Submitted by Trained Economist
Over the past few months there has been much discussion and media coverage of issues related to health care policy in Barbados. Despite the volume of media coverage I remain unclear as to a number of issues, which restricts my ability to adequate assess the health care policy issues being raised.
From what I have been able to glean there are three issues out there:
- Only nationals and permanent residents are now entitled to free health care in Barbados.
- Persons eligible for free medications who choose to purchase such medicines at a private pharmacy are now required to pay the processing fee charged by the pharmacists to public patients and previously paid by the government.
- A number of changes have been made to the drugs on the formulary and medicines previously available free of cost are no longer available free of cost.
I would like some clarity on the following issues:
- Was residency status ever a requirement for free health care in Barbados? If so what residency status entitled a person to to free health care ? The answer I am trying to get at here is whether or not we have a change in policy or enforcement of a previously existing policy? Some follow up questions from a serious media outfit trying to inform its readers and/or listeners on issues, would be , why was the policy changed if it was in fact changed? If there has been no change in policy, why was the policy not previously enforced and why is it now being enforced? I am sorry, but I expect half decent journalists to seek out answers to these questions if they are running stories on an issue.
- What is the purpose of the processing fee for public patients at private pharmacies? Is it a fixed fee, a sliding scale or what? How much is the fee? The answer am trying to get at here is why are the private pharmacies charging a fee at all for public patients, and how much the government is saving by introducing a measure that will clearly generate some degree of inconvenience and or cost to persons. Is the tax payer being fleeced by the private pharmacies? Is the government being penny wise and pound foolish? Is the policy change likely to impose a major financial burden on public patients choosing a private pharmacy? I am amazed that no such questions were posed to the Head of the pharmacy body quoted at length in a front page story in one section of the media on Sunday May 29. As a lay person reading that story the solution for the private pharmacists seemed obvious to me. Wave the processing fee and get back the business. I am sure I am way off base, but despite massive coverage of the issue I am unclear on a number of relevant issues. I am sorry, but I expect half decent journalists to seek out answers to these questions if they are running stories on an issue.
- Are there brand name and/or generic alternatives available under the formulary to the drugs removed recently removed from the formulary? How many such alternatives are there in most cases? Are there conditions previously covered from which there are no drugs on the formulary? How much money is the government expecting to save from the changes to the formulary. Even though I am personally inconvenienced I accept that you cannot run a free drug scheme without taking advantage of opportunities to source drugs at a lower cost. Alternative drugs don’t work well for everyone, but the answer I am trying to get at is whether or not patients have at least two or three alternatives to the drugs removed from the formulary? Are doctors and pharmacists making patients aware of these alternatives (if there are any). I am sorry but I expect half decent journalists to seek out answers to these questions and publish them if they are running stories on an issue.I mean despite all the coverage and discussion there has not been a single story about the merits of generic versus brand name drugs. The newspapers and call in programs are not serious.
I am really disappointed in the media coverage of this most serious and personal of issues. Health care is not an issue to sensationalize or focus on headline grabbers. It requires some serious thought and discussion. I am at the stage where I wonder what is the point of buying a paper.