The 1989 calypso De Country Ain’t Well, penned by lyrical master Stedson Red Plastic Bag Wiltshire, remains unsurprisingly relevant for Barbados today, 28 years later.
It is not merely an apt description of the economy that has been stagnated for the last few years, or the vexing almost daily incidents of violence playing out in communities across the country.
The sickness cleverly outlined in the moving piece of social commentary also pervades the operations of the Queen Elizabeth Hospital (QEH) crippled by its terminal financial ills.
Last Thursday, at the fourth annual QEH Healthcare Financing Symposium, Chief Executive Officer Dr Dexter James yet again delivered a grim diagnosis of the hospital’s ill health, as well as the general state of health care in Barbados.
He clearly pointed out that the hospital was racking up an annual deficit of about $35 million with no immediate end in sight. And with taxpayers’ dollars only accounting for $155 million of the $190 million operating costs, the island had a virtual cancer on its hands.
“So, therein lies a financing gap and the concerns around how we are going to sustain the packages of services that we currently provide to the Barbadian population,” he said.
The QEH’s operating costs are just the tip of the iceberg.
It currently costs $18 million per year to treat 310 patients on haemodialysis. Add four or five patients to that group per month.
Chronic diseases – diabetes, hypertension, heart disease are at epidemic proportions. Twenty-five per cent of the population has at least one non-communicable disease (NCD) and this is on track to rise to 33 per cent by 2025.
And there’s been an increase in injuries and accidents further compounding the crisis.
The figures, though staggering, are no surprise. It is well established that health care costs the world over are spiralling out of control and there is no vaccine to cure the problem.
Barbadians are accustomed to ‘free’ health care – that has never really been ‘free’ and can no longer remain ‘free’.
It is clear is that if we continue to delay corrective action and spending on health care continues on the same trajectory, Barbados will eventually reach the point where our reputable health care system will collapse.
Local authorities, to their credit, have conceded the system needs fixing and efforts have already begun to find a sustainable model.
However, as with most challenges in Barbados, there appears to be a certain level of inertia on the way forward – hence, why Dr James was again forced to repeat the hospital’s litany of woes
A year ago, the Government held a series of town hall meetings to find suitable alternatives. What headway, if any, headway has emerged from those discussions?
While we dawdle, the cost burden related to healthcare for consumers, businesses and Government is not diminishing. More people are getting sick and the cost of medication and equipment is rising.
How much longer do we intend to keep the patient on the table? We have to prep for corrective surgery, accepting that decisions must be made that will neither be easy nor palatable, but a sustainable plan must be found.
Among alternatives discussed so far are recommendations that the country continues to provide free health care to the most vulnerable – the elderly, babies and those who are unable to pay. This should be supported.
Experts have also floated the idea of a national health insurance scheme and taxpayers should be given a full, creditable proposal so they can analyze the benefits.
Equally, it is expected that the QEH’s operations should come under the microscope to cut out wastage, and an effective plan developed to fully upgrade and better the services of the island’s polyclinics to ease the pressure on the main hospital.
And, for Barbadian themselves, serious effort must be made to take charge of their health. Being sick costs dearly. Your health is in your hands and simple changes – exercising, eating less fat and sugary foods, choosing more local, healthy foods – can reverse the tide of disease that is not only crippling our main health care facility but is unnecessarily shortening our lives.