Mauritius is way ahead of many countries in terms of its free universal health care.
Hospitals, dispensaries, pharmaceutical products, tests, clinical interventions, go alongside the public health measures of river and canal-cleaning to prevent malaria, chikungunya and dengue fever, while public health officials immediately contact anyone back from any malaria-infested area abroad and test their blood. We all pay for this. And we all get to use the excellent service. And it is part of our responsibility to care for the service and keep its standards high. Our eyes are looked after at three different eye-hospitals now. There is a new ENT hospital for us all. The new cancer hospital is being built for all of us. The five big general hospitals on Mauritius and one in Rodrigues are already involved in curative and screening work for all of us. Vaccines are readily available for children. Old-age pensioners and all those with any lung-problems or other systemic illnesses get flu jabs, too. All of this is free. It is universal. Everyone’s life and health has the same value, for this system. There is a blood bank, too. It epitomizes the way people donate the blood from their own veins to unknown others out of the pure devotion to “the gift relationship” (1) without any idea that this blood might go into a “for profit” network, where money is changing hands for health care services.
The system is working well. It needs to be freed up from some bureaucratic lethargy. It needs some trouble-shooting. It needs some better explaining to patients. We need more nurses. But, all this is easily resolved.
So, what then is the problem?
The fact is that the private sector has a problem. It wants to invest in insurance and private clinics, and then when it does, it finds it difficult to attract enough customers (indeed not “patients”, but “clients” or buyers) into its commercialized sector in the face of such an excellent universal and free sector. That is the problem. So, Pravind Jugnauth steps in.
And the whole system of universal and free health care is now in danger.
The question we in LALIT ask is, “Do you, Pravind Jugnauth, want to go down in history as the man responsible single-handed for the ruin of this excellent, universal, free-on-delivery, health care system?” It is one of the few in the world. All it needs is a bit more investment.
In fact, that very investment that Pravind Jugnauth intends to hand over from the Consolidated Fund to the private sector every year in his announced plan, is all that is needed to improve the existing government facilities. Jugnauth intends to privatize health care. Health care, in these times of epidemics, is the ultimate “Global Public Good” and should increasingly be considered, like air and water, as a public good.
In the President’s Speech on 24 January, the announcement is clear. The Jugnauth Government intends to herd all government employees into a private insurance scam thus pouring literally billions of our VAT contributions, which should be used for the common good, into the pockets of 5-10 insurance capitalists’ pockets and then part of this into the private pockets of clinic owners and pharmaceutical importers and dealers’ pockets. This will provoke the ruin of the universal health care system: it will fracture those who provide the care by making them believe that they are superior to those who they, as civil servants, serve. The public will become the kind of public it was in the bad old days of the colonial Poor Law, where means-testing was rife instead of universal services.
In return, these poor government employees will find themselves trapped into the profit-motive sector, where health care comes only after profit, and the richer you are the more you can buy services. This means, at best, being subjected to routine over-testing (even when bad for health), over-prescribing of medicines (again harmful), prescribing of expensive non-generic medicines that are often less useful and over-operating when a clinical intervention is not necessary,thus exposing them to unnecessary risk. It means that, again and again, civil servants will find out that their insurance does not cover this, that or the other thing. They will have all the hastle of borrowing money, or of resorting en catastrophe to the rump that will be left of the previous universal health care system. All serious conditions end up in hospitals. Some conditions involve uncovered expenses that even top civil servants will not be able to afford.
Even right now, as in the USA, people are mobilizing against the terrible health care system in their country, a system which is both bad and expensive, and organizing in favour of universal free health care in the build-up to Presidential elections at the end of the year; right now, as people in Britain have forced even the Conservative Party to take a stand in favour of protecting the National Health Service during the whole Brexit process; here, Pravind Jugnauth is threatening to ruin the Mauritian system, built up so carefully over the years. The present system needs just that injection of annual capital that Jugnauth intends to hand over to private insurance companies on a golden plate.
All the trade unions initially took a stand against precisely this privatization of the health care system. We call on them to stand up once again and oppose Jugnauth on it, while vowing – through their unions – to build a new relationship of trust with those who benefit from the universal health care system, and to assure the entire people an excellent service as of right.
Our aim should be to have the best health care system in the world. This can only be built on a close relationship between all health workers – from those with the highest wages to those with the lowest wages, from those with the most prestige to those with the least – and between the totality of health workers and the whole of the people. Can unions rise to the occasion?
Now is the moment to oppose this privatization of the health care system. We say that the moment is important because we are at the beginning of an epidemic of the new Corona virus. Other epidemics will emerge, too, as humans become more populous, on the one hand, and live in huge cities, on the other. In such times, our complicated civilizations can only survive by seeing things like “health” as a public good, and the health service as a universal, free service.
We need a new social contract between the unionized workers (including the invisible ones in drain-cleaning and Biro Saniter) who together provide the totality of free services, and the whole of the people who use the services, including themselves.
We must remember that we all care for us all. Health care is a shared caring. For investors, the private sector is just one way of investing rupees to make more rupees – either through insurance, or through selling health care, itself – no matter that it depends upon a form of “blackmail” of the kind whereby you are made to feel, “I don’t love my own mother enough if I don’t fork out the money for her operation at a clinic?” as if money can buy love. Or “I can’t not love my child enough to take out private health insurance?” And somehow the very existence of private medicine makes us turn into people who don’t care about other peoples’ mothers or children. As we would like them to care about ours.
(1) The Gift Relationship is the title of Prof. Richard Titmuss’s famous book dealing with how people give blood freely to others unknown to them in Britain, and how this works so much better than the system in the USA where blood is sold for use by private profit-motive companies. What is iconic about Titmuss is that, inter alia, he was something like the father of the Mauritian welfare state.