The Politics of Healthcare
“Emerging markets are all about politics.” This was one of the first things I heard when I started in the Philippines. I didn’t really understand what this meant at the time and thought it was an offhand remark. As I studied the healthcare system of the Philippines this became a common theme.
It is interesting to see the impact politics can have on a community. The Philippines has a devolved system where the local government has control over what is funded in the communities, including healthcare. The elected official decides whether facilities such as a new stadium or a much-needed hospital are built. This produces a lot of variability from one barangay (community) to the next. It is crucial to have officials that understand the problems of their communities and who work to address these problems.
I was able to experience firsthand the differences in communities that had elected officials with interests in community health and communities whose officials had different interests. The public rural health doctors who had the support of the local government could easily get the resources they needed to solve some of the problems they faced. The ones who didn’t have such support had to play politics to accomplish what they wanted. Instead of energy going directly to solve the problems, that energy was put towards getting the support needed to go after these problems. Sometimes resources went towards things that seemed beneficial but these did not hold the best interests of the whole community. It was amazing how similar these local politics were to some of the politics seen in big companies.
One example of political failure is a politician who promised a hospital if he got elected. He secured funding to build a hospital with expensive medical equipment including x-rays and ultrasounds. The problem is there is no budget to staff the building and nobody that has expertise to run the equipment. This change is being touted as a success although there is no real impact on the community. The perception to those outside is that there is a nice new hospital in the community. It’s all fluff. Spending limited resources to address a problem that does not exist or coming up with fluff solutions that make a politician look good without impacting the community was an unfortunate thing to observe.
Seeing this has led me to believe that some things shouldn’t be a political issue.
It shouldn’t matter what party or elected official is in charge. Quality, affordable healthcare should be one of these things that is available for the entire population. In the Philippines if the costs are too high, people will forego care and live with whatever is ailing them. In simple cases such as a broken bone, this could lead to a lifelong disability. That is not right. The population should have the basic coverage they need to live their lives in good health without worrying about whether they can afford it.
In the United States midterm elections, all the candidates have a stance on healthcare. This shows that this is a real issue that Americans care about and the politicians are aware of. The problem is that this issue has become politicized and people are divided on what should be done about healthcare. If we truly want to solve this problem we must come together as a country and not let this be a partisan issue.
It’s crazy to think that single payer is portrayed as a radical left wing idea in the US. Once partisan labels are put on something it is no longer about the idea but the political party it is attached with.
After coming to Korea and learning about their healthcare system, it seems like single payer healthcare has really benefited their society. Everybody receives healthcare access by paying a low amount each month where companies will cover half of it . For procedures, 80% is covered by your insurance if it is a necessary procedure. Things that aren’t critical are paid out-of-pocket. The government sets the pricing which allows them to get cheaper prices through collective bargaining. The care is good, cheap, and it is very quick to be seen by a doctor. Korea is different from the US, but can we learn from what has worked well for them?
We as a country need to objectively look at what has worked well in other countries as well as our own and be open to different ideas. It will take a lot to change the system we have if we want to improve it. People are having more trouble affording healthcare so this is an issue that is important for us to address. The key will be to get past arguing about partisan aspects of the issue and actually come together to fix the problem.
If our politicians are truly for the people they should be able to come together and work with experts to do what is best for the people that elected them into office.
Sometimes the best way forward is to break through the politics that are holding us back. United we stand, divided we fall.