Health Care For All - A Scheme?
The success of developing countries has recently been found to depend mostly on the health of its population. Having a successful health care system in place - one that is both efficient and equally effective for varying income groups - has emerged as the leading cause of enhanced productivity/labor, education, and income. It is the number one weapon in the fight against poverty in Africa’s Ghana, where the progressive National Health Service was set up funded 100% by state revenue (taxes were paid relative to income earned).
While the services provided at no cost (to users at the point of sale) protected the poor from medical debts, those same services were not of the best quality and favored the city populace over lower income rural areas. Once user fees were introduced in the early 1970s Ghana began to experience an imbalance in payments for medical services, and in ten years the country was bankrupt due to agricultural productivity declines, a global decline in the prices of gold and cocoa, and over-borrowing to finance the country’s debt.
In 1983 a structural adjustment swept across Africa devaluating the currency and the “cash and carry” program was introduced to recover costs in Ghana’s health system. This program required patients to pay in full for medical services upon receipt while the government could no longer finance health care through taxation. Theoretically, the increase in revenue from patient charges would then go to develop health care centers and enhance services, plus would cut down on patients abusing a free system.
Ultimately, cost recovery’s “cash and carry” failed due to high levels of unemployment in the public sector, leaving people unable to pay for services. Mortality and morbidity increased, families couldn’t afford simple nutrition, education, and couldn’t afford to treat illness or disease.
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