Imagine that you are driving home late at night when you come across the scene of a traffic accident. Passersby have already managed to remove the victims from the mangled wreck, but they have no way of transporting them to a medical facility. They flag you down and implore you to transport the casualties to the nearest hospital. Incidentally, you are the first driver they have flagged down that has actually stopped.
What action would you take next? One of the immediate concerns that come to mind is that you will be taking on a responsibility to pay a stranger’s medical bill.
Truth be told, the majority of our hospitals will not admit anyone, regardless of the situation, if there is no assurance of payment for services rendered.
This scenario reflects the challenges that bedevil our health care system. According to the World Health Organization (WHO), provision of healthcare should be guided by core primary health principles which include universal coverage (read, access to healthcare regardless of ability to pay) and people-centered services (read, built around the needs of the public).
In Kenya, the situation is such that more than half of our population cannot afford healthcare, with children being most affected. We have a very large aging population whose needs cannot be met at the local council hospitals, because they are not well equipped to deal with emerging illnesses associated with age and changing lifestyles.
Furthermore, most private-sector hospitals are commercially oriented and thus are only accessible to those who are lucky to have a medical scheme, or those who can afford off-pocket payments. To top it all, we have witnessed an influx of foreigners and refugees vying for the same medical resources.
Because there’s a gap for healthcare services, some unscrupulous people have resorted to unorthodox means to cash in on this demand.
For instance, there is an increase in the number of cheaper counterfeit drugs whose potency we cannot vouch for. It is also unforgivable when drugs meant for public consumption are diverted to private clinics which then charge a premium to dispense the same drugs. But what is scarier, is that practice of medicine is under threat from fake doctors who discredit the professionalism of the industry practitioners. This is an area in need of thorough supervision and scrutiny.
Ideally, our national health insurance fund should have evolved to become a stand-alone medical provider scheme. It would have met some of the need for healthcare provision to those who cannot afford it. Unfortunately, the fund has lacked the vision and direction required to move to the next phase as a medical care provider.
So where do we go from here? When Thomas Jefferson wrote the Declaration of Independence in 1776, he stated that all men are endowed by the creator with certain unalienable rights not limited to life, liberty and pursuit of happiness. That statement was responsive to America’s needs at that time, as a country trying to gain its independence.
Perhaps as a country, we ought to go back to the basics. We ought to define the rights that we consider unalienable – which should not be taken away) and then focus on improving provision of those rights equally to all.
In my opinion, access to basic healthcare should be considered unalienable, ranked highly among other rights such as access to food, education and security for all Kenyans.
To this effect, my proposals are two-fold. One, that we set up a public health think tank, comprising of all stakeholders, whose mandate is to develop appropriate policies responsive to our healthcare needs. The use of technology is one area that can be explored as a means to improving access to medical care.
Secondly, we may want to consider levying a flat national tax to all equally, to support the provision of health care for those who cannot afford it. In the past, such proposals have been rejected because they have targeted the top socio-economic bracket and made it feel discriminatorily burdensome.
However, the issue of health must be dealt with primarily at the individual level. It is imperative that we all learn basic preventative measures to illness and that includes promoting healthy living.
Irrefutably, health care is a global issue which acts as a gulf between the haves and the have nots. For a country that is still experiencing strong negative undertones, fuelled by feelings of inequity, my feeling is that improving access to health would go a long way to promoting equity for all Kenyans.
Let us therefore join hands and declare healthcare an unalienable right for every Kenyan.