‘Free healthcare’ hoax ruins national development

12Nov 2016
Francis Semwaza
The Guardian
‘Free healthcare’ hoax ruins national development

The age-old politicization of healthcare service provision in Tanzania, especially the promise of free elderly maternal and child care services, continues to cripple the country's healthcare system.

The words that were initially aimed at winning public support have turned into a sow-throat in both medical circles and the public.

Despite the public being reminded of asking the politicians the ‘how’ question regarding the implementation of the many promises they usually make during electoral campaigns, most notably improving healthcare services, the political deception continues to hold a tight grip on most Tanzanians.

The continued deception largely owes its roots to the people’s mentality of ‘wanting everything for free’ despite the conflicting reality, given the government’s slashing of social budget in the early 1990s due to the worsening economic conditions.

Tanzanians can mostly be characterized as ‘laid back’ waiting for the state to provide them with everything as it was the case during the first phase government under Mwalimu Julius Nyerere, when politicians used to take the people for a ride by telling them what they would like to hear.

Some people would even go to as far as alleging that it is Nyerere who led the people into adopting hatred for work, quite contrary to a mastermind of slogans the likes of Uhuru na Kazi, and a leader who demonstrated his love for work even after his retirement when he devoted his time to working in the farm in his native village of Butiama.

Thus, blaming Tanzanians’ idle behaviour on the Father of the Nation’s love for his people and that he did not believe in what he had been preaching would be simply groundless. Otherwise it was just an abuse of his working philosophy by the very selfish politicians who boasted of devotion.

Should the politicians ever invoke ignorance as defense for their being unaware of the many changes affecting social policy formation and execution, then the people should question their academic qualifications including the very obvious common knowledge that does not require one to attend class to understand them.

But Tanzanians’ reputation for hating to read even the simplest materials is depicted in an infamous saying that goes: “if you want to hide information from Tanzanians, put it in writing.

” Therefore, it could be equally true that even the most learned people serving in public positions have little knowledge of the implications of the global and local events on the formation and implementation of most of the policies governing their tenure in office.

The same knowledge gap in current affairs could be the case with most ordinary citizens making them unable to make right judgments, apparently supporting a candidate whose lies sound the sweetest.

But this lack of knowledge on the part of office bearers should not at any time be invoked as defense since they are exposed to all the means of acquiring such knowledge which they could judiciously use in guiding their words and deeds as public officials.

However, even the learned ones and the politicians supposedly well abreast of global as well as domestic socio-economic changes that impact on policy making and implementation as far as healthcare provision is concerned happen to betray their intelligence and continue with the same ‘business as usual’ mentality as if they know nothing about the dynamics.

The facts like ever increasing population from 10 million during independence to the current 50 million is not trivial enough to ignore amid the state’s reduced ability to provide social services.

Other factors include the average numbers of those people currently absorbed into the country’s various economic sectors and quite a big number loitering the streets not sure of their next meal.

The increasing cost of healthcare services due to changing technology as compared to some four decades ago is yet another dimension to consider when making such enormous but hard-to-implement pledges since such cost has not remained the same over the years.

This is especially true with the country’s reduced ability in healthcare spending from providing full coverage to the current per capita budget of $30 due to economic hardships experienced locally and globally.

The totality of the situation results in the reverse of the politicians’ promises whereby it is not uncommon for a woman in labour being required to bring with her necessary items including gloves, cotton bundles and other supplies to a maternal ward.

Given these few specifics, even the most developed countries cannot afford providing its people with free healthcare services except in case of emergency.

In bridging the service provision gap in any desperate society, including in Europe and other economically advanced countries, Public Private Partnership (PPP) has become a model solution adopted by several governments in their attempts to compensate for resource deficit in the public sector, as well as in making the private sector share responsibility in caring for the very people from whom it aims at benefitting.

Together with cost-sharing mechanisms already in place since the early 1990s in most government-owned healthcare facilities, PPP could be the model the country needs to capitalize upon and implement in full scale while continuing to educate the people in finding sustainable solutions to the stubborn problems engulfing the provision of healthcare services to its people.
The same model could be piloted for efficiency purposes and employed in other sectors such as public education since there is an uncountable number of problems there too.

This could help in avoiding the ongoing political deception, especially during political campaigns, while more efforts could have been put on economically empowering the people to focus on generating more income so that they could use alternative means such as health insurance in their seeking healthcare services.

Francis Semwaza is a Dar es Salaam based development communication consultant. E-mail: [email protected]; Phone: 0717466044