More money needed to prepare for future healthcare; more price hikes to come

President of the Barbados Association of Medical Practitioners (BAMP) Dr Lynda Williams has advised Government to review its healthcare financing model, warning that more money will have to be spent to deal with the long-term effects of COVID-19 on the population and to prepare for future pandemics.

Meanwhile, private sector development professional Peter Blackman warned of even higher commodity prices and the need for investment in sustainable food production systems, as well as policies to ensure the survival of small and medium-sized enterprises.

Dr Williams and Blackman gave the caution and advice on Tuesday night during a panel discussion that was organised by the Barbados Association of Insurance and Financial Advisors (BARAIFA) under the title, The Impact of the COVID-19 Pandemic in Barbados.

“Right now, we have a public healthcare system which is financed through government expenditure and there have been many models that have been put forward as to how we can go forward in this,” the BAMP president said.

“Can we afford to keep medication free, do we need to float healthcare bonds to the public, how can we reshape our healthcare financing to deal not only with this pandemic but with future pandemics?” she added.

Dr Williams pointed to the effects on individuals’ physical health, nutrition, mental health, and the education and development of children – all of which, she said, added to the existing burden of managing non-communicable diseases (NCDs).

She added that while Government was already spending about 6.3 per cent of its gross domestic product (GDP) on healthcare, that amount would have to increase.

“We would need to spend more as a result of COVID because now you have got the rise in NCDs and COVID is ongoing,” she said, while stressing the need for preparation for future pandemics.

Dr Williams said provisions had to be made to deal with the long-term impact of the virus on the population.

“One thing that we have seen as a result of COVID is that there is a rise in non-communicable diseases directly related to persons having COVID-19 itself. So, people who were probably pre-diabetic became full-blown Type 2 diabetic; we had increase in hypertension, thyroid disease, renal failure. All of these things directly and indirectly occur through lack of people going for care and screening,” she said.

The BAMP president also spoke about the impact of the pandemic on the mental health of citizens.

“If we have more people suffering from anxiety and depression in society. That decreases a lot of productivity and that rise in mental health morbidity is something we are going to have to look at as a country very shortly. There is also potentially a rise in vaccine-preventable diseases,” added Dr Williams.

She issued a further caution about the pressure that post-acute sequelae of COVID-19, also known as long COVID, could have on the healthcare system, noting that it can occur up to months after the acute infection, and is known to have a multisystem effect.

“Anything from myocarditis and heart failure to just chronic fatigue syndrome. You have neurological effects, you have effects on basically any system of the body, and so the definition of what exactly was long COVID has been going back and forth between doctors, but we have to prepare for it,” she warned.

Pointing to “solutions that we need to look at right away”, Dr Williams said, “we need to look at our model of healthcare financing”.

She also identified the strengthening of communities and family ties to ensure “societal resilience”, greater intergovernmental cooperation, more multisectoral responses, greater use of technology for disease surveillance and control, and ways to better deal with health misinformation.

The healthcare professional said that while Barbados has done “fairly well” to avoid a severe impact on the health system through the development of the Harrison’s Point Isolation Facility and other special locations, there was still some fallout.

Dr Williams said the consequences were seen in limited testing resources, the strain on the hospital infrastructure that led to delays and backlog of procedures, the need for additional healthcare workers from Cuba, and burnout of local healthcare workers.

Meantime, examining the economic impact of the pandemic, Blackman said it resulted in higher food and other commodity prices, increased spending by Government, job losses, temporary and permanent business closures, a decline in savings for some, and a decline in productivity.

Pointing out that the rising costs of some commodity items were expected to continue indefinitely, “with consequential effects on world trade”, the former Caribbean Development Bank portfolio manager said the situation was being made worse by the war in Ukraine.

“We can now expect even longer lead times to access food and other important supplies along with increased freight costs, and this will also fuel further increases in inflation with the consequential effects of reducing disposable incomes, and possibly reduction in the flows of remittances,” he said.

Blackman highlighted the need for: investment in “sustainable and resilient food systems” to enhance food and nutrition security; a framework for increased investment in digital connectivity; a critical look at education and learning, especially for low-income households; adoption of policies that enhance the survival of micro and small businesses; the speeding up of efforts in renewable energy systems to lower fuel import bill; and a focus on building more resilient infrastructure.

He said while the signs of economic
recovery were encouraging, there was “still some way to go”.

According to Blackman, with continued uncertainty surrounding the COVID-19 pandemic, the emergence of the monkeypox virus and the war in Ukraine, this could “stymie prospects for economic recovery globally”.

“Supply chain disruptions are likely to continue along with rising energy prices once this war is prolonged between Russia and Ukraine, and this is likely to lead to increased inflation,” he said.
marlonmadden@barbadostoday.bb