Two medical doctors and a hospital administrator are recommending that Government should treat public health as a productive sector, apply user fees on careless people who fall sick, and impose a tax on fatty foods which undermine human health.
Their proposals were put forward Wednesday night at a discussion sponsored by the Faculty of Medical Sciences of the Cave Hill Campus of the University of the West Indies, where non-communicable diseases (NCDs) came under the microscope.
Dr Alifa Samuels, director of the Chronic Disease Research Centre and feature presenter on the topic, Accelerating the NCD Agenda, pointed out that foods such as French fries, which increasingly were becoming part of the regular diet of some Barbadians, should be taxed higher to make them less attractive to consumers.
Family physician Dr Colin Alert proposed that when persons flout health advice, they should be made to pay their subsequent medical bills. Queen Elizabeth Hospital Chief Executive Officer Dr Dexter James said health care should be treated like tourism.
James’ complaint was that his institution, the island’s main public health care provider, did not attract the attention of the Minister of Finance in the way the productive industries did at Budget time.
“Generally, when ministers sit around the table to discuss the whole prioritization of budgets, we have not yet found a way in which we could become [even] with tourism a[nd] all the other agencies that generate revenue,” James said. “So we go with the same old arguments about patients and how many diabetics we have in the country, and the Minister of Finance says, ‘so what?’”
The QEH administrator contended that the voice of health care will not be loud enough at budget planning time, “unless we could change that debate and to the argument that says: for every diabetic we have in the country, how does it impact GDP? What is the loss in productivity by such persons?”
James said Barbadians, mostly between 35 and 45 years of age, were falling sick at the monthly rate of 45 strokes and 11 heart attacks.
“That data needs to be translated into what extent our productive labour force [is being] compromised by the NCDs. There has got to be some costings around it,” he said.
Dr Alert said that cutting health care costs was a challenge to behaviour.
“In our system, the free universal health care system, we implore people that their health is their responsibility, but yet if somebody drinks, smokes, eats badly and gets sick, they are offered free health care, free medication, free hospital care,” he stated. “So how can you discourage them from doing unhealthy things, if by virtue of their bad behaviour, they then get lots of freeness?”
Seeking a solution, Dr Samuels asked Dr Alert: “If they do bad things, we should charge them for the care?” “Yes,” he responded.
Dr Samuels saw the remedy in punitive taxes on fatty foods that would have the double effect of dissuading Barbadians from buying them, and having the funds raised from such taxation channeled towards the health care of those who use the unhealthy foods anyhow.
As an example, she said: “Let’s tax French fries, because just like tobacco, the French fries are going to give you a heart attack down the road, so we may as well start saving money. Little by little, Government will start saving it for you, so that you can pay for the heart attack when it comes.
“We need to tax it not only to get the money but to help encourage people not to eat it.”
Dr Samuels added: “We need higher taxes on unhealthy foods, including a tax on fatty foods.” However, she was at pains to emphasize: “I did not say to tax fat people.”