Don’t make abolition of user-fees the scapegoat
We speak every so often of how important a healthy and educated population is to human productivity and national development. To the extent that a country seeks to increase its economic output, enhance its competitiveness, and develop its human resources, certain sectors must be identified as key priority areas.
For the last Jamaica Labour Party (JLP) Administration, and indeed, the Andrew Holness-led Opposition, the health sector is one such sector. The abolition of hospital user fees was an unmistakable manifestation of the importance attached to the delivery of public health care.
With the raft of crises plaguing the public health system, primarily as a result of Dr Fenton Ferguson’s tenure as minister, and the reprehensible loss of 19 babies due to an outbreak of bacteria, the state of the system has been brought into even sharper focus. I find quite disturbing, if not hypocrisy of the highest order, that those who claim to love the poor, along with their apologists, are seeking to make the no-user fee policy the scapegoat.
We must mash down that lie because it is previous cuts to the health ministry’s budget and the overall mismanagement of the sector by the People’s National Party (PNP) Government that is bedevilling the public health care system; not the abolition of hospital user fees.
To add, much of what was unearthed by the recent audit speaks to basic management and administrative deficiencies than any displacement occasioned by the no-user fee policy.
The public should note that of the $19.5 billion allocated to the health sector in 2006/07, user fees contributed a mere $1.7 billion. In delivering on its commitment to abolish hospital user fees, the JLP Government increased the allocation to health in the 2007/08 budget by 22 per cent or $4.2 billion. In the 2008/09 budget, the allocation was increased by a further 25 per cent or $5.8 billion. And while the budget for the four regional health authorities amounted to roughly $2.2 billion, a substantial increase was granted in the 2008/09 financial year, which took their allocation to some $4.9 billion. The no user-fee policy actually replaced the income stream derived from fees, which were not always certain or even collectable, and infused new net direct cash flow into the health system to help manage the anticipated increase in public hospital use.
The JLP has never suggested that the no-user fee policy was a panacea. What we have been adamant about is that the policy is way more progressive and humane than having people sitting at home dying due to an inability to pay hospital user fees. How does it serve our interests to maintain a regime which grossly understates the demand for health care as people stay away from hospitals instead of turning up for treatment?
There is no doubt that a more efficient and effective mechanism for financing public health care is needed. It is for this precise reason that the Opposition leader, in his 2015/16 contribution to the budget debate in Parliament, proposed the establishment of a National Health Insurance for Wellness Advancement (NHIWA). This new approach to funding public health care will see Jamaicans being encouraged to make prepaid contributions for the delivery of health care, and public hospital use by holders of private health insurance will see their insurance coverage paying for their usage. No one will be turned back or denied access to health care on account of an inability to pay. The JLP guarantees access at the point and time of need. To have it otherwise, in 21st century Jamaica, would be a travesty and injustice of mammoth proportions.
Marlon Morgan is deputy spokesman on agriculture and an aide to Opposition Leader Andrew Holness. Send comments to the Observer or marlonandremorgan@gmail.com.