THE EDITOR: Health Minister Terrence Deyalsingh recently articulated a fundamental principle of economics which should be heeded by all concerned citizens. Speaking about the practice of leaving elderly people and children at hospitals by their relatives and parents, Deyalsingh said, repeatedly, “This is what happens when you have free healthcare.”
The minister is obviously aware that economic incentives dictate that any good which is free will be over-used and hence become scarce (in the case of services, this means inefficient).
We see this principle being played out in practice from the health sector to education to fire prevention to the inability of the Transport Ministry to even supply a sufficient quantity of legally mandated inspection stickers for vehicles.
Let us consider what would happen under a totally privatised healthcare system. First, the abuses specified by Deyalsingh would be minimised, if not eliminated. Once relatives and parents have to pay a fee to leave their elderly parents or children at a hospital, they would be less inclined to do so.
Moreover, even if they continue this practice, the hospital benefits by being paid and the elderly people and children will get better care. Also, the medical institutions will also have the option to refuse people who do this, which public hospitals cannot do.
This is one of the reasons people are forced to wait long to be attended, since this discourages trivial complaints, but the public hospitals prioritise children and the elderly, so that informal sanction does not work in these cases.
Secondly, a totally privatised healthcare system would deliver faster and better treatment and minimise abuses (including corruption in terms of procurement and doctors not performing their duties).
How would it be paid for? Through people taking out private insurance and through healthcare costs dropping because of competition between hospitals and all healthcare professionals. In this scenario, the Medical Board would lose its monopolistic power to certify doctors, hence allowing anyone to practise healthcare (which happens now with “alternative medicine” practitioners).
How would people know if someone is reliable? Because they would have a relevant qualification (eg, someone with nurse training can open a medical office offering basic healthcare, such as giving vaccines) and because private monitoring bodies would be formed to give recommendations.
What about people who can’t afford insurance? The private hospitals would take some of these people in order to foster goodwill, the Government can subsidise them, and there are several other options to ensure everyone gets treatment.
Given the ineffectiveness of the present system, saving lives requires that we consider other approaches to healthcare.