Online Reporter
ZIMBABWE is moving towards free health care for citizens, funded from tobacco and alcohol taxes, along with capital funding from beverage sugar and fast-food taxes.
Already, the money from the tax on sugar in beverages — the first time a “sin” tax was directly linked to health funding — has seen the purchase of four cancer treatment machines, and now tenders have been issued for a range of diagnostic equipment for both the two main metropolitan hospitals dealing with cancer, as well as for provincial hospitals.
The main drive of the Government policy is that health care must be accessible for all, and practically accessible, not just in theory.
This requires twin programmes to address affordability and to make sure that the diagnostic and treatment each individual person needs is available as close to their home as possible, and certainly, for a start, at the major provincial hospital.
Already, there is a special arrangement to allow the very poor free access through application to the Department of Social Services.
The Ministry of Health and Child Care also insists on free vaccination against a growing number of diseases for all children, regardless of what their parents earn.
In recent years, as advanced medical treatment returns to Government hospitals, or is introduced in them, it has been free; we only have to look at open-heart surgery and dialysis for those with kidney diseases.
The new cancer equipment now being installed is also expected to provide free treatment for those referred to this care.
Access to advanced treatment is governed by the referral system in place in Government hospitals.
Patients move up the ladder from their first contact, where they do walk in, through specialist referrals.
And that top-of-the-line stage, incredibly expensive in the private health sector, needs to be free in the public sector, people having just paid some fees as they walk in and start the process.
We would agree that free health care is a goal.
But we also note that quite a few people are on medical aid.
Now there are plans to set up basic health insurance through the National Social Security Authority for all in at least formal employment, but considering the moves already on the pension side, to include at least some in the informal sectors.
There are also those who can afford to pay at least something towards their health care, even if they cannot cover anything like the very high charges levied in much of the private sector, which greatly exceed even what high-end medical aid schemes provide.
A critical point is that the more money spent on health, the healthier the population and the higher the probability of a major decrease in suffering.
So there would seem to be an argument that even if a significant number of Zimbabweans must have free access to Government hospitals and all the rest of the public health sector, there are good grounds for charging those who can, through health insurance or private means.
No one should be bankrupted by the need to pay for health care.
On the other hand, where there was some charge for those who could handle it, this would increase the revenue flows to Government, either directly through the annual budget or through the assignment to a National Health Fund of all those taxes generated by products that encourage an unhealthy lifestyle.
For besides essential accessibility, there is also a need to continually upgrade the quality and spread of State health services, to make sure that the treatment they offer is top of the range.
This would also see a return to the State sector of many of those who make huge personal sacrifices to use the private health sector.
That, in turn, suggests there would be more people able to pay modest fees reasonably comfortably.
All health professionals are fairly solidly in agreement that health is one of those areas where more money is always needed. No health ministry on the planet ever has enough money for everything it wants and needs.
One problem of relying on “sin” taxes on unhealthy lifestyles is that there is a simultaneous need to persuade people to live healthier lives.
If that persuasion works, then fewer people would smoke, drink, or eat less healthy products.
That, in turn, would cut back the tax revenue from unhealthy lifestyles.
Admittedly, these taxes have yet to actively discourage consumption of the food and drink they are levied on, and the cutback in smoking has largely been driven by the unacceptability of public smoking, and the tendency of young people, for all their own dives into poor choices, to reject tobacco smoking far more than their parents’ generation.
