America Can Learn From Us!

Posted on 18. Sep, 2009 by in Uncategorized

I wanted to share some thoughts with you all on the ongoing ‘raging’ debate on healthcare reform in the US and my perspective of the role of culture in all this.

Some of you may have been following events as Obamalets (the new breed of die hard President Obama fans) but for those of you whose days are too busy to bother with the details, I’ll endeavor to make it as simple as possible.

The current state of affairs is that the health system in the US is entirely privatized. What does that mean? It means that you must be insured under one of the varied policies offered by private health insurance firms to access medical services in the event that you fall ill. Proponents of this logic base their argument on the idea that everything in a capitalist society should be driven by the free market. In simpler terms, healthcare should be subjected to the same principles of business as any other enterprise. Principles such as profit or the more PR friendly term, ‘reasonable rate of return.’

In the shadow of last year’s global economic meltdown, a large number of Americans (and Kenyans for that matter) lost either their jobs or their life savings resulting in a health crisis in which people fall sick but cannot afford to pay for treatment. President Obama’s Administration felt it necessary to intervene at this point and have government step in to insure its people. This has not gone down well with the Right of American society who term the move ‘socialist.’ The general sentiment in these circles is that government should have as little to do with the day to day life of Americans as possible.

It is at this juncture that I’d like to introduce the culture angle. The competitive environment under whose umbrella America’s economic success was nurtured has grown into a garden full of weeds that chokes the flowers to death. The every – man – for – himself attitude that develops in such a cut throat society results in the current health gridlock that we witness today.

Enter the Founding Fathers of Kenya, who in their enduring wisdom saw it fit for Government to look after its own. Hence, the National Health Insurance Fund. A public insurance fund that ensures the public is covered. I will be the first to admit that it has its shortcomings; inadequate breadth of coverage due to the overriding challenge of poverty. We simply do not have enough Kenyans gainfully employed to contribute to the fund for it to be as far reaching as it needs to be. That said, I firmly believe that its foundation is sound in principle.

African culture is such that it is ingrained in us to be our brother’s keeper. That we never leave a friend behind. That we grow as One. As captured in our national anthem, “natukae na undugu.” We view it not as socialism but as social responsibility. A nation’s policies are derived from its values and in this respect I humbly submit that America could learn a lot from Kenya and Africa as a whole.

Regards,
Oduwo Noah Akala,
Chairman,
Afya Kenya Foundation.

Comments
Health care in Kenya is based on public outlets such hospitals and health centres, through which health services are subsidized. This is somewhat similar to the British system but differs by the more carefully planned and managed British system.
A comparison of health systems is more meaningful if it is between the carefully planned and managed British system and the American system, because the Kenyan system is so far poorly planned and managed
The Kenyan health policy formulation should be choosing between the American model and the British model
This is because experience in other of planning in Kenya reveal a dangerous trend in Kenya of reinventing the wheel
This reinvention of the wheel leads to creating new designs which have already been tried elsewhere without researching on the opportunities and constraints revealed by the experience of those who have tried the same design model elsewhere
At the core of health care planning is the basic issue of the ‘components parts of the price of health servives’. This is the same question carefully summarized by Adam Smith in the Wealth of Nations
In Kenya, a number of services have been offered without working out the component parts of the price of the services.
A system of subsidy which has not identified the cost elements that are to be subsidized has always failed.
Even in the American system, the first task of health care insurance will be to identify the cost elements of each health service and to choose what will be insured

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