Healthcare: a human right or a luxury?
I want to thank Bob Stewart for his opinion piece in The Royal Gazette on the health reforms.
I want to thank him because it shows so clearly why people oppose the proposed reforms: disinterest in a common good and lack of understanding.
The people for whom the status quo is working — about 8,000 judging from the signatures on the Patients 1st petition — are avid to stop the reforms. But if I judge by the many people I have spoken to, there is a lot of interest in changing the parts of healthcare that don't work for Bermuda as a whole.
Bermuda's health system is incredibly complex. For a small country, we have managed to create a system where it's nearly impossible to control costs or direct funds to prevention and health maintenance. The system has the wrong incentives, and they won't change if we don't reform.
I invite people emboldened by Bob's claims to check facts for themselves. How has “socialised medicine” worked in other countries? How does Bermuda compare to them? How have countries with systems similar to ours, such as the United States, performed compared to “socialised” systems? This is very easy to see in the Health in Review Report 2017, available online. It compares Bermuda to high-income countries on more than 60 indicators showing hard data on how each performs.
And the conclusion? Bermuda does some things really well, and others not so much. And fairly consistently we do poorly on cost, value for money and sustainability. Why? Because our “system” is a fragmented and convoluted “Wild West” where patients, actually, are not first at all.
And which countries do better in terms of outcomes, access and quality? The socialised ones ... indeed, the civilised ones who long ago enshrined in their health systems that health is a fundamental human right, to which all citizens must have access.
The United Nations itself promotes #HealthForAll to advocate that “health is a human right, not a luxury”. It is joined by the World Health Organisation, the World Bank and many other international bodies who know more about healthcare than most local commentators.
It is unsurprising that Bob Stewart should seek to undermine this principle. Libertarians like him would have us rely on the invisible hand of the market delivering healthcare to deserving souls.
To date, the “invisible hand” has failed us and it is, rather, the charity of willing health professionals, GoFundMe pages, and our taxes and insurance premiums that are picking up increasingly large bills for expensive complications owing to untimely care.
Bob Stewart says he has never heard of anyone being refused care for lack of funds or for any reason. I seem to read such stories on our front pages all too frequently; and I know the Bermuda Health Council fields complaints from the public regularly and assists people in accessing care.
I know of people too proud to tell a health professional that they can't afford to pay. I know too many people who ration their medicines because their insurance coverage will run out. I know 75-year-olds are not allowed to buy private health insurance. I know of people who incur huge, crippling debt because they needed and got healthcare they couldn't afford.
Maybe I live in a different universe from Mr Stewart, but I know these situations are real and I know that without fundamental changes to our healthcare, the problem will become worse as our already sickly population ages. Doctors' charity and benevolence cannot fill this gap.
The belief that any politician stands to gain power from pursuing a healthcare for all agenda is laughable. The local altercation over health reform, and other countries' experiences, show that, in fact, trying to achieve health for all is a sure way to become unpopular quickly.
I for one, like many others, have personally applauded those seeking reform and asking for our views. It takes courage to do the right thing.