Towards equity in medical, private health care

Recently, looking for a bed for my ailing younger sister, I was told, at Bokamoso, that one without medical insurance, had to cough up P300, 000 upfront for a COVID-19 patient. Sidilega, demanded P30, 000 a day, while GPH were literally closed. The P300, 000 covered only 10 days.

Look, I’d have robbed a bank to keep her alive, but there was another problem: there were no beds. I have a university qualification, and that has afforded me a modest life. But I was rudely reminded that the trapping of comparative privilege brought about a university degree, mean nothing so long as the socio-economic foundations upon which the entire country rests, is fundamentally flawed. No one is safe, until everyone is safe. I lost her. As a general proposition, people aren’t poor, because they are lazy. We are thrust into and innately unfair world, from positions of inherited, and sometimes enforced, socio-economic inequalities. A young girl must deal with the reality of having been raped in their infancy before they can muster the courage to face the world. A young boy must emerge from child labour to find his place in the sun. Someone must overcome challenges that come with social stigma, albinism, and tribal prejudice, before they can compete for limited opportunities in a rigged economic system that perpetuates class inequities. Often, we look to someone, who has achieved mozdes success, and parade them as an example of what we could all be, if we tried harder. Fair enough, one who rises to be a general where they were born a private deserves commendation and generous applause. What we overlook, is that effort does not always translate to upward mobility, and financial success. There are those who have put in twice as much, with little or no success. Merit is not a guarantee of success, even though it is as a general proposition, a function of it.

Merit or no merit, you must still deal with an unfair world. There are academically brilliant kids who had to drop out of school when their parents died, because they had to take care of their younger siblings. There’s another like circumstanced kid who had a kind hearted, and selfless auntie who stepped in as a mother, and allowed them to finish their education. The challenge of any society, and any government, is to be cognisant of substantive and formal socio-economic inequalities. When we do, we will be more empathetic to the plight of the less fortunate, and will be less cynical when required, as a collective, to deal with their suffering. The word equality has left the eloquence of most human rights and social welfare advocates, all for the right reasons. The word, equity, instead, has taken root. There has overtime, been a realisation, that the inherent inequalities endemic in our societies, cannot be wiped off by a one size fits all policy, or political ideology.

Communism failed on its own demerits, but as Joseph E. Stiglitz, observed, its failure was not testament to the merits of capitalism. Capitalism has remained with all its ugly, and glaring, imperfections. Tight-lipped deference to it, robs us of the strong points from alternative ideologies, including those untried. For example, centuries old cultural norms, that fostered societal equity, or at least preserved human dignity, must now be replaced by government welfare programmes. In Africa, generally, orphan care was never the business of government. It was a role, to which, no one was elected or requested. It was assumed the way nature fills a vacuum. African culture had inbuilt mechanisms for self-healing, and for addressing human suffering. It was far from perfect that must be accepted. But there are merits from it that ought now to have been interwoven into economic policy. My children have medical insurance because their mother is alive, and her employer part pays, for it. Many orphans do not have medical insurance for no reason but that their parents are dead. That has nothing to do with merit. Why should there still be insistence on medical insurance companies, for example, that one can only extend cover to a spouse and biological children, to the exclusion of orphans demonstrably under their care? Why can’t one include, in their medical cover for those who, while being over 18, or 21, depend on them in times of hardships. There is institutional discrimination that comes with being an orphan, and with being poor. It is just a plain unfair, and, it is that simple. My contention is that it need not be this way. We need to reignite dialogue around medical insurance, and ensure reform to foster access to private health cafe, as a complementary necessity to government health care efforts. Fair enough, my sister didn’t die because she had no medical insurance. I was already considering which cars to pawn, to pay her bills, assuming I could find a bed. But there are many who certainly did, even on account of non-COVID-19 causes. And we just let them die. A friend and colleague of mine, Joram Matomela, argues that private hospitals are all about extinguishing your insurance credit, and then spitting you out to the great equaliser of all citizens, Princess Marina Hospital.

That same, are little more than emblems of class and status, providing mainly “working class women”, with premium addresses for child birth certificates. I think it was harsh in his criticism. I do believe they do serve much more purpose beyond that. Harsh as he may be, there is a ring of truth, in his argument. Actually, plenty. For what it’s worth, we must consider humanising both medical insurance and as a corollary, private medical care. As it is, medical insurance companies and private hospitals combine the vices of rabid capitalism, a caste system, and criminal cartel all rolled up together, and reinforce socio-economic inequalities in life and death matters. Some friends have charged me that that is also true for legal. Insurance, and law firms? Far from it. Legal insurance is hardly ever about life and death, and is accessible at PSO per month for everyone. I have a doctor on speed dial right now. The majority of fellow citizens must die in queues. We can do better. Life should not be a class privilege.