{"id":12697,"date":"2018-04-16T08:49:53","date_gmt":"2018-04-16T04:49:53","guid":{"rendered":"http:\/\/www.mauritiustimes.com\/mt\/?p=12697"},"modified":"2018-04-16T09:34:18","modified_gmt":"2018-04-16T05:34:18","slug":"health-care-the-nation-deserves-better","status":"publish","type":"post","link":"https:\/\/www.mauritiustimes.com\/mt\/health-care-the-nation-deserves-better\/","title":{"rendered":"Health Care: The Nation Deserves Better"},"content":{"rendered":"<h6 style=\"text-align: center;\"><span style=\"color: #800000;\"><em>For far too long (50 years to be precise!) we have contented ourselves with just taking the ball from the British and running with it &#8212; without much reflection on the real needs of a new, emancipated post-colonial citizenry. The nation deserves better<\/em><\/span><!--more--><\/h6>\n<p><span style=\"color: #000000;\">Healthcare is defined as \u201cthe diagnosis, treatment, prevention and management of disease, illness, injury, and the preservation of physical and mental well-being in humans.\u201d (Wikipedia). An efficient, caring National Health Service (NHS) is essential for the provision for these services because people do fall ill, meet with accidents and emergencies arise all the time.<\/span><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"12698\" data-permalink=\"https:\/\/www.mauritiustimes.com\/mt\/health-care-the-nation-deserves-better\/hospital-2\/\" data-orig-file=\"https:\/\/i0.wp.com\/www.mauritiustimes.com\/mt\/wp-content\/uploads\/2018\/04\/Hospital.jpg?fit=1100%2C619&amp;ssl=1\" data-orig-size=\"1100,619\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Hospital\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/i0.wp.com\/www.mauritiustimes.com\/mt\/wp-content\/uploads\/2018\/04\/Hospital.jpg?fit=640%2C360&amp;ssl=1\" class=\" wp-image-12698 alignleft\" src=\"https:\/\/i0.wp.com\/www.mauritiustimes.com\/mt\/wp-content\/uploads\/2018\/04\/Hospital.jpg?resize=640%2C361&#038;ssl=1\" alt=\"\" width=\"640\" height=\"361\" srcset=\"https:\/\/i0.wp.com\/www.mauritiustimes.com\/mt\/wp-content\/uploads\/2018\/04\/Hospital.jpg?resize=300%2C169&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.mauritiustimes.com\/mt\/wp-content\/uploads\/2018\/04\/Hospital.jpg?resize=768%2C432&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.mauritiustimes.com\/mt\/wp-content\/uploads\/2018\/04\/Hospital.jpg?resize=1024%2C576&amp;ssl=1 1024w, https:\/\/i0.wp.com\/www.mauritiustimes.com\/mt\/wp-content\/uploads\/2018\/04\/Hospital.jpg?w=1100&amp;ssl=1 1100w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<p><span style=\"color: #000000;\">Needless to say that all this cost money &#8212; a lot of money! But this money has to be found because\u00a0people\u2019s aspirations for a happy, healthy and productive life can only be met if they are in good shape. Some wise man has rightly said that a healthy nation is a wealthy nation. But as Dr RN Gopee says \u201cto create (that) wealth every society needs a healthy population.\u201d <em>(<\/em>MT 02-Mar-2018). So Health=Wealth=Health\u2026<\/span><\/p>\n<h5 style=\"text-align: center;\"><span style=\"color: #800000;\"><strong>NHS Budget<\/strong><\/span><\/h5>\n<p><span style=\"color: #000000;\">Almost every week, we get newspaper reports of lack of equipment, vital equipment waiting to be repaired, shortage of medication, shortage of staff and long waiting lists that drive ordinary working folks to seek private medical treatment at great cost. But given the financial constraints of the Government of Mauritius (GM), this is not surprising!<\/span><\/p>\n<p><span style=\"color: #000000;\">In the first 10 years of the millennium (2001-2010), GM expenditure on the NHS amounted to a mean average of 2.13% of GDP. The corresponding figure for next 6-years (2011-2016) was slightly better at 2.37% (Table 1).\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #000000;\"><strong>Table 1: <\/strong><strong>GM expenditure on the NHS<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Year\u00a0 \u00a0% GDP spent\u00a0 \u00a0 Total GDP\u00a0 \u00a0 \u00a0GM Health\u00a0 \u00a0 GM Health<br \/>\n<\/strong><strong>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0on Health\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 USD-bn\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Budget\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Budget\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0USD-bn\u00a0 \u00a0 \u00a0 \u00a0 \u00a0MUR-bn<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">2011\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a02.46\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a011.52\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 0.283\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 9.34<\/span><br \/>\n<span style=\"color: #000000;\">2012\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a02.29\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a011.67\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 