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 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.