REGISTRATION FOR benefits from the National Health Fund (NHF) began at some 70 designated centres, as well as hospitals and clinics, doctors' offices and Electoral Office registration centres across the island yesterday. In his Budget presentation of expenditure, the Minister of Finance publicly commended his Cabinet colleague, the Health Minister, for his dogged persistence in having the NHF financed in this year's Budget.
When 65 per cent of the national budget is devoted to debt servicing, social programmes are usually among the first casualties in cuts. The Finance Minister's remark exposes the internal Cabinet scramble for the 35 per cent 'what lef'. And we are left to wonder on what basis other than persistence of appeal that allocations are made!
Some 750,000 people are expected to benefit under the Health Fund to access, at costs highly subsidised by the Government, drugs used to treat 14 designated medical conditions. The heaviest burdens on the health care system are from trauma cases and chronic lifestyle diseases and the NHF is intended to provide support for the latter category.
It is interesting to note that alongside physical ailments like arthritis, asthma, a number of common cancers, diabetes, hypertension and heart disease are the mental ailments depression and psychosis. It is estimated that some 20 per cent of the population suffer from mental ailments which have traditionally received much less attention than physical disorders.
Not on the list of NHF-covered illnesses are HIV/AIDS and kidney diseases. Thousands of Jamaicans are living with HIV/AIDS. Treatment is costly, as is the case for kidney disease. It is not yet clear specifically why these two illnesses were left off the list, but prohibitive costs to the Fund may be one important reason, as health professionals are speculating.
Limited intervention and support will always have the difficulty of deciding what to exclude. A list of 14 medical conditions is only the tip of the iceberg. Full-scale state support for HIV/AIDS sufferers to First World standard, for example, could easily derail the entire health budget considering the extent of infection and the costs of intervention. Health officials are therefore faced with the difficult task of applying triage assigning priorities of medical treatment. The public deserves to at least know the criteria of assignment.
Commercially operated pharmacies will be a vital part of the system for dispensing medication. The Pharmaceutical Society of Jamaica (PSJ) has raised some concern about the timeliness of re-imbursement payments by the Government. This is a legitimate concern in light of tardiness on the part of Government in meeting financial obligations on time on other projects. The matter is on the agenda for a meeting between the PSJ and Minister of Health this week. The NHF will not escape the usual teething pains and critical concerns of new schemes but its objective of providing some support for large numbers of Jamaicans over a range of medical conditions within a tight Budget is to be commended.
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