SONGSOPTOK: Do you consider primary healthcare to be a fundamental right? Is it deemed as such in the society you live in? Please explain your answer with a few examples if possible.

SILAS OLA ABAYOMI: Yes, I strongly believe that primary healthcare is a fundamental right, after all, one of the three unalienable rights espoused by Thomas Jefferson, which became a major part of Bill of Rights is: "All men are created equal and endowed by their Creator with certain unalienable Rights, that among these are  life, liberty, and pursuit of happiness." If a child or an individual is denied quality healthcare through a non provision, how would divinely given right to life be enjoyed? Even though, not every human society as of today provides primary healthcare to its citizens, but  people shouldn't relent by insisting on  quality healthcare, which is not only a must, but a sacrosanct.

SONGSOPTOK: What is the system of healthcare in the country and the society you live in? Is it a just and equitable system in the sense that all citizens enjoy the same benefits across economic and social classes?

SILAS OLA ABAYOMI: I live in a society where health-related issues are considered as both a  right of individual and major duty of a  state to provide. Yet, we are still far from health for all. Even though, the 2010 Affordable Care Act passed by the  Congress was a significant leap in healthcare sector in the United States;  I will say: "it is not yet uhuru." Because not everyone has access to quality healthcare, even those that do,  sink under the burden of high cost of medical care.

SONGSOPTOK: Do you think that free healthcare cannot be a right, but it can be a privilege and a shared burden of sacrifice for the sake of the social contract? 

SILAS OLA ABAYOMI: No, I do not; but it is very unfortunate that  many human societies see "free healthcare" as a privilege rather than a right, which shouldn't be. But beyond right-privilege issue, most governments today do not see healthcare issue as a contract, rather, they see it as more of business, more of commerce, and more of economic activities of demand and supply.  People will be sick, that's demand, care  provided with a price tag is the supply that professionals and medical  institutions do provide. With the rising cost of medical care, decline in revenue for governments worldwide, the social or humane aspects of healthcare which include but not limited to compassion, humanitarian, and sympathetic standing are lost; what we have today is cash-and-carry service.  Pay before or during service, failure may result in non provision of  care with  a fatal outcome or consequences.

SONGSOPTOK: What, in your opinion, should be the role of the government for ensuring equal healthcare to all citizens? What role is played by the government of the country you live in?

SILAS OLA ABAYOMI: To me, primary healthcare should be one of the major duties or responsibilities of the state just like education and security; because health is wealth; and if health is provided at primary level, it reduces care cost and fatalities at secondary level. Remember a healthy citizenry is the bedrock of development and greatness of any nation.  Although,  governments in United States involve in healthcare of their citizens at different levels through multiple social and insurance programs such as Medicare-insurance for Americans aged 65 and older, who have worked and paid into the system; some younger people with disabilities, people with  terminal and end stage illnesses. Another program is the Medicaid-social health care program for families and individuals with low income or limited resources.  These are great government supported programs; not to say they are perfect, but they offer some hope to they needy.  They serve as fallback to the society.

SONGSOPTOK: According to the data published by World Health Organization (WHO), nearly 16 000 children under the age of 5 die every day in the world (5.9 million in 2015) from infectious, neonatal or nutritional conditions. Is this a reality in the country you live in? If so, what would your suggestions of improvement be?

SILAS OLA ABAYOMI: Although, the situation in United States is far better compare to what happens in other parts of the world, yet, it is not the best; considering reports and available data,  a Health Affairs, an online health reporting journal said: "US infant mortality was poorer than twenty-six countries in the Organization for Economic Cooperation and Development (OECD)"; the situation was not better with post neonatal  mortality,  and other age groups, because United States in "1999 ranked thirty-third in its death rate for children under age five (thirty-seventh for females and thirty-first for males)." More so, subsequent reports have be encouraging as other industrialized nations performed better than United States. However, what the report shows is there are always need for improvement in healthcare provision even in advanced economies.

SONGSOPTOK: “Free access to healthcare is a fundamental human right. Access to free healthcare is not” – do you agree with this statement? Please explain your choice.

SILAS OLA ABAYOMI: I do, but it depends again on where individual lives. Citizens of most industrialized nations in the world have free access to healthcare, more so, it is one those rights they enjoy.  In most of these countries, children under 18 years of age have access to free medical services. In United States, the newly passed Affordable Care Act places children under twenty-four years of age on parents insurance and plus several other medical benefits children can enjoy.

SONGSOPTOK: How important is the role of the private sector for providing healthcare and related facilities in your country? What it is your opinion about it?

SILAS OLA ABAYOMI: Just like government, private sector has a major role to play in providing healthcare for their employees, more so, help with medical related  facilities in communities they are located.  Sad to say, it barely happens. Employees, the core assets in corporate organizations are barely provided with health insurance, and where they do, it is very expensive because corporations neither contribute  nor provide match up money  to offset cost. In most cases, private sectors concern is their profit, and how best to maximize  it. This situation may continue as long government keep silent to employees   plight; it will get worse in a monopoly and, or oligopoly economies, where there is an "exclusive possession or control of supply or trade in a commodity or service; or a state of limited competition in which market is shared by a small number of producers or sellers." However, with government's intervention in these ways, things could be better:

1) Making corporate organizations contribute certain percentage of their annual net profits into Health Trust Funds. Funds to invest in both capital and material development in health sector.

2) Encourage a plough-back  system, where corporations are encouraged to invest in health sector in communities where they operate.

3) Make it mandatory by law  for  corporate organizations with certain number of employees  to provide health insurance for their staffers.
Failures to do so  must come with severe penalty.

SONGSOPTOK: Are charitable and Non-Governmental Organizations (NGO) active in the domain of public health? If yes, then in what spheres? Do you think that the civil society, either independently or through these organizations, should become the prime actor for ensuring healthcare for all?

SILAS OLA ABAYOMI:  In several societies Non-Governmental Organizations, religious bodies, good cause related organizations are very active, but with minimal impact. Some of these bodies have health facilities and clinics around the globe, some even do send health personnel to areas of need, especially, in times of crises or emergencies. However, their activities are limited by funds, unfavorable political climate, inclement weather,  and though geographical terrains. Regardless of difficulties they encounter, they should be encouraged, more so,  be included as  part of primary healthcare providers.

SONGSOPTOK: Do you think that multinational pharmaceutical and healthcare companies are responsible, to a certain extent, for the widely variable quality of healthcare in different countries? Can you please illustrate your reply with somemujl examples?

SILAS OLA ABAYOMI: There is no doubt,  the  multinational pharmaceutical companies and other healthcare providers are responsible for different care in countries around the globe. In western hemisphere, where most of these pharmaceutical companies are based, they give  the best drugs, medical procedures, and quality tools to home medical personnel, even with a cost. On the other hand, politics, profit, and stiff competition adversely affect what Pharmaceutical companies do in foreign lands. The Pharmaceutical Industrial Complex, in most, if not in all cases push profits ahead of social responsibility in lands other than homelands.

SONGSOPTOK: Do you think that adopting the Social Security model implemented in a lot of countries in Europe which ensures primary health coverage to all citizens and is financed by the totality of the working population can be relevant and efficient in all countries?

SILAS OLA ABAYOMI:  I think adopting the Social Security model will go a long way in providing  quality healthcare to the citizens, but a caution: no single European nation's Social Security model is perfect and error proof; even United States' therefore, no particular nation's model should be automatically adopted.
But it will be advisable to study all available models and the intended beneficiary in order to craft a model that will suit the local need.


We sincerely thank you for your time and hope we shall have your continued support.
Aparajita Sen

(Editor: Songsoptok)


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