The following is an open letter to Minister of Health Dr Christopher Tufton:

I have long heard horror stories about the country’s health care system and my concerns have only increased since news broke that more babies died.

On Monday, October 10, 2016 I had a personal experience at Spanish Town Hospital’s accident and emergency section, and many people took the opportunity to tell me about some of the horrible incidents they have experienced or witnessed. This prompted me to write this public letter to the Minster of Health Dr Christopher Tufton and the chairman of the National Health Fund Christopher Zacca to start a conversation about strategies to improve the health care system.

There is a renewed interest in health care around the world for two main reasons. Firstly, good health is of profound importance to people, which was evinced in the United Nations Millennium Poll as the issue people value most in life. Secondly, we now know more about the importance of health to economic and social development: healthy societies are more likely to become wealthy societies.

There is now significant evidence demonstrating the aggregate impact of health on growth and on levels of real GDP per capita. There are three key channels through which health affects economic performance. The first channel involves the effect of health on labour productivity; because healthier workers are more energetic, have better attendance records, and are likely to have higher mental capacity and morale. A major study showed that health differentials accounted for 17 per cent of the difference in worker productivity between countries, giving health roughly the same influence on productivity as physical capital (18 per cent) and education (21 per cent).

The second channel from health to wealth involves the effect of health on education. Healthy students are better able to attend school and learn, plus healthy families impose fewer burdens on children, like having to care for sick relatives. The removal of health care expenses due to ill health also facilitate greater investment in education activities such as books, school attendance, and extra classes.

The third channel involves the effect of health on savings and capital accumulation. Healthy people are more capable of saving without the expense of health care. This impact on savings is very important to acknowledge, as studies have shown that a country’s development holds a direct relationship with the average propensity to save.

It is for this reason that I applauded former Prime Minister Bruce Golding’s intent to provide free health care and improve access to health care. Indeed, the goal of achieving universal access to health care can only be achieved by having those who cannot afford it gaining access to it freely.

The ultimate goal, however, is to achieve universal access to quality health care. I believe this is the essence of equal access: where availability meets quality. This assumes that equal access only starts with universal access but doesn’t end there. Instead, it should go further. Equal access demands a base acceptable quality available to all.

However, our current, poorly organised health care system will never be able to deliver quality health care. The continued misdiagnosis of “freeness” for “fairness” has caused both political parties to stay committed to free health care at the expense of reasonable, quality health care. As I noted before, some individuals will need free access, but nothing suggests thst all individuals, including those who can afford health care, should equally receive free access.

To this extent I ask that that consideration be given to what I call the Quintile Health Card System. The basis of the proposal is that the Statistical Institute of Jamaica should divide the society into five income quintiles. The top 20 per cent being the richest, the second 20 per cent being the second richest, and so forth, until the fifth 20 per cent being the poorest.

The colour-coded quintile health card with a machine-readable strip could offer free health care to the poorest 20 per cent of the population in quintile five. Thereafter, quintile four pays 20 per cent of their health cost, while quintile three may have a co-payment of 40 per cent, quintile two would have a co-payment of 60 per cent, and quintile one having a co-payment of 80 per cent. This co-payment could be further subsidised by the use of private health insurance for the co-payment portion.

The proposal goes further to suggest that for a citizen to qualify, he/she must attend a clinic or doctor’s office within five days of their birthday each year to do a medical. This will place greater focus on primary health care as well as create an environment where ailments can be caught and corrected in the early stages before they become life-threatening or impossible to cure.

If implemented, this proposal will reduce a lot of the financial burden the health sector now faces, and facilitate the general improvement of services available to all citizens.

Damion Crawford is a former Member of Parliament and junior minister in the People’s National Party Government.