Kenya needs non-profit model for affordable healthcare system

It may come as a relief to note that, beyond the fact that the words Hippocratic and hypocrite rhyme and share a common Greek origin, they have no other meaning in common.

The Hippocratic Oath is a code of conduct for practising medicine, written by the accepted father of modern medicine, Hippocrates of Kos. On the other hand, hypocrite is an English word, albeit with Greek origin, describing a person who puts on false appearance of virtue or religion (hypocrisy).

It is, thus, purely a coincidence that we live in a time where although we still have the medical practitioners swearing the Hippocratic Oath, their tendency to remain true to that very noble of callings has unfortunately been rendered hypocritical — thanks to what I refer to as the unfortunate influence of capitalism.

Let me clarify. This is not a blanket rant against the medical profession and neither is it a lecture to the healthcare fraternity on how it should carry out its business. I feel sufficiently incompetent to manage such a feat.

This is but an honest assessment and suggestion of what I feel is the continued bending of the healthcare industry’s trajectory to the wrong direction and what can be done to correct it. Let me share a personal account.

My wife and I are expecting our first child and as you can guess, we are overly excited about the prospect.

As with any first engagement, we have been devouring every piece of advice available, including pregnancy books, stories from other mums, doctors and of course our good friend Google.

What has impressed me though is the kind of over-zealous customer service we have been receiving from hospitals in particular with each introducing to us a ‘plan’. I have obviously naively assumed that the premium medical cover accorded to her by her employer has nothing to do with this. But a non-scientific poll I conducted recently has got me worried stiff.

More than half of her friends, within the same age and income group, and all who delivered through top hospitals locally, underwent a C-section. So odds are higher beyond the toss of a coin, that given that she is likely to choose one of these hospitals for her delivery, she too is a prime candidate for the knife.

Evidence-based medicinal studies indicate that generally, doctors should perform far fewer caesarean sections than they do. Many C-sections done unnecessarily are unfortunately motivated by financial incentive rather than the well-being of the mum and child. Obstetricians understate to the patients the increased risk for hysterectomy, haemorrhage, infection and deep vein thrombosis.

The worst thing is that while all this will be happening and her getting what may well be an unnecessary surgical intervention, we shall have some mothers in other parts of the country on the same day who will probably die on the delivery table because they need the C-section but it won’t be offered to them as a priority because they can’t afford.

Which raises an issue, what if I could pay the higher standard fee, regardless of whether the delivery would be surgical or otherwise but in return, in case it turned out to be much cheaper, I end up subsidising the mum who would otherwise not afford to pay?

That would be noble, but it is not the kind of structure that works in many for-profit models and probably, given the offer, I would probably start rationalising about why I am being double taxed.

Listen to Russell J. Andrews – an American neurosurgeon who has served in the US Army as flight surgeon as well as a medical device developer with NASA. He wrote an interesting book, Too Big to Succeed: Profiteering in American Medicine.

His verdict on his own profession and industry is damning, “… the morphing of medicine from a function of a humanitarian society into a revenue stream for healthcare profits, drug and medical device companies, hospitals, and insurance companies has in essence transformed healthcare into an industry whose single goal is to be profitable and nothing else”.

But the fact is that, it is time our policymakers thought more seriously about incentivising the non-profit model for healthcare facilities and creating a system that will most enable the achievement of the universal affordable access to healthcare for all.

Commercialisation of healthcare has ended up dividing our population into two: profitable and non-profitable patients. It is, however, a sick double edged sword.

Despite the fact that the availability of good medical care for the unprofitable patients is highly compromised, the other fact is that the sincerity of the healthcare afforded to the ‘profitable’ patients is also brought into question.

Expensive drugs

Many ‘profitable’ patients are unfortunately used as guinea pigs in expensive surgeries and administered large dosage of expensive drugs that create a dependency syndrome on the healthcare system to optimise their profitability.

A for-profit healthcare system is but a ripe recipe for patient manipulation and exploitation placing the well-being of patients in serious jeopardy while undermining the trust so essential to the physician-patient relationship.

We can’t really blame our doctors and medical practitioners though. Most of them are very well meaning and it’s through their able hands that I hope to soon touch my first bouncing bundle of joy.

Unfortunately, just like our politicians, they are being shaped by our common values as a society and what we stand for.

It’s time we started a proper values discussion on the way forward for the healthcare industry. Or else, we shall live in a society in which for some women, getting pregnant is as good as signing a death sentence. And we shall collectively be a hypocritical society for permitting such a tragedy.

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Twitter @marvinsissey