Medical cover helps in the hour of need

Pooling resources eases payment burden. FILE PHOTO | NMG

Q A surgeon saved the life of my cousin by performing a kidney transplant. Our family does not know how to thank him for this very kind gesture, which unfortunately left us with a huge bill that we cannot begin to pay.

I hope the question is clear and that what you would like to know is how a patient should feel about a person who “saved their life”. If that is your question then in a sense, the answer is simple. You went to the doctor, he did his job, and exactly like the mechanic, you paid him for his skills and time and, therefore, to both the doctor and the mechanic you should say thank you and move on!

There might, however, be another question you are asking, which is to do with the debt that many people are left with after the doctors have done all that wonderful work and an organ has been transplanted. This is a completely different question and is one that the government is addressing as one of its development pillars in the next five years.

Because it is the easier question, let us deal with the second question first. A story will illustrate the point.

Many years ago, my mother told us the story of how houses could be built in a day (mud huts in reality).

The principle was that a large number of people from the village would gather on an appointed day, and different people would, in a well orchestrated event do different things, starting with drawing out the size of the hut, cutting the sticks and grass that would be used, while other people made the cake or mud that would be used as the walls of the hut. Working together, a hut was ready in hours. Working alone, the hut owner would take a long time!

More recently, women (in particular) have formed merry-go-round groups in which they visit each other, pool their financial resources, and give one of them a lump sum to enable her do something bigger than she could do by herself.

The recipient could for example be able to buy a sewing machine, get a lot of day old chicks or even be able to build a shed for her goats. With the help of friends, one is able to lift a load that is heavier than she could if left alone.

Medical insurance and social protection works in a similar way. We all pay into a big pool, from which we draw, at different times, and always only in our hour of need. The reality is that we will need organ transplants at different stages (just like we don’t all build huts on the same day).

By the law of average, we will, like the ladies with the merry-go-round, be able to help each other shock absorb in our different hours of need. Prepayment of small amounts into a common pool, by a large number of people will solve the second problem. That is how insurance works.

The first issue you raise is much more complex and in some ways depends on how you decide to look at the doctor who “saved your life”.

A few months ago, a woman who I hardly recognised embarrassed me in public (incidentally this happens to many doctors). She announced at a social gathering that her grandson had been named after a member of our team because of the good work we had done many years previously for her son.

In great detail, she explained that her son had been like the prodigal son. At the age of 17 he had left home (and school) had gone to Mombasa and was living with strangers.

Following his third attempt at suicide, he was diagnosed with depression and Attention Deficit Hyperactivity Disorder (ADHD). He was put on medication, settled back in high school and had an easy time at university where he later met his future wife.

The mother went on to explain that he is gainfully employed in a local bank, is the father of two, and, according to the embarrassing woman, all this would not have been possible without our team!

All attempts to explain that all we did was our job fell on deaf ears! Like the transplant surgeon (we protested) all we did was what we were trained to do.

All ended well when her family prevailed upon her to go slow on the praises for the team that had saved the prodigal son!

As you can see, there are times when on thinks he has only done their work but as in this case the family feels indebted for life.

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