Universal healthcare must have same standard for the rich, poor
What you need to know:
Elitism in Kenya and, perhaps, across Africa as far as healthcare is concerned is misplaced and grossly unjust.
We must approach healthcare policies in a more humane and compassionate way with every patient’s needs at the core.
There is no one type of malaria for a State officer and another for the pauper; universal healthcare is better while free for all.
A nation’s greatness is measured by how it treats its weakest members, said Mahatma Gandhi. And the Indian civil rights icon might as well have had Kenya in mind: The disparity in healthcare between the rich and the poor is glaringly huge.
The National Hospital Insurance Fund (NHIF) medical cover for civil servants and the disciplined forces, as well as that for high school students and the one promised for the elderly, have come as many families struggle to access affordable healthcare.
The schemes will help to expand healthcare but not address the core issues that beleaguer the health sector.
AMBULANCE CHASERS
The best solution is to first improve the welfare of health workers. Better working conditions in the health sector will improve morale and give clinicians more time to focus on patients and research.
Our doctors have become ambulance chasers in order to survive, and that’s not fair.
I had the privilege of working in Britain’s National Health Service (NHS) in London while pursuing my studies. Most of the doctors were well paid and, therefore, could dedicate time to patients. The same with doctors in Canada, who, interestingly, declined a pay increment recently, instead suggesting that the money be used to boost the Canadian health sector.
Another challenge facing the NHIF is the risk of leaving a section of the population without cover. The NHIF is, of course, based on contribution. Speaking to those on low wages, you get the feeling that NHIF contribution is a luxury they cannot afford and still put food in their plates.
FULL ACCESS
The minimum monthly contribution might appear a paltry amount to the affluent but it might surprise you that many families in Kenya cannot afford it.
Provision of emergency care under the NHIF is also a challenge as it cannot fully address the patients’ needs. This problem can only be resolved by having well-funded and fully equipped referral hospitals across the country that can handle critical care confidently.
Many Western European countries adopted a model of free care inspired by the tenets of the Universal Declaration of Human Rights (1948). They tax their citizens heavily but set large segment of their national budget for healthcare and make it free and accessible for everyone. Rich and poor.
I am sure many Kenyans would rather pay higher taxes to achieve free universal healthcare than endure what we have. I know I would.
NO GUARANTEE
The World Health Organisation’s (WHO) preamble states that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being”. But in Kenya and many other African countries, healthcare is still considered the preserve of the few rich and powerful and never as human rights issue. It is also politicised and used as a campaign tool rather than being seen as a States’ obligation.
It is shameful and insensitive for African leaders to be trooping to hospitals in the developed countries at the expense of the poor, whom they leave to die for lack of basic care. Again, there is no guarantee one would be cured of cancer by undergoing treatment abroad. If chemotherapy can fail you locally, chances are, it can fail you in New York, London or Johannesburg. It is, therefore, cost-effective to fund local hospitals that are fit for all.
CORRUPTION
The healthcare in the developed world, which attracts the rich and powerful from Africa, does not have a magic wand for treatment. All they do is pay key staff well, fund research and stock hospitals with life-saving equipment and medicines. The standard of such hospitals is made fit for both the rich and the poor.
Another issue that will not go away any time soon is corruption. The health sector is the last place one would associate with the vice but the reality is painfully true. And it is, regrettably, justified.
I don’t condone corruption and my heart bleeds when I say this: By failing to offer remuneration that is commensurate with the expected standard of care and level of expertise of the medics, we leave them in a precarious position. To make ends meet, they trade in patients’ medication and gut hospitals of essential equipment.
HUMANE
Poor healthcare negates socio-economic advancement. Elitism in Kenya and, perhaps, across Africa as far as healthcare is concerned is misplaced and grossly unjust. Class, or status, must be expunged from our conscience if we are indeed serious about universal healthcare for all.
We must approach healthcare policies in a more humane and compassionate way with every patient’s needs at the core. There is no one type of malaria for a State officer and another for the pauper. Universal healthcare is better while free for all.
Ms Guyo is a resarcher in public law. [email protected]
