Some good attention is coming to Rwanda's national health plan.
Imagine that you had the job of repairing a country torn apart by years of ethnic combats, which had recently exploded in months of hand-to-hand massacres. What could possibly bind together the survivors? Historical experience suggests nationalism and resentment as binders. Such a choice-- always feasible, as a small country surrounded by larger ones can sing the paranoia song convincingly-- would just push the wheel of revenge through one more turn. The newly-installed government had a better ambition, and decided to win over the people of Rwanda with solidarity.
With a spectral budget and help from the specialists in delivering medical services to those least likely to receive it, the Government of Rwanda has been able to do a lot. The first steps in introducing modern medicine bring spectacular results. Sanitation, hygiene, clean water, aspirin, routine antibiotics clear up a great deal of disease and lengthen a lot of lifespans. Then come the harder tasks: TB, AIDS, restorative surgery, and so on. The tremendous thing is that they have been willing to take the first steps.
Perhaps a prod to our slow-developing national health system, weighed down by the need to confer profits on private insurers?
My grandfather on the Toussaint side was one of the leading clinicians in the virtual eradication of TB in this country, where its endemic hold amongst the poor had been exacerbated by recent war, at around the time when the NHS was being devised: his solutions were by modern standards quite simple. At that time this country was reeling after six years of war and solidarity and fellow-feeling were on everyone's minds. I ought to add that the standard of living, even during the period of most harsh rationing, was nowhere near as low as that of most Rwandans. Our NHS is now coming under pressure, largely due to the continuing demand for the latest pharmaceuticals and diagnostics and a necessarily finite budget.
I see this as an execrable example of greed. Now I should suggest that it is the companies which charge so much for the latest treatments who are being greedy but I think I'll be a bit more radical than that and say that it is the beneficiaries of the healthcare who are being greedy, not for money but for life. Here (and probably there) it would be front page news if someone were denied a fMRI scan on economic grounds. We don't resent paying taxes for healthcare or ask for refunds, in fact many opt out of the NHS and pay for private healthcare. Whatever we do, though, we expect the absolute best.
While there is any economic underpinning to healthcare provision of services of the quality to which we are used in the US and the UK to the entire world population will always be unachievable and, even if it were, there will always be limits on what can be provided whether they be geographical, logistical, whatever.
We in the “developed world” (for it is no longer just “the West”) have done a remarkably subtle job of outsourcing slavery and an even subtler job of not looking at what we've collectively done. We even feel the need to offer help to those who work without hope and for fifty cents a day in order that we can continue to wear Italian shoes and the occasional bit of gold, as if we hadn't done this to them in the first place.
Everyone has to take a cut in both standard of living and the expectations of what that life will provide them with: and I mean everyone: the result would be a better quality of life. Of course a better solution would be to completely revise the global economy and remove the impossible equivalencies that money makes possible: same result but easier but only if we get rid of the greed.
Sorry for the rant!
Sorry, forgot to add that no one in post-war Britain could not afford $2 per year, because no one was that impoverished.
Okay, everyone in the “developed world,” in case that wasn't clear!
Tricky thing is that healthcare, or life, is not a good like any other. You can reasonably ask people to accept a reduction in their sugar consumption (as the antislavery activists did in the 18th c.), you can demand a levy on incomes or put a tax on consumption, but life being the good of goods or the condition of all other goods, it's ticklish asking people to accept less of it. (The principle that self-defense is a permissible reason for otherwise inadmissible violence derives from the same intuition.) So a bit of reflection is required to detach people from the idea that more of every kind of health service is equivalent to more life. It isn't, but people often discover that only when they, or their folks, are embarked on a hard-to-reverse journey through the marvels of medical technology.
Nature doesn't have to answer the question “why me?” but any decent social order does. Wherein society is shown superior to nature.
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