Private patients ban

Speaking last week Tuesday at a sod-turning at Mount Hope he complained that some people were not using the private hospitals linked to their private medical insurance but were instead trying to get onto the Surgical Waiting List Unit (SWLU) to have their surgery done at public hospitals.

He said that move, by people employed by “top notch” companies but who wished to avoid paying the requisite 20 percent of surgery cost not covered by their insurance, was adding to the public hospitals’ waiting lists for surgery.

Newsday reported Rahael as saying that the SWLU plan is solely for people in the public sector who cannot afford to pay privately for surgery, until such time as a new national health insurance scheme is introduced.

Minister Rahael must clarify his statement. We are concerned that he might be suggesting that anyone who has any form of private health insurance or health care plan, whether held as an individual or as part of their employer’s company health plan, could find himself debarred from accessing any form of public health care. Is this Rahael’s intent?

His statement is worrying enough in the matter of accessing surgery, but could be of even worse concern in broader areas of healthcare.

If, for example, one contributes to a modest health plan at work, are you to be debarred from the Accident and Emergency Department of Port-of-Spain General Hospital if you are in a car crash? Are your children to be denied access to the Emergency Department at Mount Hope Medical Complex when they are suffering diarrhoea and vomitting during the annual national outbreak of gastroenteritis? What about their vaccinations? Are you to be denied access to the expensive equipment at Mount Hope such as CAT-scan and MRI machines which all of our citizens have been paying for over the past three decades?

We are concerned that Rahael seems to be arbitarily and unilaterally announcing a new policy on the trot, which could have broad implications for many members of the public. Is Rahael dividing the population into two groups, of those who can pay privately and those who go for free publicly? Does his statement, for example, suggest a shift from the Government’s policy that people are not “means tested” in order to receive free medication under the Chronic Disease Assistance Programe (CDAP)?

It is our view that the Government should provide the basic health facilities to all citizens without any form of discrimination, including on the grounds of socio-economic level or perceived ability to pay.

If anyone then opts to seek certain medical services privately, that is his or her choice, but the exercise of this choice should not debar him or her from accessing the basic health services at public hospitals, clinics or accident/emergency departments. People are paying tax deducted from their salaries and in the form of VAT on many goods and services each time they make a purchase, all of which money is pooled to fund essential public services like healthcare, education, social services and national security. Citizens also pay a Health Surcharge (not to mention a levy towards the National Insurance Scheme for benefits upon death, retirement or long-term sickness). It is our view no-one should be debarred from public healthcare.

The Ministry of Health last year spent $2.23 billion or 7.29 percent of total governmental budgetary expenditure. In a population of 1.2 million, this amounts to almost $2,000 per person.

There are two issues we would like Minister Rahael to bear in mind. Firstly, no-one chooses to fall sick, and because illness is not a voluntary option, neither too should medical treatment be seen as optional but should be fully available. Secondly, many illnesses such as HIV/AIDS are in fact issues of public health in that the well-being of an individual patient can affect the well-being of those persons connected with him or her.

While we acknowledge that healthcare is expensive and that few governments in the world can meet all the expectations of their citizens, we feel Minister Rahael’s statement is the wrong way to proceed. We would like clarification from the Minister.