0.267\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 8.81<\/span><br \/>\n<span style=\"color: #000000;\">2013\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a02.37\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a012.13\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 0.287\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 9.47<\/span><br \/>\n<span style=\"color: #000000;\">2014\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a02.36\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a012.80\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 0.302\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 9.97<\/span><br \/>\n<span style=\"color: #000000;\">2015\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a02.37**\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a012.16\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 0.288\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 9.50<\/span><br \/>\n<span style=\"color: #000000;\">2016\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a02.37**\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a011.68\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 0.276\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 9.10<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"color: #000000;\">Exchange rate USD\/MUR = 33<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"color: #000000;\"><em>** Extrapolated from 2011-1014 figures\u00a0<\/em><\/span><\/p>\n<p><span style=\"color: #000000;\">Straightaway the reader would have noticed that there has been no increase in the Health budget to compensate for any increase in staff and material costs (think PRB, the rise in the cost of medication\/equipment and new treatment coming online). So, in spite of all the hype and hyperbole from every Finance Minister on Budget Day, the level of services would have\u00a0<em>a priori\u00a0<\/em>declined over the years. This is something of which chronic users are only too aware; Mo Ibrahim and other obscure index notwithstanding. On the other hand GM simply does not have the cash.<\/span><\/p>\n<h5 style=\"text-align: center;\"><span style=\"color: #800000;\"><strong>Comparison<\/strong><\/span><\/h5>\n<p><span style=\"color: #000000;\">In 2014, we spent 4.80% of our GDP on health services &#8212; split almost 50\/50 between the public and the private sector. Thus, for a middle-income country, we are found not only lagging behind the developed nations but also shockingly compare badly &#8212; very badly &#8212; with several developing African states (Table 2).<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Table 2: % <\/strong><strong>GDP on health services<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\">2016\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Income Per Capita\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Percentage of GDP<\/span><br \/>\n<span style=\"color: #000000;\">Country \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 USD 000\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0Spent on Health-care<\/span><br \/>\n<span style=\"color: #000000;\">USA\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a061.6\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 16.6<\/span><br \/>\n<span style=\"color: #000000;\">Euro Area\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 40.0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a010.4<\/span><br \/>\n<span style=\"color: #000000;\">UK\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a038.8\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 9.9<\/span><br \/>\n<span style=\"color: #000000;\">Afghanistan\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a00.6\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 8.2<\/span><br \/>\n<span style=\"color: #000000;\">Liberia\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 0.5\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 10.0<\/span><br \/>\n<span style=\"color: #000000;\">Maldives\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a09.9\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 11.4<\/span><br \/>\n<span style=\"color: #000000;\">Malawi\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a00.3\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 11.4<\/span><br \/>\n<span style=\"color: #000000;\">Sierra Leone\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 0.7\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 11.1<\/span><br \/>\n<span style=\"color: #000000;\"><strong>Mauritius\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a011.7\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 4.8<\/strong><\/span><\/p>\n<p>The figures are so eloquent that they do not need much comment. One would naturally expect the rich OECD countries to spend considerably more than Mauritius. But the absolute shocker is that countries which are poorer than us &#8212; in some cases much poorer &#8212; spend a larger percentage of their GDP on their health services. Thus Malawi with a meagre IPC of just USD 0.3k spends 11.4% whilst Mauritius \u00a0with a much greater IPC of USD 11.7k spends a shameful 4.8%. Even Afghanistan which has been ravaged by armed conflict continuously since the 1980s spends 8.2%.