New proposal for Government health care financing
A concern that Barbadians are eating too many unhealthy foods is fuelling calls for them to pay for their overindulgence.
During last night’s town hall meeting on the financing of health care, Director of the Chronic Disease Research Centre at the University of the West Indies, Cave Hill, Dr Alafia Samuels was among those arguing strongly that Government should “tax the fat” .
Many participants also expressed the view that the combination of an aging population and rising obesity placed an added strain on the public health care system.
However, while getting old was unavoidable, the general sentiment was that non-communicable diseases were the result of unhealthy habits and therefore should be taxed.
“We need to put on a fat tax,” Samuels told the meeting, while warning that “all of this deep fat fried food that we are eating is leading to heart attacks and strokes.
“So if you eating it now, put down a little money to pay for the heart attack down the road,” she said.
Samuels also painted the scenario of a portly man, who had reportedly suffered a “sudden” heart attack.
However, “somebody said it wasn’t sudden, he worked on it for years,” she said, arguing that self-indulgence over the years was a build up to the medical emergency.
“So while he is working on his heart attack, we need some of his money to put down to supplement your national health insurance scheme, so we can have more cash to pay the bills, because the bills are going to be significant,” Dr Samuels told the gathering.
Last night’s meeting at Queen’s College was organized by the Ministry of Health.
Samuels, who was a panellist, also expressed support for the creation of a Government-run health insurance scheme, while saying that the proposed tax on fat would not only help to create an environment that promotes healthy living but take money from those who were deemed to be “high risk” to add to the financing pool from which payments are made.
She also complimented the Freundel Stuart administration for its introduction last year of a ten per cent tax on sweet drinks, although she was of the opinion that the beverage levy should be higher.
“However, as we increase the tax on sugar-sweetened beverages, we need to drop the tax on coconut water,” she suggested, adding, “I don’t know if we tax coconut water, but we need to find a way to subsidize it so that coconut water can become cheaper and the sugar-sweetened beverages can become more expensive.”
In terms of the health insurance proposal, which would be funded by contributions from all workers, the Senior Lecturer in Public Health and Epidemiology argued that everyone would benefit, since “sickness is not something that you can predict. . . [and] you don’t know at what age you are going to get the sickness and you don’t know how much it is going to cost.
“So you may feel that at age 20 you are just contributing in order to subsidize the 65-year-olds [but] you are also contributing in case you get something bad,” she said.
In support of her comments, one audience member said: “We’ve been trying to be politically correct and we only putting the fat tax on the sweet drinks. Put the fat tax on the people.
“It is not a case of rich versus poor, it is irresponsible versus responsible,” he said.
His advice to Government was: “Start talking about cost reduction, rather than acquiring more money,”. The vocal participant also called for more measures to encourage behavioural change among Barbadians, which he said would lift the current burden on the state-run health system.
“If you shift the paradigm from cost reduction, you’ll find it is much easier to do that,” he added.
Chairman of the Diabetes Foundation Dr Oscar Jordan also stressed the need for a lifestyle change.
“We have to start with children, we have to promote healthy lifestyles . . . 30 per cent of the school children are overweight,” he told the gathering.
“And we need to introduce systems in the school where we ensure that adequate exercise and attention to proper meal-taking are instituted,” he added.
One audience member complained that too many Barbadians drive to work and sit in their offices all day.
“At some point in time we need to encourage our population to ride a little bit more, simple things like cycling to work . . . There are some of us who live very close to work who need to put down the car and cycle to work,” he argued, adding that adults should also be “encouraging our school children to ride to school”.
He recommended a “United Kingdom programme” of giving financial incentives to doctors who were successful in getting their patients to lose weight.
However, he complained that there was a lot of “hypocrisy” in the system since “we speak about weight loss and healthy lifestyles, but some of the people who talk about weight loss and healthy lifestyles need to engage [and lead by example]”.
The meeting, chaired by Danny Gill, was the second of three town halls planned to get public opinion on an appropriate financing scheme to meet Barbados’ ballooning health care costs of $732 million annually.
“How are we talking about financing health care through universal healthcare reform, when I have not seen any document which indicates that there has been a thorough review of the practices of the Ministry of Health?” asked Alan Corbin, who further questioned, “Where is there any figure that clearly outlines where the money is spent and what return we’ve got from it? Where is the analysis?”
In response, Gill, who is the Director of Planning in the Ministry of Health indicated that there was such a document. However, only members of the head table had copies, but Gill said members of the public could obtain copies upon request.
There nonetheless appeared to be general agreement that costs were escalating, and the option of a pooled health insurance system that takes minimal contribution from all workers on the island seemed to be accepted as a reasonable idea.
But, this apparent acceptance of pooling also triggered discussion on penalties on those whose lifestyle habits encourage obesity, leading to avoidable illnesses that pressure the health care system. (GA)