The Ministry of Health should be challenged to reconsider its recent directive that the Social Health Insurance Fund (SHIF) can only foot bed charges for patients seeking health services in faith-based hospitals.
For families with terminally ill patients, this intervention is too little too late considering that they are required to pay one-year premiums before seeking admission in such hospitals.
Whereas the quality of palliative care is generally satisfactory in faith-based hospitals, the cost remains relatively high due to the direct and indirect costs of securing the services.
The upshot of this is that families will end up paying a steep price for the care of terminally ill patients because the current public health insurance system falls far too short of expectations compared to the disbanded National Health Insurance Scheme (NHIF).
Part of the reason palliative care in faith-based hospitals is attractive is that it offers better quality services and compassion by health professionals compared with public institutions, many of which are in a general state of decline and whose professionals are not as invested in their calling as their counterparts in private and faith-based institutions.
It is understandable that the public health system is beset with many challenges, not least of which is wanting remuneration of various cadres of workers, particularly professionals.
Whereas this is a historical problem that has unfortunately been allowed to fester for too long by successive governments, it is a challenge that can be addressed through political goodwill and streamlining the management of the institutions and their workers.
Indeed, this is a challenge that newly designated health Cabinet Secretary Aden Duale needs to appraise himself about if he is to make an impact in the beleaguered ministry. One other major challenge that is not as easy to address is the lack of a work ethic — or sustainable care-giving culture — that traditionally ails public health institutions.
This is a more difficult challenge to address as it will require a major culture change within the ministry’s bureaucracy. This, however, will be difficult to birth given the lethargic mindset of the health sector’s union leadership team. Unfortunately, illnesses do not take this into account.
They demand to be addressed as they happen and cannot wait for the day the health system will work seamlessly, which may never come anyway.
To get around this, therefore, it is advisable for ministry honchos to find ways in which the challenges that patients and their families experience when seeking care can be mitigated especially in light of the far-reaching directive that seeks to redirect human traffic from faith-based to public hospitals.
Finding a formula that works will critical for the wellbeing of the terminally ill, who require not only the management of their health conditions but also compassion and their loved ones who seek clear guidelines on what is best for patients in their sunset days.
One such intervention would entail finding ways in which the direct costs of caring for the terminally can be reduced so that these debilitating conditions do not impoverish families or turn WhatsApp groups into veritable fundraising forums for the distressed as has been happening all too frequently.
Needless to say, this is a tough call because institutions must balance between the need to generate profit while also offering quality services to the affected. Is there, for instance, a way in which the costing of critical medicines and medical equipment can be reviewed downwards?
Is there a way in which the public health insurance scheme can mitigate some of the costs that it routinely passes on to patients and their families to pay out of pocket? Is there a way in which such services can be sustainably devolved to local health centres without compromising on the quality of care? Is it possible to subsidise the cost of such care for the elderly and the very young?
These are difficult questions and do not lend themselves to answers that are either simple or straightforward. They require making hard choices in terms of re-prioritising funding for health services and consulting with care givers so that the arising solutions are both practical and cost-efficient.
In this regard, it is important for health scholars, policy makers and hospital managers to put their heads together, and where possible undertake on-the-ground surveys, to come up with suitable interventions that will benefit health institutions and patients alike given that it is next to impossible for private insurers to stand in this gap.
What health sector stakeholders need to come up with, if possible, is a system that will change the current course which, if left unchecked, will continue leading to sure destitution of families with terminally ill patients. The question is: Is this achievable given our present circumstances?
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