Medical Welfare Fund is urgently required

Dec 27, 2015 Letters

---

Dear Editor,
Kaieteur News (Dec. 7, 2015) carried an article that dealt with the abuse of public funds allocated as medical aid, for cosmetic purposes rather than bona fide medical emergencies, etc. In one case, a former minister had used up $2.1M to fix her teeth. This would have occurred even while many persons, particularly children, continued to suffer from life-threatening conditions. Some died awaiting that helping hand that never came.
In a country like ours, with so much wastefulness and disparity in wealth, there must be something that can be done to make such heart-rending situations something of the past. Surely we can find the money to put aside for helping those who are the most-needy amongst us.
There are three things that we, as private consumers, spend a fair deal of money on: alcohol, cigarettes and legalized gambling / lottery, and which we cannot say for sure, brings any benefit to society. The fact that many can complain so bitterly about a 2AM curfew on the sale of alcohol, suggests that we have a lot money to splurge.
Each of these “vices” in our society represents a significant opportunity cost at the individual, household and national level. The monies spent on these items means that many other things of value had to be forgone. In many poor households, the opportunity cost of these expenditures is very glaring, with what is actually forgone often being the sustenance and healthcare of family members.
There has been a government-administered “Lotto Fund” since the lottery company was established here in 1997. There are taxes applied to the sale of tobacco and alcohol, which I am sure amounts to a sizeable share of public revenues. Whether or not the tax rates applied to these items are justified is debatable, but as a bystander they do not seem to have forced demand downward, which is one of the purposes of such taxes.
These three streams of revenues all now go into the big barrel we call the Consolidated Fund (CF), a victory for public accounting that was well-fought for. However, we know what happens with how the CF operates. Tax administration is meant to redistribute inflows to where they are (most?) needed and not necessarily in support of development related to their sources / sector. Like how the environmental tax is used!
Using the argument of a collective opportunity cost to society, I am suggesting that we take these three revenue streams – alcohol and tobacco taxes, and the Lotto Fund – and commit these monies to starting a special Medical Welfare Fund for helping the most-needy with their healthcare.
With our current capacity for providing effective medical care still being below the desired level, there will be some net outflows from the economy, particularly where medical treatment must be sought overseas. However, with ongoing improvements in technology and capacity in the existing hospitals, and with the Turkeyen Specialty Hospital coming on stream sometime in the near future, many healthcare issues that could only be dealt with abroad will soon be taken care of right here in Guyana. Even when that happens, the cost of effective healthcare will still be prohibitive for our most-needy and as such public support funding will still have to be sought. Welfare expenditure in this area will mean that a larger share of the money will actually re-circulate within Guyana’s economy.
Removing the three revenue streams from the CF may suggest undoing what was fought for, in the case of the Lotto Fund. However, there can be special provisions for channelling these revenues to the Medical Welfare Fund on an “as-needed” basis, or to keep the fund at a certain replenishment level that matches our needs in the described healthcare areas. Whatever needs to be done, can be done: the technicalities of fund management can be worked out later.
With an increasing number of children requiring corrective surgeries, and with chronic non-communicable diseases such as hypertension, diabetes and cardio-vascular disease being on the rise, there will be increased demand for healthcare-related welfare support. Part of the welfare fund can also be used to push education about the harm associated with alcohol and tobacco abuse.
There are many possibilities of what can be done, when what is seen as wasteful spending can be taxed and brought back to benefit society. And certainly, spending tax-payers’ money on fixing cleft palates in 2 or 3 poor children, or helping a breadwinner stay alive to see his children grow up is going to be more “palatable” than brightening the smile of one mature woman who can well afford to do so, on her own. Let us make 2016 a year when no one has to beg to save their own life, or that of a child in Guyana.
Khemraj Tulsie

---

---