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The curse of private healthcare

TAUREEF MOHAMMED “THEM IS money satans there,” I overheard someone say, talking to a group of people about a private hospital in Trinidad. On another occasion, somebody commented to me about the callousness of a private institution: “You know, them ent move that lady from the emergency room until we make the deposit. A hospital shouldn’t operate like that.” And a throwback to the pandemic: “Them doctors in the private covid hospital make a killing you know. Them probably get sad when the pandemic ease up.” If you want to hear people say the worst things about doctors, just bring up private healthcare. The comments are unforgiving. But if you dig into these comments, it is almost never about patients disliking particular doctors, feeling like certain doctors ripped them off, or doctors being unethical. The comments are almost always as a result of ignorance – people not knowing how the costs of private healthcare are determined. There is no reference point, nothing to compare to. As a patient, how do you know if you are getting value for money in the private healthcare sector? How do you know that you are not getting ripped off, that the $40,000 you paid for the knee surgery was a fair price? Or the $1,500 that the specialist charged was actually reasonable? How do you reconcile two neurologists, specialised in the same specialty, doing the same work, diagnosing the same conditions, and charging two different consultation fees? Where do you find some solace – at least from a financial point of view – after emptying your bank account to give your loved one a fighting chance in a private hospital’s intensive care unit, only for your loved one to die, then to pay a bill well over $100,000? And what about the costs of tests, MRIs, CT scans, PET scans? How do you know that the thousands of dollars for these tests are actually fair and reasonable? Should we, as a country, even care about this? After all, it’s probably a minority who is able to afford these expensive services in the private sector anyway. And if these privileged people cannot wait like the rest of the public for the same services – in some cases, even the same doctors and specialists – in the public system, then they should not complain about the costs. But this issue – the cost of private healthcare – is more than just privileged people complaining. It is not so much about the actual cost, but the lack of regulation of it. The outcome of an unregulated private healthcare sector is suspicion, mistrust, and the disappearance of the medical profession. What is left of the medical profession if the system breeds mistrust? How does one build trust in a system that, when it comes to cost, is just a big black box? A mystery until you see the bill after a hospital admission, and realise that you paid not just for a doctor and medications, but for gloves, needles, and syringes, too. How to rectify this? How to heal these wounds that have been allowed to fester over years, decades even? The most obvious way is to restructure the entire healthcare system, abolish out-of-pocket private healthcare, and replace it with a national health insurance plan that would cover all essential healthcare costs across the board – nobody will ever have to walk with hundred-dollar notes to the doctor anymore. I haven’t heard any government come remotely close to suggesting that this might indeed be possible – so don’t hold your breath. A less radical solution is for the government to mandate the establishment of an independent body – similar to the Private Healthcare Information Network in the UK – that would oversee private healthcare, build an inventory – accessible online to everyone in the public – of the costs of the various services in the private sector, and publish reports on the quality of the services. This body would function separate from the Medical Board of TT. The medical board as it is right now does not have the capacity to do this. If this body is established and the website is built, any member of the public will be able to search a doctor, or a medical/surgical procedure, and find estimated costs and reviews. The costs of private healthcare will be less of a mystery; there will be less suspicion, and more trust – and perhaps the curse of private healthcare will be lifted. Visit www.phin.org.uk for more information. Taureef Mohammed is a physician from TT working in Canada E-mail: taureef_im@hotmail.com The post The curse of private healthcare appeared first on Trinidad and Tobago Newsday.