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Tennyson Joseph, [email protected]


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THE RECENTLY reported policy prescription by Dr Carlos Chase, president of the Barbados Association of Medical Practitioners (BAMP), that heath care should be fully privatised and “run like a hotel”, is a classic indication of the naïve understanding of public policy that now defines the post-colonial generation, who reduce good governance to “economic efficiency”. It is naïve since it appears unable to understand the wider social and political implications of its underlying assumptions, nor its political source.

Its naiveté is also seen in the “surprise” expressed by BAMP that its “innocent” policy prescription would have been so thoroughly rejected by the more progressive elements in society such as attorney at law David Comissiong. Thus, following Mr Comissiong’s reminder of the social history behind “free health care”, the BAMP responded by reducing his concerns to a “a racial issue”, and insisted that the topic “requires clarity, soberness of thought and must not be reduced to emotional outbursts unworthy of the gravity of the issue”.

Missing in the BAMP’s prescription is a historical understanding of the intellectual, economic and political conjuncture of forces which has made its call for privatisation “reasonable”, “sober”, “clear” and devoid of class and other biases, and which conversely, has made Mr Comissiong guilty of the opposite. No policy is value free. Indeed, BAMP may wish to explain why the Moyne Commission, in the dying days of colonialism, would have insisted upon public provision of health care and would have never seen the health sector as analogous to the private hotel sector.

It is the assumption of the “policy neutrality” of its position which is perhaps the most dangerous aspect of the naiveté of BAMP’s position on privatising health care. When looked at differently, it is the hotel analogy which appears as “emotional”, “unreasonable” and “unrestrained”. Indeed, given the history of Caribbean hotels as playgrounds for the rich, and as places where the poor majority were, until recently, excluded except in their capacities as barmaids, performers and prostitutes, BAMP, as part of clarifying its position, will have to admit that its hotel analogy was indeed unfortunate and inappropriate. Without this, Mr Comissiong’s concerns will remain justified.

When our medical doctors drink from the heady wine of neo-liberalism, we are on the slippery slope to crisis, especially when we are in the throes of new epidemics like Zika and Chik-V which are no respecters of “one’s ability to pay”. Equally troubling is the fact that neo-liberal policy prescriptions are now seen as “normal” today at the very moment when the capitalist north is returning to social democracy given the abject social failures of the neo-liberalism. Observe, Bernie Saunders in United States politics.

Our doctors, instead of slavishly swallowing the neo-liberal Kool Aid, should be insisting on social democracy as a necessary element of advancing public health.

Tennyson Joseph is a political scientist at the University of the West Indies, Cave Hill Campus, specialising in regional affairs. Email [email protected].