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EDITORIAL: High cost of free health care

BEA DOTTIN, [email protected]

EDITORIAL: High cost of free health care

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Minister of Health Donville Inniss recently boasted that Government had realised a $12 million reduction in the costs of the Barbados Drug Service without compromising the delivery and quality of health care.
He estimated that on the current trajectory, the Ministry of Health should spend about $25 million less this financial year, which ends in March, than last year. This is all well and good, but at what price to patients?
Two weeks ago the public was informed that a leading pharmacy in Barbados has closed two of its branches in light of the fact that more people seem to be going to the Queen Elizabeth Hospital Pharmacy to fill their prescriptions.
It is clear that if such a policy is impacting negatively on the traditional pharmacies which have serviced the population for many years, Government may be catching at the shadow and losing the bone.  
Granted, much of this cost reduction may have been the fact that Government this year discontinued the practice of paying user fees directly to the pharmacies for dispensing drugs and allowed them to collect the fees directly from the customer.
This seemed to have been confirmed by Minister Inniss as he reportedly said that the savings were as a result of people shifting from using private sector pharmacies to those in the public sector in an attempt to avoid payment of the dispensing fees to private pharmacies.
According to the minister, the result was a 31 per cent increase in the number of prescriptions filled by the public pharmacies. To even a disinterested observer this would lead to long-term increased cost to Government as there would be greater need for more pharmacists to meet the growing demand.
In addition, Government would have to purchase much more drugs to cope with increasing pressure on public pharmacies. So though there might be a short-term saving, the longer–term costs are likely to skyrocket.
If that is indeed so, then a vital component in the delivery of health care would be lost as more pharmacies are now under financial pressure and there is every likelihood that we would see further contraction in this sector, with the long-term pressure on the Drug Service.  
It is already being felt, for in 2010 there were 359,932 prescriptions filled at Government pharmacies compared with 433,866 for 2011. Unless there is significant enhancement of service and delivery, bottlenecks in service will ultimately follow.
The private pharmacies have served this country very well in the past and though the current move by Government may have been well-intentioned, if the result is their eventual elimination, then it will prove counter-productive.
If it were possible to identify a single issue that would have the most profoundly negative effect on the economic health of the country – it is health care services controlled and regulated by Government.