<\/p>\n<h5 style=\"text-align: center;\"><span style=\"color: #800000;\"><strong>Solution<\/strong><\/span><\/h5>\n<p>My friend Keshraj never tires of telling me \u201cdo not criticize without suggesting possible solutions.\u201d He would therefore never forgive me if I did not end this piece with some suggestions.\u00a0<strong>Essentially we need to pump more money (and resources) into the NHS.\u00a0<\/strong>But GM does not have the funds to increase the NHS Budget. However the money is out there; we just need to be bold enough to tap into the source.<\/p>\n<p>But first and foremost, we need to carry out a thorough Organization and Methods study of the NHS. And instead of just talking about it (it&#8217;s been at least 20-years now!), computerize all patient files. Both these measures will save on time and money. Computerization will also help avoid mix-ups; which undeniably happen sometimes with fatal outcomes!<\/p>\n<h5 style=\"text-align: center;\"><span style=\"color: #800000;\"><strong>Funding<\/strong><\/span><\/h5>\n<p>Shedding crocodile tears, politicians decry the widening gap between the rich and the poor whilst deftly introducing policy measures that actually boost this phenomenon. Like halving the Corporate Tax from 30 to 15% &#8212; the same rate that the working man is made to pay. Where is the principle of fairness in this? Make the rich richer and the \u201ctrickle-down effect\u201d will take care of the rest, went the argument from the self-styled Gurus.<\/p>\n<p>Unfortunately the world is now finding out that the \u201ctrickle down\u201d theory and even the John F. Kennedy famous \u201ca rising tide lifts all boats\u201d were chimeric illusions that beguiled humankind for decades. So I\u2019m afraid it\u2019s back to the basic honesty of schoolboy Economics which tells us that Equity, Redistribution of Income\/Wealth and General Welfare can\u00a0<strong>ONLY\u00a0<\/strong>be achieved by the transfer of income\/wealth from the rich to the rest. PC this may not be, but it is the naked truth!<\/p>\n<p>(A) To begin with, scrap the mandatory CSR which is a not-so-clever way to recycle profits to create jobs for the boys and the girls internally; and leave it to each Corporate to spend whatever they wish on CSR. In 2015, corporates paid taxes amounting to Rs 9.8bn to the MRA. A special levy of 5% in favour of a special NHS Fund would bring in\u00a0Rs 3.267bn. This would still leave the effective corporate rate at a very favourable 20% (Table 3).<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #000000;\"><strong>Table 3\u00a0\u00a0: Average Top Marginal Corporate Rate 2017<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Region\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0Average %\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0No of Countries<\/strong><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>Mauritius\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a015.00\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a01<\/strong><\/span><\/p>\n<p style=\"text-align: left;\"><span style=\"color: #000000;\">EU\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 22.45\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 28<\/span><br \/>\n<span style=\"color: #000000;\">N. America\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a023.51\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a031<\/span><br \/>\n<span style=\"color: #000000;\">OECD\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 24.66\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 35<\/span><br \/>\n<span style=\"color: #000000;\">S. America\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 27.27\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 11<\/span><br \/>\n<span style=\"color: #000000;\">BRICS\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a028.32\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a05<\/span><br \/>\n<span style=\"color: #000000;\">Africa\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 28.53\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 40<\/span><br \/>\n<span style=\"color: #000000;\">USA\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a038.90\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 1<\/span><br \/>\n<span style=\"color: #000000;\">UAE\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a055.00\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 1<\/span><\/p>\n<p><span style=\"color: #000000;\">(B) The labour force comprises of 400k workers. As a rough guide, let the 150k lower paid contribute Rs 100 and the rest pay Rs 200 per month. This can be graduated so that higher earners contribute substantially more. That\u2019s an easy Rs 780k+ pa into the NHS Fund.