Dickson Igwe. Photo: Provided

And yes free healthcare is an inaccurate term. Social medicine is not really free. It is paid for in higher taxes, or in a full socialist system, by the state that owns and manages the economy. But ask any citizen of any one of these countries that have fully socialized healthcare if they would rather have the US style private insurance based medical system, and they would think you, well, let’s say, not all there.

Most Europeans would gladly make a significant financial contribution to their social medicine model. And then have the assurance that government will look after their health needs, and the health needs of their families, from cradle to grave. And even the richest in these countries use the public healthcare system, and may make higher personal contributions to the system, depending upon national taxation policy. And the quality of treatment in these countries on average is better than those that adopt a privatized model. This is borne out in fact, through various metrics showing quality of treatment per citizen.  However, for the system to function at optimum, it must mean the total commitment by the state: both government and ruled, thereby ensuring the viability and effectiveness of the social healthcare model.

The fact is that apart from the very wealthy and those who may feel their careers are carved in stone, these are employers and employees who possess excellent private health insurance access, the vast majority of average folk are one catastrophic illness away from either the poor house or grave, and frequently both. However, the very powerful lobby that is the medical insurance industry, typically US multibillion dollar businesses are very happy with the current system. It is a system that is a very lucrative symbiosis with the medical profession, especially in this hemisphere.

However, the medical insurance system as it presently stands is essentially a gamble: it is a casino type dynamic, rolling dice with the lives of hundreds of millions of people. A game of medical poker that one can only hope does not devour the average patient’s frequently meager resources at the first incidence of serious illness. It appears uniquely designed for a USA where multibillion dollar businesses can afford to keep the present system up and running, and to the benefit of their senior managers, and their most valuable employees. Private insurance based healthcare is is essentially a menu of medical services with a very high price tag attached.

However, even for many of these US citizens, financial catastrophe is frequently the norm when disaster strikes in the form of a critical illness. Treatments today in the present capitalist healthcare model, for even the most basic sicknesses, can range from the tens of thousands of dollars, to the hundreds of thousands.

And treatment that is whole of life, in other words terminal, is simply unaffordable by most. This is the realm of the celebrity surgeon and insurance company: a choreography that is danced around the hospital bed of the suffering or dying patient, while serious cash is being divided between key stakeholders. Sickness to these individuals who appear to have the power of life and death is all about the bottom line.

The patient is a simple statistic. From cradle to grave, the US healthcare system is not about compassion, although laws have meant that it is difficult for a central hospital not to treat the critical patient. No, the privatized system is first and foremost about money.

It is not about prevention, treatment, and cure. It is about Dr. Garibaldi, the celebrity and multi millionaire surgeon, and his weekend golfing forays to Monte Carlo. Every time someone comes down with a catastrophic illness, the rich doctor albeit very concerned, smiles at the thought of the extra two hundred thousand dollars in his bank account, courtesy of a system that rewards the powerful medical practitioner, and is two tiers. This is a medical model where the wealthy frequently get a second chance at life, and the poor are destined to a slow death.   

For Joe Average, even if he has insurance, a bill of a hundred thousand may mean a second mortgage, or worse, losing the roof over his head.  And do not forget the scores of others who suffer with Joe: immediate family especially.

So enter an alternative system that states the government will manage healthcare, and aggressively ensure that the system is oriented to the economic and social benefit of the patient: the Cuban model is an example.

One argument for socialized medicine is this extract from Monthly Review of December 7, 2012, which described how, ‘’ the US squanders 10 to 20 times what is needed for a good affordable medical system.’’ Especially when compared with countries that adopt a well managed social model. This includes, ‘’ 30% overhead for private insurance companies, an enormous amount of overtreatment, and disease focused instead of prevention focused research.’’

On the other hand, Cuba’s infant mortality rate is below that of the US, and the country has an unmatched record in dealing with chronic and infectious diseases. Monthly Review further alluded to another fact about Cuban medicine, that apart from being 96% cheaper than the US medical product, and ‘’ despite being a poor country, Cuba has sent over 124,000 healthcare professionals to provide care to 154 countries, and has over 20,000 students from other countries studying to be doctors at its Latin American School of Medicine in Havana.’’  Interesting!

Another feature of the Cuban social medicine model is this: Cuban doctors and medical personnel, ‘’ are very aware that most lives are saved through preventative medicine such as nutrition and hygiene and traditional cultures that have their own healing wisdom. This is in direct contrast to Western medicine which uses costly diagnostic and treatment techniques as the first approach and is contemptuous of natural and alternative approaches.’’

Returning to the Virgin Islands and it will of course mean higher taxes for Joe for the privilege of a fully socialized medical model. But the choice in reality is a very simple one. Is Joe Taxpayer confident that the US based, private insurance health care system, will take care of all of his healthcare needs and that of his family?

Or is Joe willing to come together with the rest of the Virgin Islands community, pool social, communal, and financial resources, and established a socialized model that is totally free after taxation, and effectively managed. It is Joe’s choice at the end of the day, notwithstanding the mechanics of a Virgin Islands national Health Model. But losing that private insurance means Joe keeping his fingers crossed while he plays a game of Russian roulette with his health and finances.    

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