Garth Rattray THE REPORTED decision to apply GCT to some medical equipment, testing reagents, disposable materials and drugs demonstrates a fundamental unawareness of the existing vicissitudes within society and reeks of an insensitive and uncaring attitude towards the unfortunate sick and disabled among us. I don't mean to sound facetious when I say that the Finance Minister could never have come up with such a horrible plan. Some person or persons must have advised him badly.
I could not believe my eyes when I read that some drugs used primarily for the treatment of asthma would now attract GCT. Thousands of our asthmatics just barely manage to eke out enough money to purchase their life-saving medication; consequently they are often dangerously under-medicated. The devaluation of our dollar and inflation has sent the cost of everything spiralling upward, and now our sick must also pay GCT on essential health-related items. I have patients working as civil servants who cannot afford everyday asthma medications, what then are average Jamaicans to do?
ABSOLUTE IGNORANCE
Dr. Davies' adviser(s) exhibited absolute ignorance when they suggested that he tax brand-name medications. Most of our drugs are brand-name and the companies that distribute them in Jamaica already do so at reduced prices. The added GCT on brand-name drugs will render them non-competitive. They risk being withdrawn leaving many of us in grave danger. Brand-name drugs are usually more expensive than generic drugs because they cost millions to research, promote and market. Generic drugs, on the other hand, ride in on the slipstream of brand-name medicines and although they provide a great alternative, some may occasionally be inferior because of the excipients, delivery systems, bio-availability or coating.
It is cruel to tax diagnostic reagents, testing equipment and medications for diabetes (a common, chronic and debilitating disease). When our diabetics and asthmatics can no longer afford their medications and become seriously ill, the economic backlash will swamp any GCT revenue collected now. The deleterious financial effects of unbridled chronic diseases are well known. The short-sightedness of Dr. Davies' adviser(s) is astonishing.
RECURRENT EXPENSES
Physicians, dentists, nurses and medical technicians all use latex gloves and gauze. These essential 'disposables' already make up a fair proportion of medical care recurrent expenses. Taxing them with the GCT will bring about an unavoidable across the board increase in the cost of health care. Eventually, Health Insurance rates will escalate and as the economy adjusts to this new insult, the conservatively projected inflation rate figures so proudly announced by the Minister will fly out the window.
For years physicians islandwide have been encountering patients who are unable to fill prescriptions (brand name or generic) and unable to complete prescribed courses of medications (because of financial constraints). Too often patients cannot afford to perform diagnostic procedures. Many are unable to acquire needed ambulatory and rehabilitative apparatuses. Some seek refuge in the public health system in order to procure some semblance of good health but nothing is free anymore. It is impossible for the National Health Fund to adequately cover everything.
REPREHENSIBLE
Taxing aids to recovery and appliances for rehabilitation is reprehensible. Prostheses, implants, corrective and supportive devices are not cosmetic nor are they luxury items. They should be sacrosanct and free from "consumption" taxes. Depending on the exchange rate, the unfortunate elderly who break their hips already have to come up with about J$65,000 just for the replacement part no matter where he/she goes for help. Artificial limbs for amputees already fetch approximately J$30,000 for the below-knee prosthesis and J$40,000 for the above knee device. Once the GCT is applied, the cost of these items will make them inaccessible for even more Jamaicans relegating them to the ranks of the immobile, a potentially lethal situation. One row of dentures now costs between J$11,000-12,000, the GCT will push them outside the range of those unfortunate older folks who have to scrounge and depend on the charity of others for financial assistance. Are we now going to take unfair advantage of our disabled fellow human beings?
Increases in medical care costs will push the already teetering patient into the abyss of hopelessness, where life-saving medicines and services will remain outside the grasp of their desperate hands. As a health care provider and concerned Jamaican, I petition Dr. Davies' adviser(s) to rethink the dire consequences of the poor advice given to the Minister and have him withdraw the proposed tax on the sick. Implementing this decision will produce untold hardship and precipitate a medical and financial disaster.
Dr Garth Rattray is a medical doctor with a
family practice.
