40 per cent

UWI lecturer complains too many Bajans pay for health care

A “completely unacceptable” 40 per cent of Barbadians dig into their own pockets to pay for their health care, placing them at risk of financial hardship, Lecturer in Medical Science at the Cave Hill Campus of the University of the West Indies Dr Natasha Sobers-Grannum has said.

Dr Natasha Sobers-Grannum
Dr Natasha Sobers-Grannum

Dr Sobers-Grannum identified this as one of many inequities and imbalances that have led to deterioration in the quality of the delivery of health care here and called for restructuring of the system.

“From a World Health Organization perspective when you have persons paying out of pocket for health care it means that they are at immediate risk of financial hardship. That is problematic and it is unsustainable. If for no other reason, the mere fact that 40 per cent of Barbadians are opting for out of pocket health care, policymakers should be thinking of change,” Dr Grannum said last night as she addressed a town hall meeting in the assembly hall of The Alexandra School in Speightstown, St Peter, which explored ways to sustainably finance the country’s health care system.

She pointed out that in an attempt to correct this challenge to health care delivery, most countries have opted for mandatory health insurance.

The leading academic complained about inequities in the system, which she said had a telling effect on the poor.

She pointed to her research on imbalances based on educational and economic backgrounds and gender biases and how these imbalances impact health care.

“There are persons who cannot afford what is becoming basic investigations. There are persons who would go in with a heart condition and they cannot afford an echocardiogram, for example. If you have money $400 looks like nothing to you, but if you do not have any money $400 looks like a lot. You may have to go on a six-month waiting list. That is our reality and these are the inequities that currently exist in the health care system.

“We are talking about universal health coverage because these inequities exist. Part of the definition of universal health coverage says that not only do we make sure that people do not experience financial hardship, but we have to look at reducing inequities. Actually there should be no inequities. There should be no imbalances in the way we experience in the system. It should not matter if you are a man or a woman. Your educational status should not matter, but it does matter. It is starting to matter in Barbados,” Dr Sobers-Grannum added.

The UWI lecturer acknowledged that Barbados had a good health system in place, but contended that in recent times the quality of service offered has left a lot to be desired.

She made reference to “long waiting times” at health facilities and “persistent” complaints of critical pharmaceutical shortages.

“These are areas that speak to quality and we need to improve in these areas. It is in these areas which drive us into insisting that we must look at changing the system.”

Dr Grannum dismissed suggestions that the system simply needed “tweaking”, insisting that it must be restructured in order to eliminate the inequalities and improve the quality of service.

The Ministry of Health has organized a series of town hall meetings to solicit the public’s input as it seeks an answer to the $700 plus annual health care bill.

At one such meeting last week, Director of the Chronic Disease Research Centre at the University of the West Indies, Cave Hill, Dr Alafia Samuels was among those arguing strongly for Government to impose a “fat tax” on overweight Barbadians.

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.

Minister of Finance Chris Sinckler, in an interview with Barbados TODAY, ruled out the proposed “fat tax”, warning that any such move by Government to levy Barbadians based on their eating habits would be “grossly discriminatory”.

However, he did not rule out the possibility that other revenue-generating measures would be imposed on the vital health sector when he presents the upcoming budget.


7 Responses to 40 per cent

  1. 3rdsun February 18, 2016 at 7:44 am

    People who can afford it will go to a private doctor. That doesn’t put them in financial risk. What you are saying is flawed. You can’t paint everybody with the same brush.

  2. Victor Franklin February 18, 2016 at 9:06 am

    The rich can get immediate care due to available finance…whilst the poor will have to wait for a date or forego healthcare due to the unavailability of funds. Agree with you Dr. Sobers

  3. Sue Donym February 18, 2016 at 9:56 am

    True, not everyone who is paying is doing so because they can comfortably afford it. Some people find themselves in situations that they can’t afford to wait, either because of the time to get an appointment or the fact that hospital facilities are unavailable!

    The system is in a mess when priority is based on ability to pay. Take for example a request for x-rays at QEH. First question is if it’s coming from a private doctor or polyclinic/QEH; the difference being that if it comes from a private doctor there is a ($100.00) fee and a much earlier appointment. Even the reporting times differ greatly (know of a case where the patient referred from polyclinic waited 4 months for the report and another had to be redone because it was lost, then took weeks for the report)

    I think an important point though is that patients should not have to suffer the indignity or uncertainty (with the resulting stress) of not knowing that they can get care – or even the best care – because of finances, at the time they least need to worry.

    While larger, more vibrant economies are trying to work out how they can achieve free high quality care for citizens, we appear bent on deconstructing our system which really requires stricter discipline and oversight.

  4. david gibbs February 18, 2016 at 1:34 pm

    Are these statistics correct ? Is it that 40 percent of Barbadians are paying out of pocket for health care OR is it that 40 percent of the over $700 million ( and it is $700 million, not $700) spent annually on health care in Barbados is spent by Barbadians out of pocket?

  5. jrsmith February 18, 2016 at 3:24 pm

    People stop wanting everything for free, the world is changing wake up smell the coffee, you all moan about taxes , you all moan about everything which needs financial support, the private , system and the public system runs side by side , this was like this for decades, I am in my seventies and remember my parents paying for private medicine, way back, I am living in the UK, but many times, I have went private, for dentist for opthamaltic, and minor operation…

    This is the same issue, who could afford to go , private , do so , this takes the strain of the public system, the problem with everything public in Barbados , is failing or has failed ,because of bad polical management.. we were told Barbados has become or becoming a middle class society, so they..

  6. jrsmith February 18, 2016 at 3:28 pm

    Our politicians ,seems not to have learnt anything from the wide world around us, life could be so easy in Barbados ,we just need the right people to govern our island…

  7. Simon P. February 19, 2016 at 3:17 pm

    This article shows the continuing ridiculous attitude of the Barbados people. Many persons with money are using private doctors and not burdening the system, which should not be the focus point but the focus should be on the upgrade of the QEH.

    Also I agree with mandatory Health Insurance in Barbados, it will help aid in the financial and work strain placed on the health care system. Barbadians have their priorities wrong, they will cry and plea heath care is to expensive and health insurance is to much as well. But will have the latest cell phone if not two, brand name bags and enough money in gold jewellery to start a small business. They then turn around and go in A&E because their head hurts or for a stomach ache, and complain that they didn’t get through.

    The staff at the QEH do a fantastic job with the financial resources and man power they are provided with and I applaud their efforts.
    Could the QEH be of a better standard? Yes! but that is for the government to allocate or raise funds to improve the situation. Overall the health care system in Barbados can not be improved until we ourselves choose to take steps to improve ourselves as well as help to improve the system.


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