A line in the hymn/folk song “All My Trials”, says: “If religion was a thing that money could buy, the rich would live and the poor would die”. As it relates to health, if you have the money, you can get the best specialist care. But health practitioners can only do so much. While the most expensive medical care might keep you alive long after your productive and conscious years on earth are over, it might not be able to keep you in the best of health, and no amount of money can keep you alive if you get a disease that has no cure.
From time to time our health system is challenged, and the brunt of the attacks is usually aimed at the public healthcare system. On June 28 of this year, a national celebrity, Jenny Lovell died while in public care, and last week a sister of hers, a practicing physician abroad, has commented that the care her sister received was substandard. According to XTV News, Dr. Glenda Lovell, Jenny’s sister, registered her disappointment in the public health system in a letter “to the Minister of Health [that was] copied to the CEO and to Dr. Jorge Polanco as the Director of Hospital Services and Allied Health”, but is yet to receive a response. XTV News said they contacted Dr. Polanco and “he shared that the matter was addressed but did not share how, even though we asked”, and that Lovell’s family said “it will weigh its options.”
Doctors are human beings, so it is not impossible that they erred in the care of Jenny. Sometimes people who modern medicine determined to be in the best of health die suddenly, some of them very young.
Our medical professionals are taxed; the amount of trauma patients they have to care for is enormous because of rampant reckless and violent behavior; and they also have to attend to a high number of patients with heart and kidney disease, diabetes, and cancer because many of us have unhealthy habits. Adding pressure on the healthcare system is the fact that Belizeans are living longer; with age come chronic diseases no matter how well we live, and the majority of our people will turn up in the public system, because it is far less costly than the private system.
If there was neglect, was it related to salaries? Money shouldn’t be an issue with our medical personnel. Doctors and nurses belong to the world’s most noble profession. They are human beings, and while their primary motivation is to heal, they are interested in their pay, especially when they look around and see some people in less important professions raking it in. The world outside beckons to people in the medical profession; out there they can “order what they want.” No one should quarrel if we paid our medical personnel what they wanted, if higher salaries are what they need to make them happy.
It is right that Dr. Glenda questioned the handling of her sister’s case, which she believes was not up to par. This matter and others similar to it must be addressed.
Our present healthcare system—is it the best model for Belize?
The healthcare system should be, but almost never is, a hot button issue in our national elections. In 1998, the PUP had a bold vision to remake our health system, with a national health insurance (NHI) scheme the main feature, but the sales tax (VAT) and the economy overwhelmed the national consciousness leading up to the election. In office, between 1998 and 2008, the PUP introduced the NHI, and there was the startup of a new private healthcare facility, Universal Health Services (UHS), whose owners, it was said, were people close to the government.
UHS collapsed, maybe because the government was unable to deliver all it had promised, and its failure reverberated throughout the healthcare system and the national economy. A government bailout would lead to a drawn-out battle in court when a new government (UDP) took office in 2008. By the time the dust settled in court, a $30 million debt had ballooned to over $90 million.
How much of our limited financial resources we allocate to healthcare is very serious business. Because not enough is allotted for specialist care for children and youth/young adults with chronic diseases/physical handicaps, it is common to see families scrambling to pay medical bills at private institutions here and abroad. From where would government get the money to take care of the young ones who need specialist care? Would it have to borrow from funds earmarked for the care of others it has responsibility for?
In the US, members of the Republican Party swear against the Democratic Party’s signature piece, the Affordable Care Act (ACA). A March 2024 factsheet from The White House said the ACA “gives millions of Americans access to quality, affordable health coverage”, but “just last week, House Republicans released another extreme budget that would rip coverage away from millions of Americans while doing Big Pharma’s bidding to drive up prescription drug costs.”
The JAMA Network says the federal government in the US operates about 200 hospitals, and they “provide care for routine medical and surgical problems for specific patient populations, such as active military personnel.” Pankaj Dhiman, in the paper “Navigating the US Healthcare System: A Step-by-Step Guide”, said health insurance is the backbone of the [US] system, and most Americans obtain it “through their employer, a government program like Medicare or Medicaid, or by purchasing private plans.”
Dhiman said that “beyond insurance premiums, there are often co-pays, deductibles, and out-of-pocket expenses to consider”, and that “medical bills can be a significant financial burden, leading to medical debt for many Americans.” The US is also one of the most litigious countries in the world, and malpractice lawsuits against hospitals add considerable costs to medical care.
Josh Chang, Felix Peysakhovich, Weimin Wang, and Jin Zhu of Columbia University School of Professional Studies said in the story, “The UK Health Care System”, that “the UK has a government-sponsored universal healthcare system called the National Health Service (NHS)”, and that, according to the WHO, “government funding covers 85% of healthcare expenditure in the UK.” This report says, “15% [of the cost of healthcare] is covered by private sector”, and that “private insurance is usually accessed through employer groups or, more rarely, by wealthier individuals seeking additional benefits who access the carrier directly.”
Cuba Platform, in the story, “The Cuban Healthcare System”, said, “in 1961, the Cuban government created a new National Health System and began to phase out all private healthcare and expand public services,” and that, “today, all healthcare is regulated and financed by the government, and is provided to Cubans free of cost.”
In our country, well-off Belizeans have private insurance for their healthcare, and the Social Security Scheme provides health insurance for contributors for work-related injuries and illnesses. Our present government believes that through the NHI, that is yet to be extended countrywide, it will be able to bring better health care to less well-off citizens. Belizeans who get service at public hospitals that fall under the NHI receive drugs and medical tests, some from private providers, at prices that are heavily subsidized by government.
As with all matters that involve the people’s money, what is spent has to be accounted for. Who monitors NHI to ensure that resources are managed efficiently? Government is planning to build a tertiary level university hospital. If public hospitals become too good, will private hospitals be sustainable? If too much of our resources go to private hospitals, will public ones suffer? Is our present system the best model for Belize?