Adithi Randeni, Year 2
Considering this pandemic, healthcare is now, more than ever, in the spotlight. It is being pushed to its limits all over the world and therefore presents an opportunity to ask: is free healthcare really all that it was meant to be?
Even with the breakthroughs that science makes on an almost daily basis, many around the world cannot afford basic healthcare – a right akin to the right to life. With pharmaceutical giants charging extortionate prices for medication, a shortage of medical professionals and budget cuts at every turn, healthcare is a facet of our lives that needs re-evaluating.
‘The strategy of the free healthcare system is to ensure that every citizen, from any socio-economic background, has proper access to health services at a minimal cost or no cost at all’ (Honest Pros and Cons, 2020). Free healthcare lowers costs for individuals. It ensures those paid lower wages have equal access to health facilities. In Portugal ‘those who are not in employment, dependent family members, or retirees do not have to make [tax] contributions’ to the healthcare system (Cronin, J. 2018) (Expatica, 2020).
Free healthcare has its financial benefits within the industry. For one, it lowers administrative expenses. In the free market, doctors negotiate with agencies for medical supplies. This is overcome in a setting like the NHS by allowing tasks to be undertaken by one group (Honest Pros and Cons, 2020). Free healthcare also reduces long-term costs (Honest Pros and Cons, 2020). By providing the entire population with access to health services it ensures that illness is caught and treated early. This lowers the likelihood of citizens developing chronic illnesses that are expensive to treat due to the duration over which care must be provided. (Honest Pros and Cons, 2020).
Healthcare access to all, in a very round-a-bout manner, boosts the economy. Universal healthcare ensures that fewer employees get sick and so productivity increases, allowing economic growth (Honest Pros and Cons, 2020). It also eliminates competition. Many multi-billion-dollar industries prioritise quantity over quality. By standardizing care and costs, the healthcare industry has overcome this organisational issue (Honest Pros and Cons, 2020). On the subject of standardisation, the implementation of universal healthcare ensures equal quality services across the country.
However, free healthcare decreases the motivation to innovate. If everything is standardised and there is less opportunity to progress, individuals are less keen to improve current procedures. This is unfavourable as improvement requires progress and progress requires innovation. Therefore research and entrepreneurial experience should be factor in any healthcare professionals’ CV (Kandie, L. 2020).
Free healthcare can degrade service quality as well. A larger population means more people accessing services. This causes longer waiting periods, tired staff and equipment shortages. This decreases standard of care, sometimes with fatal consequences. A study by Maphumulo et al (2019) found a ‘Decline in quality health care has caused the public to lose trust in the healthcare system in South Africa’. It also concluded that quality care requires ‘fewer errors, reduced delays in care delivery, improvement in efficiency, increased market share and lower cost[s]’ (Maphumulo, W.T., 2019).
Additionally, free healthcare prioritizes chronic diseases. Most hospital beds are filled with patients who will require around the clock care for extended periods of time (Honest Pros and Cons, 2020). This severely limits the resources available for other procedures. This method also brings with it the less obvious risk of increasing the number of chronic patients in the population overall. For example, when elective surgeries are pushed back, the likelihood of the condition progressing and the patient deteriorating increases. This leads to increased hospital admission times and amount of care needed.
Universal healthcare also poses a major burden to a government’s budget. Healthcare costs account for most of the spending of most governments and whilst developed nations may be able to shoulder the burden and proceed, developing nations run the risk of entering debt. Consequently, it also causes one of two undesirable coping measures. Either funding for healthcare itself is reduced, or funding for equally vital fields such as education are cut. A key factor noted by Localiiz (2017) is that the Hong Kong healthcare system, despite all its achievements, provides ‘Limited access to patients with special needs or different backgrounds’ due to the funding difficulties.
Conversely, at the risk of sounding unbelievably cliché, free healthcare allows doctors to uphold their oath to save lives without discrimination (the discriminatory factor being, in this case, financial status). Universal healthcare has the potential to allow the child who would otherwise die of pneumonia to grow up and live a full and healthy life; it gives the couple who are struggling to have children the chance to start a family of their own; it enables the father diagnosed with prostate cancer to live to hold his grandchildren in his arms—regardless of how much they earn on an annual basis.
After examining the pros and cons, we should consider the healthcare system of Sri Lanka. A report by the World Health Organisation (Perera and Perera, 2017) describes this as ‘a healthcare system in transition’. Set up to battle communicable diseases such as malaria which it has successfully eradicated since 2013 and polio since 1993, this system is credited for the country’s quick and efficient response to COVID-19. However, it is under reform to account for non-communicable diseases and it is changing to better improve care.
In conclusion, universal healthcare has a multitude of advantages, both moral and financial. However, its pitfalls cannot be overlooked. Therefore, the most ideal situation would be to reform and change current healthcare systems to maximize tax usage and to maximize availability. Change is possible. If one nation, such as Sri Lanka, can strive to alter a decades long initiative, then change is just as viable all around the world.
References
Cronin, J. 2018 Is Free Healthcare a Possibility for International Citizens or Travelers?. Countries with Free Healthcare [Online]. [Accessed 14th Nov 2020]. Available from: https://www.internationalinsurance.com/health/countries-free-healthcare.php
Expatica, 2020. A Guide to Healthcare in Portugal. Expatica [Online]. Available from: https://www.expatica.com/pt/healthcare/healthcare-basics/healthcare-in-portugal-106770/
Kandie, L. 2020 Advantages and Disadvantages of Free Healthcare. Briefly [Online]. [Accessed 14th Nov 2020]. Available from: https://briefly.co.za/47269-advantages-disadvantages-free-health-care.html
Localiiz, 2017. Opinion: The Problem with Public Healthcare in Hong Kong 11th Jan 2017 My Life in Hong Kong [Online]. [Accessed 12th Nov 2020]. Available from: https://www.localiiz.com/post/opinion-the-problem-with-public-private-healthcare-in-hong-kong
Maphumulo, W.T. 2019. Curationis Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review 42(1): 1901 [Online]. [Accessed 14th Nov 2020]. Available from: doi: 10.4102/curationis.v42i1.1901 or https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556866/
Perera, A. and Perera, H., 2017. Primary Healthcare Systems (PRIMASYS) Case Study From Sri Lanka. WHO [Online]. [Accessed 15th Nov 2020]. Available from: https://www.who.int/alliance-hpsr/projects/alliancehpsr_srilankaprimasys.pdf?ua=1 Racheal, 2020 11 Pros and Cons of Free Healthcare 16th March 2020. Honest Pros and Cons [Online]. [Accessed 14th Nov 2020]. Available from: https://honestproscons.com/pros-and-cons-of-free-healthcare/
THE WORSLEY TIMES 
Leave a comment