Where is medical insurance taking Tanzanian health services?

Where is medical insurance taking Tanzanian health services?

Extra-ordinary Tanzanians probably want comfortable health services with Hilton hotels type meals and best nursing care.  Do privileged Tanzanians really care how expensive such 5-star health care is and who will foot the bill?

The speed with which every government department has been enrolling staff into contributory health insurance schemes at public expense may be good news for private medical services. Private health services in the country are becoming extremely expensive. It is cheaper to send patients for surgical treatment and recovery for a month in India.  It costs more to admit them for the same procedures in Dar es Salaam or Mwanza for a week.

By sending their staff to private hospitals for treatment, public corporations and government departments are enriching private practitioners at home and abroad.  Privately-insured patients and those who pay out of pocket for procedures at premium hospitals like Aga Khan, TMJ or Muhimbili for that matter know how painful it really is. Just pray you do not get sick while uninsured.

Meanwhile peasants and uninsured workers endure lack of medicines, overcrowded hospital wards, procedures and operations that get dropped for lack of one thing or another, and the list goes on. Many doctors probably own private clinics.  Many more medical staff moonlight as visiting consultants or nurses at private hospitals.

The national health system is probably not functional, at least not the way it should. If we want a functioning health delivery system that provides equitable services we have to change it completely.  First, money that is being invested into health insurance must be ploughed back into public health facilities.  

Every public employee whether in the executive, legislative or judiciary branch of government ought to be treated at public hospitals. What is reason for having fancy buildings and qualified staff some of whom are fellows of royal college of something or other, if we cannot treat skin diseases, nose infections and heart malfunctions affecting the high and mighty of the land of Kilimanjaro?

If we force MPs including ministers to seek treatment at siri-kali hospitals, we can ensure parliament will allocate enough money  for medical staff to buy and service essential equipment, stock enough medicines and ensure health facility employees work diligently. When ''waheshimiwa'' become regular clients, regional and central medical officers will crack the whip to get things going rightly.

If after 50 years of independence, we have to send our MPs and ministers abroad for effective treatment, we should tear down big hospitals with fancy buildings like Muhimbili and fire all their medics. We do have qualified medics. Their academic qualifications and experience of all MNH staff could fill up an encyclopaedia Tanza-nyika.

Private hospitals should hire doctors from wherever they can get them.  Meanwhile nurses and medical specialists should only be allowed to work in public or private health facilities, not both. Being able to work part time in private hospitals only enriches the medics without improving services like one wife serving two husbands.  That is mission impossible without top gun Tom Cruise.

I have heard some horror stories that would make your blood boil, if you are the type with a low boiling point and high pressure like a pressure cooker.  They are very lucky nurses out there who probably would have been fired and fined heavily if Tanzanian patients knew how to sue for lousy service or dangerous treatment.

For example, a patient admitted with multiple fractures called for help at night because he needed to pee.  No nurse appeared with a bedpan or urinal so he relieved himself on the bed. He then tossed and turned the whole night because of the smell and itching.  You wonder how some hospital staff can sleep soundly at night while patients shout for help. Do you know of similar stories?

Anyway, the guy had to endure many similar nights because the pains from his broken bones and other injuries were much higher than the irritation and embarrassment of sleeping on his waste matter. In the morning, nurses coming on duty would refuse to change the soiled sheets because it should have been done by the night team. Over time he learned to push the sheets to the floor.

His mother was very lucky she did not get a stroke from arguing with nurses for not attend her son on time.  The point here is, it is difficult for those who work for public hospitals to switch off their bad attitudes when working in private hospitals.  They just remain their crappy selves whether in Mtakuja government hospital or Massawe charity health centre.

This is why attitudes of nursing staff at private health facilities closely resemble those seen at public hospitals.  Do not be surprised if nurses at private clinics behave as if they are giving you free service.  They probably expect you to give thanks with a grateful heart because they are giving you the time of the day.  Go ahead, curtsy and bow. You are in the presence of medical royalty.

To avoid putting their staff through the no-medicines, doctor-out-of-stock and beds-shared-by-three public health system, many companies and organizations have found an alternative in health insurance schemes. Such private sector staff can enjoy medical treatment at a wide choice of clinics.

Government departments are joining the private medical insurance bandwagon in droves. Great.  What about other Tanzanians? Will medical insurance improve health services delivery in Tanzania? So far it is an expensive model that is only reaching a small minority of citizens.  Is this what the father of the nation had in mind to make Tanzanians healthier post-independence?
tnaleo@hotmail.com; cell 0787-246-136


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