- File
There is a growing reliance on public sector doctors to provide the nation's health care needs.
Andrew Green, Staff Reporter
JUST UNDER one in every eight of us has formal health insurance, so the vast majority of Jamaicans are responsible for their own medical costs, with more than a little help from the Government.
And we are not doing too badly as providers either. The Jamaica Survey of Living Conditions 2002 reports that ability to pay is not a critical factor in health seeking behaviour.
But Jamaicans, and particularly poorer Jamaicans, have become increasingly dependent on the heavily subsidised public sector health care facilities. In 2002, for the first time, more Jamaicans used public sector health facilities than private sector ones.
This dependence on the public sector will continue to grow, with the introduction of the National Health Fund last year. Finance and Planning Minister, Dr. Omar Davies, estimated that 750,000 persons suffering from chronic illnesses would benefit.
UNIVERSAL ACCESS
This fund is a slimmed-down version of the National Health Insurance Plan for Jamaica, which promised universal access to health insurance when it was proposed in 1997. Originally, more than 1.2 million Jamaicans suffering from 15 chronic diseases were to have been assisted.
"There are very few countries, regardless of how wealthy, which have solved the problem of providing some measure of health insurance to the general public," Dr. Davies said during his Budget presentation in Parliament last year.
"Most countries find it very hard to pay for health care," said Paulette Ulett, vice-president for Life of Jamaica's Employee Benefits Division. "Programmes have to be well monitored and run."
Thus the National Health Fund omits coverage for four of the chronic illnesses initially listed under the Insurance Plan. Critically, it omits the Catastrophic Care Fund, which would have helped citizens accessing very costly and sophisticated services."A catastrophic illness could be a major problem," Mrs. Ulett said. It can have dire consequences for uninsured individuals.
The omissions from the National Health Fund mean individuals will continue to be forced into making public appeals for assistance to pay for expensive medical procedures.
More than one in every eight Jamaicans gets sick each month, according to the survey findings. Of those who get sick, more are seeking medical care, with 64 per cent doing so in 2002, against 51 per cent in 1993.
MORE EXPENSIVE
Not only are more Jamaicans seeking health care assistance, but they are finding it more expensive to do so. Adjusted for inflation, it cost 55 per cent more to visit public hospitals in 2002 than in 1993, and 73 per cent more in private hospitals.The cost of visiting a public hospital rose by less, but the reverse was the case in terms of drugs.
In private hospitals drugs cost 76 per cent more in 2002 than in 1993, but in public hospitals the increase was 122 per cent.
"Inflation of medical costs is usually higher than national inflation," Mrs. Ulett said. "Worldwide, the costs are high and growing."
The Finance Minister has cautioned that public hospital fees will have to rise soon. He said last year that fees collected at the University Hospital of the West Indies account for only 12 per cent of its recurrent costs.
He said Mandeville Hospital was faring better with 20 per cent.An important consideration for individuals is that health concerns will vary by gender and age. The Survey of Living Conditions pointed out the women were substantially more likely to report an illness than men. Children at 0-4 years, and individuals from 50 years and over, report higher levels of illness.
GRADUALLY AGEING
The Jamaican population is gradually ageing, Mrs. Ulett said. Health care costs are rising because of the challenges associated with this, along with advances in medical technology which makes more sophisticated and more expensive tests available.
Against this background, the Government is increasing its support for health care in some specific respects, but will be reducing its level of support in others.
Individuals can get private health insurance coverage to help address some of the concerns, according to a spokesperson from the Consumer Affairs Commission. He said there had been attempts to broaden access to health insurance by making plans available through banks, building societies and credit unions.
And insurance adviser Cedric Stephens says local health insurance coverage can be topped up by policies originating overseas to enhance the level of coverage.
People get just what they pay for, Mrs. Ulett said. Jamaicans should understand that, "with health insurance there is no free ride."
