I have already indicated in a previous column that the delivery of an acceptable level of health care is among the foremost priorities that should be addressed in this country. Within the health care system I have identified the introduction of national health insurance as one of the greatest urgencies and I will explain why I am of that view. Any country that considers itself developed and progressive has in place a regime of satisfactory health care services that is available to all its citizens. And Trinidad and Tobago is aspiring to developed country status.
Although we boast of public health services which are free to all, few will maintain that the services generally are of an acceptable standard or are timely in delivery or efficiently administered. There have been persistent reports that there is a shortage of medical personnel throughout the system, clinics are overwhelmed with patients, at times no specialist doctors e.g. neurosurgeons, are on staff at some institutions, drugs are not available, the medical equipment is outdated or non-functional and emergency surgeries cannot be performed.
One medical practitioner, Dr. Harry Singh, who is also a County Medical Officer of Health, stated in the press last: “In fact, patients continue to have long waiting times for most medical procedures and medical specialties because of limited operating time, inadequate specialists to manage the large patient load at institutions, and inadequate available resources at institutions to facilitate efficient health care delivery.” Another doctor, Dr. Budhooram, has complained thus: “Imagine waiting six weeks for a CT (computer assisted tomography) and MRI (magnetic resonance imaging) report long after the patient has been operated on. What a financial waste.”
Given the above realities, many patients, even those of limited means, are forced to seek medical services at private health institutions at enormous cost. The estimate for a CT scan can range from $2,000 to $6,000, or an MRI from $3,000 to $8,000. Blood, urine and bone analysis can easily come up to $2,000 or $3,000. Doctors’ fees can vary from $200 per visit to $700, and drugs, not available in the public health care system, can cost between $1.00 and $100 per tablet depending on the type prescribed. And of course if surgery is required the financial outlay can be astronomical. Surgeons have been known to charge $25,000 for minor surgery and up to $200,000 for major surgery. This is exclusive of the cost of stay at the private medical institution and the medication administered there.
The family of one former Chief Justice has recently bemoaned the inability of this distinguished public servant to meet his medical expenses and the need to put himself at the mercy of governmental charity. But in any self-respecting society this eventuality should not occur, and under a system of national health insurance it would not. In view of the current deficiencies of the public health care system and the necessity to resort to the services of private health institutions, many middle and even upper income families have been pauperised. Family savings have been depleted and resort has had to be made to loans and charity to meet health care costs. If a family has a total income of $10,000 per month, it will be severely financially challenged if any member gets seriously ill. And if the family income is $5,000 or less, it certainly marks a descent into destitution.
The scenarios I have outlined above are not an exaggeration, the truth of which could be verified by appropriate surveys focusing on the financial and emotional distress occasioned by acute or prolonged illness of one or more member of a family. And since the health and wellness of a loved one are an emotive issue, the vulnerability of families can easily be exploited by those in a position to do so, whether they are medical practitioners or owners and managers of private health institutions. They operate on the assumption that the money to meet medical costs is certain to be raised by families and friends through whatever means possible because they find themselves in desperate straits, especially if a life may be in danger or if a procedure will not be commenced without an advance payment. I am not implying that all practitioners and institutions are thus motivated but the reality is that many are. For many the practice of medicine and provision of medical services are a business.
There has been a great deal of promotion of the establishment of the Children’s Life Fund and the benefits to be derived from its operation. Some members of the Government have been in fulsome and glowing praise of the initiative. And indeed it is laudable venture.
(To be continued)
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