THERE IS no question that we have achieved a lot in primary health care and also in secondary and tertiary health care. The big danger to countries like ours is debt ... that increasing debt is affecting our ability to provide social services, not only health, but especially education, and therefore that essential investment that is needed for human resources and human capital to develop is also being seriously compromised. It is affecting our ability to develop properly and to sustain our wealth. As a matter of fact, even when we train people and have people qualified (but) we have difficulty in keeping them in our country.
My concern is the question of how health care is organised for the efficient delivery of health care, how we spend the money we have and how to improve the inflows of revenue into the health services.
QUICK STUDY
I have in fact done a quick study comparing about 10 countries. I selected 10 countries quite randomly, as to what the product of their input is, their investment in health. I ranked them in order of the outcomes, in terms of longevity, and the healthy lives that they enjoy. In the second aspect, I ranked them in terms of the survival of pregnant mothers (and) infants. The rankings were: Canada 1; U.K. 2; Cuba 3; Costa Rica 4; Chile 5; Barbados 6; Jamaica 7; St. Lucia 8; Mauritius, 9 and Trinidad and Tobago 10. When we know look at the relationship to the amount of money spent on health care on those countries, one can see that there is a very strong correlation. That Canada that spends US$2,163 per capita is Number 1. United Kingdom second, with US$1,835. Cuba is third in terms of the outcomes, but Cuba spends only US$185 per person. Costa Rica (spends) US$293 per person; Chile US$303, Barbados US$613, ranking number sixth. Jamaica US$191 per person per year ranking number seven and Trinidad and Tobago ranking number ten with $279. The importance of that is that there are some countries that spend, like Cuba, spend relatively very little money on health care but because of the level of organisation and the efficiency of the level of health care they have better results than most countries.
Another criteria looking at the ranking is out-of-pocket expenditure. We found that where out-of-pocket expenditure was a small proportion of the money spent on health, then health care was better, their outcome was better and where there was a lot of out-of-pocket expenditure on health, the outcome was poorer. So (in) the countries that had organised funding, organised health care...either coming through Government, through health insurance schemes or through social security schemes, those countries were far better off than those countries that depended on people spending money when they are sick, out-of-pocket expenditure. The National Health Fund, the NI Gold, JADEP (which are) all efforts to put in organised funding of health care through prepaid scheme (are) commendable efforts, but I believe that we don?t have the courage to go the full way. I think that may not be feasible right now, but the policy should be in place so that as we improve in terms of levels of employment and better incomes, people can purchase, can buy into prepaid health schemes. I believe that we can amalgamate these factors and put them together to come up with a better scheme.
Dr. Kenneth Baugh, opposition leader and spokesman on health
