The costs of financing education and primary health care are major issues for modern Barbados racked by the realities of an economic tightrope, along which the relevant ministers and their colleagues in Cabinet have to walk.
Obviously it requires balance of a high order, for unless we fine-tune the mechanism for financing these social needs, we may create social havoc among the vulnerable of us who cannot but rely on state-funded assistance to have access to tertiary level education and primary health care.
The issue arose recently when acting Minister of Health Donville Inniss suggested that private sector ideas would be useful additions to the debate. Even more to the point, chief executive officer of the Queen Elizabeth Hospital Dr Dexter James, has questioned the effectiveness of the present method of financing health care in our country.
The current method of financing it through the general revenues may have to be modified, with a larger direct input from those who seek such care.
Of course, the problem of implementing change of any kind which calls for direct payments by patients is that those at the bottom of the economic ladder may experience great difficulty in securing health care; and the problem is exacerbated if the service is required for an emergency situation.
The experience with the University of the West Indies is a classic case in point, for education, which has long been regarded as the ladder of upward social mobility, seems to have been adversely affected, mostly for those whose families are still struggling to escape the quicksand of poverty.
A country at our stage of social development, which has not yet eliminated some of the more persistent potholes of poverty, cannot afford a full-scale plan in which every family funds its own health care, for many can neither fund their tertiary level education costs nor their own health care. It would be a heartless country which allowed some citizens to fall through the cracks without having in place a proper safety net.
As far as tertiary education is concerned, the announcement of bursaries is meant to be some sort of safety net for the vulnerable; and this is to be commended. However, what must now be done is a structured method by which the bursaries are processed and drawn down by the students. It may not be perfect, but at least it would show where we are headed and how.
Coming up with a plan to finance health care which does not disadvantage the poor will obviously require much more thought. The numbers are larger for a start, and we have an increasing older population whose medical care needs will cost more than those of their younger relatives.
The time has passed when people could feel that they had some entitlement to largesse of the Government’s finances. The task now is to come up with plans which recognise the paradigm shift in financing education and health costs. But we must always bear in mind those who are still too poor to carry their share of the costs.
We cannot afford to leave them behind!
