Which Would You Prefer: Time or Health?

Time for all living creatures has its end.  Health for all living creatures is essential for happiness until the end.  Ideally, humans want to live in harmony with both.  The fact is that there are people living in poverty, suffering and dying from diseases and there is nothing they can do but wait – simply wait for recovery or death.  Who is to blame?  Perhaps the uncontrollable situations that contribute to their illness, lack of knowledge, resources, and access to care?  Regardless, this is a universal problem – countries around the global are faced with the fact that many of their citizens don’t have access to health care. Mozambique, for example, has several remote regions (with lack of transportation and health resources) where there are 2 million inhabitants with just 63 doctors, meaning that for every 30,000, there is one doctor (Ravenscroft, 2013), leaving many to suffer due to inaccessibility and wait time.  The USA has approximately 42 million disproportionately sick Americans uninsured (Angell, 2003), who wait for an opportunity to access insurance. Tobacco kills 670,000 people each year in India, yet India’s main source of funding healthcare is out of pocket expenditure (Duggal, 2007), restraining many from accessing care and perhaps waiting on personal funds to pay for treatment.  Canada’s infamous universal systems provides equity, yet patient’s have an average wait time of ~4-6 months for care due to supply (available doctors) and demand (number of patients)(The Centre for Spatial Economics, 2008).  This imbalance is affected by the strategies used to fund healthcare, and whether countries, as some may argue, view health as a privilege or a right, leaving health to the vagaries of the market (Duggal, 2007).  If healthcare is more “widely recognized as a basic human right, and the urgency of some global health issues has pushed global health policy to the top of the international agenda” (Gottret, 2006), then which systemic approach is most advisable as cost effective and equitable – private or public healthcare?

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Image Credit: http://www.marilyntong.com/about-happy-life-project/

According to a literature review conducted by Sampath and Wilson (2012), adopting a private funding model would create inequity in access, leaving low-income groups unable to purchase insurance, therefore, strongly advising the USA to consider public funding.  Their study determined that although Canada has it’s ~4-6 month wait time for treatment, the US systems isn’t any better – of the ~42 million uninsured people, many can never afford to ever be on any waitlist (2012).  My interpretation – poor uninsured US citizens are on a waitlist to suffer unhealthy lives.  For instance, while the US provides rapid cancer treatment, there is a huge socio-economic inequity in who has access to cancer treatment (Sampath et’al, 2012).  So is public care worth the ~4-6 month wait – both for the people and the country? 

The Centre for Spatial Economics (C4SE) states that Canadian policymakers are interested in initiatives that reap economics benefits by reducing wait time (2008). According to C4SE, the cumulative province economic cost of waiting for treatment in 2007 was an estimated $14.8 billion, based on impact of reduced activity in the labor market and higher health expenses (2008).  Their total cost analysis highlights the possibly avoidable expenses for treatment and care that otherwise wouldn’t have been accrued had the wait time not exceed the maximum recommended (C4SE, 2008).  Wait time has a trickling effect, not just to the patient, but to the economy as well.  Such expenses lead the government to increase taxes, but if people are sick and unable to work, then there aren’t any contributions to income or sale taxes, hence “robbing the economy of workers – both patients and caregivers” (C4SE, 2008).

So again, which has the best cost-benefit ratio – private or public?  Which is priceless – access to immediate care, at all cost for just some of us, so that one is happy and healthy, and provides our government with financial stability? Or publicly funded care for everyone, where people wait in pain (keep in mind, handicapped from normal activities) to receive “apportioned” treatment on follow-ups and referrals?

India would vote for a public care model like Canada’s, a common system, ensuring healthcare for over 90% of the population, without any barriers (Duggal, 2007).  But isn’t a ~4-6 month wait a barrier? Then perhaps it’s worth paying for private insurance?  Activists like Dr. Maria Angell would strongly vote against it, defending that it categorizes health as a market commodity – targeting it to the ability to pay and not medical need (2003). 

Which would I vote for? I don’t know…I feel torn about this. Each strategy has its pros and cons, making it overwhelmingly difficult to defend either one.  We need healthy people, but we also need a strong economy – which should countries “give up”?  Either way, there is something to say about social justice, basic human rights, and as Dr. Angell (2008) puts it, “vital needs” of each human being.  At the end of the day, this all refers to human life – which in my opinion is priceless.

References:

Duggal, R. (2007). Healthcare in India: changing the financing strategy. Social Policy & Administration, v. 41(4), pages 386-394.

Gottret, P. (2006). Health financing revisited: a practioner’s guide.  The International Bank for Reconstruction and Development / The World Bank.

Physicians for a national health forum. (2003). Statement of Dr. Maria Angell introducing the U.S. national health insurance act. Retrieved from http://www.pnhp.org/resources/statement-of-dr-marcia-angell-introducing-the-us-national-health-insurance-act

Ravenscroft, J. Access to healthcare in Mozambique.  Retrieved September 29, 2013, from http://www.globalhealthcheck.org/?p=1359

Sampath, P., Wilson, D. M. (2012). A case study and state of science review: prviate versus public healthcare financing. Global Journal of Health Science, v. 4(1), pages 118-126.

The Centre for Spatial Economics. January 2008. The economic cost of wait times in Canada.  (no author), pages 1-60.

 

 

 

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