Monday, August 12, 2013

Health Inequality

Someone very famous said that " Off all the forms of inequality, justice in health care is the most shocking and inhumane".

I am one young doctor who had just started the learning curve of treating the unwellness of another human. Coming from a humble background, my empathy to people who are disadvantaged in getting health care makes me sad. And this is even sadder when those whom claimed to have been living in reality long enough; laugh off the very discomfort I have for the injustice of healthcare. They say "This is How the World Work" and that "Welcome to the world".

Is that so? I know you would have think the same.

And any hope and ideals in having a just and equal world, is immature, unrealistics, and idealistic, or even utopian?

Lets not digress into other inequality, just stick to health care. Apparently it is acceptable and reasonable that the world works by the concept of the more money you have, the better care you would have, and this is at the expense of those who have less money than you.

Queue is different for everyone. Treatment is different for one person to another. Same disease, different persons, would have different course of treatment, despite having similar natural history and progress.

I can give aplenty of examples.

Those who has money will go to top class most senior doctors, who get their years of experience by treating the poor. So when you have money, you dont have to take part in providing learning curve and avenue to young doctors.

Other examples like doctors placement. This has been going on and on for tens of years. Same story different centuries. We cant actually blame these doctors. Human are born to be individuals, and no one would want to be away from the comfort of families, entertainment, connectivity, and good future. Meaning it is understandable why doctors are still packing up, overflowing the cities and big towns, leaving very few in the rural areas. We have 20 doctors seeing 20 patients a day, but at the same time there is one doctor seeing 200 patients in the rural. Is this acceptable?

Other examples like hospital placement. The best of facilities are almost always at the biggest city in the state. If we go by simply the above examples, having 200 doctors in the rural areas but no modern facilities, it is pointless too. But at the same time, it is unavoidable that the best of equipments must be in the biggest town, I understand. However, there must be a real effort to alleviate the scale of facilities inequality.

In simple words, the difficulty of a patient travelling from his house to the healthcare facilities need to be address.

This bring me to the most important message that I want to convey in this piece.

We need holistic development. Building a world class hospital needs to bring with it a world class connectivity of roads and public transport. The education level of the society around the area needs to be improved. Schools, sanitations, transportations, healthcare, educations, and so on and so on, needs to be pull together, not just one after another.

Those in power in Health Ministry can slowly take sips of their hot coffee at the comfort of their air conditioned offices looking at the many projects they put in placed; Mobile Clinics, Flying Doctors Service, latest PET scan machine in Putrajaya, hundreds of new clinics and hospitals across the country; but if there is no simultaneous development of roads, public transportations, educations and sanitations, the real problem of health inequality will still depressively, be there. How can we claim success when patients earning RM70 a week spend RM40 on transport to see us in the clinic follow-up frequently?

The recent General Election concluded with a razor thin majority to the current government. As an impartial and concerned civil servant, this is very unfortunate. I would hope for a clearer majority to whichever sides to form government. This is so that there will be less politiking, less populist decisions, and more difficult but necessary steps can be taken.

But there is still hope, I hope.

1 comment:

Anonymous said...

You kinda nailed the reason why developed countries have nationalised health insurance schemes.

The only major developed nation that does not have a health insurance scheme is the USA. And even they spend 15%++ of their GDP to support their highly "intense R&D" [read: Big Pharma Dominated] medical care system.

Ang, great article.

- Chillax