HAVING TOLD THE COUNTRY during the last election that the water in the privatisation well was poisoned, the Freundel Stuart administration must now come up with new ways of saying it really wasn’t.
The effort this requires has delayed the inevitable move to more privatisation of the vast array of services still being carried out by a Government, which has taken deficit spending out into deep unchartered waters and is desperately trying to find its way back to shore.
Nobody is feeling the pain more than the Minister of Health John Boyce, whose portfolio, along with education, eats up most of the revenue and loans that the Government takes in or has to find every year.
So, after hinting at it at least once before (that I remember) the Minister of Health said again last week that we as a country must talk about how to pay for health care, and there was the clear hint that the citizen will have to pay more toward services currently funded by the Government, at least for treatment of non-communicable diseases (NCDs).
(Full disclosure: I, too, am on the bandwagon. My prescription for hypertension, which, I’m told, would normally cost me over $80 per month; currently costs me only about $20, thanks to Government subsidies).
Now, that is only my interpretation. But in a world where obfuscation drives almost all present Government pronouncements, it is incumbent upon us all to find some sort of path of meaning through the mountain of words thrown at any one subject.
So the rationale put forward by Boyce last week for taking to the public the urgent topic of “who will pay for health care?” had to be couched in stats that show clearly that if we don’t look after ourselves, we must help pay the price. In short, NCDs to the rescue.
The statistics, to be sure, are paradigm-shifting, as the Minister of Health said. Speaking at a function held at the Savannah Hotel to receive his official copy of the Strategic Plan For The Prevention And Control Of Non-Communicable Diseases 2015-2019 from chairman of the National NCD Commission, Professor Sir Trevor Hassell, Boyce quoted some startling percentages from the report of the chief medical officer.
He revealed that the leading causes of sickness and death in Barbados in the last ten years were stroke, heart disease, diabetes mellitus and cancer. And here’s another chilling statistic: eight per cent of non-maternal health and non-child health visits at polyclinics were due to NCDs.
This, said Boyce, represented what he termed a paradigm shift in the medical profile of Barbados from the 1960s, when all we had to worry about was poor sanitation, malnutrition and those quaint communicable diseases. Those were the leading contributors to ill health and death back then.
Today, the picture has changed, he said, noting that 25 per cent of all Barbadians have at least one non-communicable disease and a similar percentage is at risk of developing one. This equates to 140 000 Barbadians either having, or at risk of developing, an NCD in the near future, Boyce stated.
The statistics further revealed that 65 per cent of the population was overweight or obese, with women twice more likely to fall into this category than men. According to the Health Of The Nation Study 2012, 18 per cent of the population has diabetes mellitus and 25 per cent has hypertension.
According to the World Health Organisation, diseases that fall into the NCD category are brought on in part by unhealthy lifestyles.
For instance, it notes, “unhealthy diets may show up in individuals as raised blood pressure, increased blood glucose, elevated blood lipids, and obesity. These are called ‘intermediate risk factors’, which can lead to cardiovascular disease, an NCD.”
Besides those unhealthy diets, says the WHO, other “modifiable behavioural risk factors” – in other words, things we can do something about – which increase the risk of NCDs include tobacco use, physical inactivity, and the harmful use of alcohol.
I am all for Boyce and his effort to get the Cabinet to approve this national debate, and I agree wholeheartedly that we have to get the private sector involved and make citizens take more responsibility for health factors they can do something about.
At the end of the day, the consumer of health services is going to have to pay some sort of fee for the largesse of the state – through some form of medical insurance run by the state. You know, like Obamacare.
But while I accept that a lot of the increasing cost of health care is due to the rise of NCDs in the population, I get the feeling that the NCDs are being used as the rationale for saying we must start paying for health care.
Boyce should not tiptoe around an issue which has been building ever since then Prime Minister Tom Adams failed to get a national health system going, way back in the mid-1980s.
We should be open to all solutions and engage in a really useful national debate that will lead to some bold policy moves, “bolting on” (as my LIME rep likes to say) allowances or exemptions for those unable to pay. That way, the strong help pay for the weak. That is the whole point of insurance, isn’t it?