didn’t do much to help students learn more. However, making the schoolwork more relevant to students, working closely with neediest students and holding teachers accountable through short-term contracts were more effective where teachers often miss classes. It would be good to hear what the government and Jamaica Teachers’ Association think about these findings.
In addition, a study is needed on the impact of the Michael Manley initiative of free education in the 1970s on access to higher education and productivity. Jamaica needs more rigorous research to inform our policy decisions.
It was the same Bruce Golding who, as prime minister, once said every time Jamaicans who are poor get a benefit there are those who decry the move. So, large companies get bailout and tax holidays but when a small man gets a waiver, it distorts the market.
While we may not be able to give free healthcare that is of the highest standard, we should endeavour to provide healthcare that is affordable, accessible, adequate and available to all Jamaicans.
Rev Devon Dick is pastor of the Boulevard Baptist Church in St Andrew. He is author of ‘The Cross and the Machete’, and ‘Rebellion to Riot’. Send feedback to firstname.lastname@example.org