<\/span><\/p>\n<p><span style=\"color: #000000;\">(C) As promised prior to its launch, direct all contribution from Lotto to the NHS Fund instead of the Consolidated Fund. That\u2019s another\u00a0Rs 392k (2016 figures).<\/span><\/p>\n<p><span style=\"color: #000000;\">(D) When our citizens go abroad, they need to buy adequate health cover which would pay for any medical expenses that may arise during their visit. On the other hand foreigners receive free treatment in Mauritius. This generosity must stop, and they must be made to pay. Another source of income?<\/span><\/p>\n<p><span style=\"color: #000000;\">(E) QED! A total of Rs 4.439bn+ in the kitty of the NHS Fund.<\/span><\/p>\n<h5 style=\"text-align: center;\"><span style=\"color: #800000;\"><strong>Private Medicine<\/strong><\/span><\/h5>\n<p><span style=\"color: #000000;\">In his last Budget, Indian Finance Minister Arun Jaitley announced that his government would provide free health cover to 43% of the population. That is 100m families &#8212; comprising 500m (yes half a billion!) individuals &#8212; would be insured for INR 500k each. And the Indian PCI of USD1.9k is only 1\/6 of Mauritius\u2019s!<\/span><\/p>\n<p><span style=\"color: #000000;\">In spite of GM mouthing for years that it wants to encourage private medicine, all we have had so far is a measly tax relief on the first Rs 12k of premium paid on health insurance, while the cost of medical treatment has risen substantially. I am certain that, if deduction was allowed for the full premium, more people would be encouraged to take up private cover. With the result that by shifting yet more patients towards the private sector, this would release more NHS facilities for the needy.<\/span><\/p>\n<p><span style=\"color: #000000;\">We have to remind ourselves that it is not only the rich who go for private treatment. Many poor working people are <strong>driven<\/strong> to take that route. So it behoves us to implement measures that would enhance general welfare. A simple policy would be to encourage Charity Status Private Hospitals (CSPH) through a different tax regime.<\/span><\/p>\n<h5 style=\"text-align: center;\"><span style=\"color: #800000;\"><strong>Virtuous Circle<\/strong><\/span><\/h5>\n<p><span style=\"color: #000000;\">By just taking these relatively easy, doable steps in the first instance would result in (i) an increase of 50% in the NHS budget, and (ii) a better health service for everyone. Remember Health=Wealth=Health&#8230; a very virtuous circle!<\/span><\/p>\n<p><span style=\"color: #000000;\">But we need to act urgently. Sitting on our laurels whilst patting ourselves on the back is no longer an option, for we really have not done as well as we like to imagine! For far too long (50-years to be precise!) we have contented ourselves with just taking the ball from the British and running with it &#8212; without much reflection on the real needs of a new, emancipated post-colonial citizenry. The nation deserves better.<\/span><\/p>\n<p><span style=\"color: #000000;\">If we have got any local\/diasporic Aneurin Bevans in the wings, pray let them come forward!<\/span><\/p>\n<p>&nbsp;<\/p>\n<hr \/>\n<p><span style=\"color: #00ccff;\"><em>* Published in print edition on 13 April 2018<\/em><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>For far too long (50 years to be precise!) we have contented ourselves with just taking the ball from the British and running with it &#8212; without much reflection on the real needs of a new, emancipated post-colonial citizenry. The nation deserves better<\/p>\n","protected":false},"author":19,"featured_media":12698,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[3360],"tags":[3652,3755,9026,9024,3622,2380,82,9027,9025],"class_list":["post-12697","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-public-health","tag-aneurin-bevan","tag-arun-jaitley","tag-charity-status-private-hospitals","tag-corporate-tax","tag-john-f-kennedy","tag-national-health-service","tag-ramesh-beeharry","tag-redistribution-of-income-wealth","tag-trickle-down-effect"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.mauritiustimes.com\/mt\/wp-content\/uploads\/2018\/04\/Hospital.jpg?fit=1100%2C619&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p8QzSF-3iN","_links":{"self":[{"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/posts\/12697","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/users\/19"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/comments?post=12697"}],"version-history":[{"count":0,"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/posts\/12697\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/media\/12698"}],"wp:attachment":[{"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/media?parent=12697"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/categories?post=12697"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mauritiustimes.com\/mt\/wp-json\/wp\/v2\/tags?post=12697"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}