. . . Towards a new health financing model
Efficiently run health care services that constantly strive to be on the cutting edge of medical technology for the effective prevention and treatment of disease are indispensable for the smooth running and successful development of every country in the 21st century.
“The health of a nation,” as the familiar saying goes, “is the wealth of a nation.”
By helping the population to stay in generally peak physical and mental shape to perform the myriad functions required to drive the modern economy and contribute to national prosperity, the health care system gives real meaning to this old saying.
One of Barbados’ outstanding success stories since Independence almost 50 years ago has been the development of a top-notch, publicly funded health care system that compares favourably with what is available in more developed countries with far greater resources.
This success story, allowing Barbadians to access quality care at no cost on delivery, can be attributed to the policies of successive Democratic Labour Party (DLP) and Barbados Labour Party (BLP) Governments, which both agreed health care was a national priority and provided the necessary resources to facilitate its growth and development.
In most developed countries, health care comes at a direct, often hefty cost to the patient on delivery, even though it might be subsidized to some extent by the state. In Barbados, once persons are citizens and legal residents, they can access a range of high-quality services –– from child delivery at birth to sophisticated open-heart surgery –– for free.
Alongside the outstanding achievements in education, the equally outstanding performance of the public health care system, with the Queen Elizabeth Hospital as its centerpiece, has been an immense source of pride for Barbadians. Even with current financing and other challenges, our health care system remains second to none in the English-speaking Caribbean.
Times, however, have changed. Following a sharp downturn in the economy over the past eight years, resulting in money not being as plentiful as before, new circumstances have forced Government to rethink its long-standing model of 100 per cent health care financing as this old arrangement is clearly no longer sustainable.
After education, health care for many years consumed the second largest chunk of the annual public budget. Proposals on the table make a case for Barbadians to contribute, for the first time, to covering the costs of care accessed through the public sector, be it at the QEH or the network of polyclinics around the island.
The move follows a similar change, a few years ago, in the arrangements for pharmaceutical drugs available through the National Drug Service, which once had a 100 per cent free policy.
In a most welcome development that augurs well for the outcome of the process, health officials are engaging the general public through a series of town hall meetings where they are sharing their ideas and getting feedback. This is a wholesome approach as it ensures that whatever new arrangement emerges, will have public input and buy-in, which will be critical for it to work.
The Barbados Association of Medical Practitioners (BAMP), representing a key stakeholder group in the health sector, is proposing that going forward, Government should meet the health care costs of only those who cannot afford to pay. Everybody else presumably should be required to do so from their own resources, including health insurance. A big question to be determined is whether such coverage will be provided through a state entity or the private sector.
An excellent public sector model to examine is the provincial health insurance schemes in Canada, which is recognized globally for excellence in health care. The Ontario Health Insurance Plan or OHIP would be familiar to Barbadians who live or have lived in the province of Ontario as it was the source of their medical coverage.
It is a highly successful system which covers treatment even by private doctors. Coverage guarantees care up to a determined level. If patients want extra frills, they have to purchase private insurance which will cover the difference. Alternatively, in Barbados’ case, the financing model could be totally private sector as many companies already offer good health insurance plans.
Or it could be a public-private sector partnership.
Health care financing is a crucial issue that will impact every Barbadian going forward. We urge Barbadians, therefore, not only to follow the discussion closely, but also to go out to the town hall meetings and other events and air their views. It is important that your voices are heard. Do not miss the opportunity!