SONGSOPTOK
INTERVIEW WITH ASIM
HEALTHCARE – A RIGHT OR A PRIVILEGE?
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.
ASIM
RANJAN PATI: Yes, I believe primary health care should be a
fundamental right. Unfortunately many in USA (where I live) believe this should
not be a right but rather a service that people should buy just like other
services, for example from a lawyer or financial adviser. Health care for all
is expensive, a financial burden to the society and may increase taxation on
taxpayers - not everyone would like to share the responsibility of others less
fortunate. More compassionate citizens however will disagree and believe
healthcare should be accessible to all.
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?
ASIM
RANJAN PATI: Even though emergency care in this country (USA) is
available to all, routine care is not. So it is an unjust system. Citizens from
lower economic and social class do not enjoy the same benefits as those from
higher economic and social class.
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?
ASIM
RANJAN PATI: Free health care should be a universal right, not a
privilege. Thus it should not be a burden of sacrifice but rather a moral and
ethical duty of the society to provide for all irrespective of ability to pay.
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?
ASIM
RANJAN PATI: After all,
citizens elect the Government especially in the democratic countries. So when the majority believes in equal
healthcare for all citizens, the government elected by the people has to make
sure the infrastructure and the resources are in place to provide the care.
However, a compassionate Government may sometimes pass laws that may not be
supported by majority but may benefit all citizens. Hopefully they will
persuade citizens to see the benefit to the society and come on board. On the
other hand, a conservative right wing Government may do exactly opposite and
create limited access for health care for the lower socioeconomic class.
Unfortunately
in the USA still there is lack of access to health care for many millions of
people from lower socioeconomic class. The Government sponsored Medicare
program benefit the older citizens while the Medicaid program helps the young
unemployed or poor patients. But there are many millions of underemployed or
poor people who are not covered and lack access to health care. In
countries that are not democratic, presumably the Government has much more
power and influence to create equal healthcare for all its citizens provided
they have the will and determination to ensure utilization of resources to make
this happen.
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?
ASIM
RANJAN PATI: In the USA,
early childhood mortality has declined overall. In the longer term however
disparities persist with increased mortality among black children as well as
those in poorer socioeconomic class. While every country has their unique
problem in this field, in the USA, the leading causes are injuries, birth
defects, homicide, heart disease and cancer (ref: Singh GK US Department of
Health and Human Services, Health Resources and Services Administration,
Maternal and Child Health Bureau).
Improvement in
access to healthcare for less fortunate citizens, education and
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.
ASIM
RANJAN PATI: I do not agree
with this statement. Unless healthcare is free for all citizens, the lower
socioeconomic class will never have free access to health care. When someone
has to choose between food, shelter or healthcare, healthcare can no longer be
regarded as freely accessible.
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?
ASIM
RANJAN PATI: In the USA,
private sector provide the health care of the employed citizens and their
families - the wealthy citizens can of course pay their health care insurance
premiums. Since in this country health care system is not universal, the
private sector has an important role to cover health care in this population. I
believe universal health care coverage like in several countries in Europe
would be a better system to ensure coverage for all citizens.
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?
ASIM
RANJAN PATI: Yes. Throughout
the world many charitable and NGO's are active in providing health care
specially for the underprivileged. Starting from basic health care, they are
active in providing health care in many other specialized fields like cataract
surgery to name one. While these organizations provide a great service, I
believe the society should ensure healthcare for all. The civil society can
create the right environment by voting for a Government with vision to enact
legislation and taxation to ensure healthcare for all citizens.
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 some examples?
ASIM
RANJAN PATI: The
pharmaceutical companies are very important in drug development and research
and contributing to overall improvement in health care. They also sponsor
teaching and research programs and play a significant role in education.
However, they have also been criticized for their aggressive marketing and
influencing physicians and the physician community should be aware of their
vulnerability. Since they are private profit motivated businesses, they
cannot be entirely blamed for variable health care in different countries. I
believe a strong Government should be able to handle a rogue drug company by
creating proper legislation and oversight
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?
ASIM
RANJAN PATI: I think this is a good starting point. I have personal
experience of working in such a system as I also worked as a health care
provider in United Kingdom for a decade.
For the most part it is an
efficient system specially for primary health care coverage. However, there
will always be room for improvement and justified criticism for inefficiencies
and long delays for patients in need of non urgent care like hip replacements
and routine surgeries among others. What is possible for Europe however may not
apply for poorer countries in the world where many other demands on the society
and the Government make provision of a reasonable health care for all a real
challenge.
DR. ASIM RANJAN PATI:- A PHYSICIAN,
SPECIALIZED IN HEMATOLOGY AND ONCOLOGY. HE HAS BEEN PRACTICING MEDICINE IN
SOUTH CAROLINA, USA FOR THE PAST TWENTY YEARS.
We sincerely thank you
for your time and hope we shall have your continued support.
Aparajita Sen
(Editor:
Songsoptok)
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