ONE OF THE BIGGEST MYTHS in Barbados is that health care is overwhelmingly delivered by the public sector. To comprehensively reject or accept the myth would require a scientific survey that is costly. In the absence of such a survey, we used the telephone directory to identify that the total number of physicians is just over 250. According to another more reliable source, this figure is in excess of 300 when interns in the public service are accounted for.
On a daily basis, a substantial number of Barbadians utilise the services of private physicians. These services can be had for the head to the feet. The demand for these private services varies seasonally predominantly with respect to weather conditions that can influence the prevalence of water-borne and airborne diseases.
Unlike educational services which are much easier to plan for, health care services are much less predictable. From year to year the physical size of an educational institution hardly changes. The institution’s enrolment may vary but not considerably. This is why it was always difficult to understand how the Government could suggest that the enrolment at the University of the West Indies came as a surprise. In fact, I am sure that the university received slightly more than its budgetary request in the fiscal year 2007/2008.
The fact is that expenditure on education is far easier to plan for. The demand for educational services does not change dramatically in the short term. And given that the supply is demand determined, surprises ought to be minor, if at all.
In the case of health care, it is not easy to predict the demand for services. Furthermore, it is even more difficult to determine the nature of the services. As a consequence, the yearly expenditure on health care is far more difficult to determine.
On the supply side of health care, technological progress is ever changing. The cost of delivery reflects the progress if the sector keeps abreast of the technology. Unlike education, both the demand and supply side changes can influence expenditure on health in the short and medium/long term.
In the absence of a costly survey, it is still possible to argue that the private side of the health care sector is ahead of the public side in keeping up with the technological progress as measured in the human capital. As a consequence, it should surprise no one that Barbadians go in large numbers to private physicians, given the way they value health care.
Virtual monopoly
It is easy to believe that hospitalisation is health care, in which case the public sector has a virtual monopoly. The service is perceived to be “free” to the user but it is paid for by the taxpayers. The real issue is not who pays for the service, but rather how the service is managed and supplied.
The notion that asking Barbadians to pay for the full cost of health care will resolve the country’s fiscal problem is economic madness. It fails to understand that the money in the economy will simply be reallocated. This means that other areas in the economy will be deprived.
Such a policy will not cause wealth creation in the economy, which is the only way to tackle the country’s current woes. The last time it was believed that a fixed amount of wealth could lead to economic growth and development was during the mercantilist period, well over 300 years ago.
It is therefore shocking that a 21st century Government in Barbados would seek to suppress consumption as a way of creating wealth. The belief that a foreign investor in the hotel sector could be singled out for special treatment long before domestic investors imitates the sentiments of a mercantile system.
The truth is that Barbados has been taken down a backward road by a Government that is now fully prepared to come to push Independence in the faces of Barbadians. It represents the highest order of contradiction. After making access to fundamental social services more difficult over the last eight years, it is illogical and inconsistent to use Independence as a symbol of progress. In fact, there is a self-inflicted irony in trying to do so.
Who would have thought that a country which punched above its weight in its younger days would be struggling to provide basic social needs at 50? Furthermore, at 42 it was alive and still kicking with its lowest unemployment rate, more than adequate foreign reserves and a debt profile, though high, that was much more manageable.
Dr Clyde Mascoll is an economist and Opposition Barbados Labour Party adviser on the economy. Email: [email protected]
