EDITORIAL: Be creative with health-care options
WE APPLAUD the Government generally, and the Ministry of Health in particular, for acting on the recognition that Barbados’ health-care system is in urgent need of an overhaul. Even more importantly, the Freundel Stuart administration must be given credit for scheduling a series of town hall meetings across the country to encourage dialogue with citizens at all levels.
It would be hard for anyone to argue that major reform is not absolutely necessary at this time – if not long overdue. Our health-care system has served us well for decades. In many ways it has offered Barbadians far more services, and of a higher quality, than many of our neighbours have been afforded.
But circumstances have changed dramatically. While we have been getting more, we have also been demanding even more; our ageing population has created a fresh set of demands and challenges; chronic non-communicable diseases now afflict a larger number of citizens spread across a much wider demographic – and in the face of it all the country’s capacity to pay has diminished.
It is a cocktail for collapse of the system if we don’t act urgently and decisively. The current roster of public meetings is therefore a step in the right direction, but we admonish those responsible to do everything possible to avoid us suffering from one of our greater afflictions in the management of our public affairs – talking much and doing little.
When all the talking is done we will have to be extremely creative in the exercise of formulation and implementation simply because it will be very hard to get Barbadians to accept any kind of roll back of the number, breadth or quality of services they have enjoyed so far – or even a denial of new services as they become available in our part of the world.
Against this background, we believe that a lot of serious thought will have to be given to the utility of shifting from the current direct funding of primary health care though the Queen Elizabeth Hospital (QEH), and ancillary services through polyclinics across the country, to indirect funding through a national health insurance scheme.
We believe there are enough major players in the local insurance sector to encourage a system of competitive bidding that could be the foundation for such a system. Additionally, there is enough evidence to suggest that the volume of wastage in our health-care system currently is higher that would be expected if all the players – patients, medical personnel, health administrators – were intimately aware in every instance what was the cost of the service they received.
There is also the very high probability that if insurance companies were the ones reimbursing the QEH for services rendered to their clients, for example, the costs associated with long waits that compound treatment would be more frontally addressed.
We also hold the position that where patients are aware of what it costs to treat them, and have available to them financial incentives (or disincentives) in the form of lower or higher premiums, they are less likely to engage in lifestyle habits that send them to the doctor for regular treatment as opposed to routinely scheduled preventive visits.
Such an approach can have a significant positive impact on our efforts to reduce the national pain of chronic non-communicable diseases.
We therefore admonish every Barbadian who is available to attend the meeting scheduled for their catchment area to do so – and participate constructively.