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Former M.P. Pierre Dupuch comments on Bahamas healthcare system.


Published: Aug 12, 2017

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Dear Editor,

 

Many moons ago when I was a freshman studying economics at St. John's University, my professor, Fr. Martin, walked into the classroom and said, "Open your books and write this down. The definition of economics is the allocation of scarce resources among competing needs and wants."

Over the past sixty years I have seen successive governments run this country contrary to the basic rule of economics, the allocation of scarce resources among competing needs and wants. In 1982 Sir Kendal Isaacs appointed me the shadow minister of health in the House of Assembly. From there for ten years I watched the then government whittle away scarce money with no rhyme or reason. Since then I have seen successive governments do the same thing in the healthcare system — waste public funds.

I suggested then that the government should buy well-equipped ambulances for each Family Island. This would make healthcare mobile, far less expensive and more efficient. So if a person in south Eleuthera had a chest pain, the ambulance would go there, hook the person up electronically and transmit the patient's vital signs to the main hospital in Nassau.

This information would be interpreted by a specialist who would instruct the operator how to treat the patient. If it showed indigestion, the patient would be told to take two Tums and go home. If, however, it indicated a pending heart attack, the specialist would instruct the operator what to do to stabilize the patient and fly him/her to Nassau for further treatment.

In those days the most difficult part of this operation would have been electronic transmission. I said then that I was sure the Americans, who had bases throughout the islands, would be glad to cooperate and lend their facilities.

With the invention of cell phones, transmission is no longer a problem. The problem is the lack of common sense.

X-ray machines are now manufactured to fold up and fit in the back of a car; medical information and scans can be recorded on machines that look like a cell phone. Why are we investing in all of these inoperative, expensive and inefficient monuments that look great and serve as photo opportunities for the politicians?

This is not rocket science. It is done every day in the United States. An ambulance is called to the scene, the patient's vital signs are immediately transmitted to the emergency room of a nearby hospital, and a specialist gives the operator instructions as to how to treat the patient.

Some time ago I visited one of these state-of-the-art hospitals, which had recently been built on a Family Island. It was beautiful. It looked like a hotel. The most expensive lights were used for its vast parking lot. The entrance would make Baha Mar look sick. The operating room was grand with state-of-the-art equipment in it. The x-ray equipment was the best money could buy. There were at least two-dozen beds. There were desks and telephones on at least twelve administrative desks. There was at least one-thousand square feet for "expansion".

Sounds great! Looks great! Great photo op! But how much did it cost and how effective is it? There was no x-ray technician to operate the state-of-the-art x-ray machine. There were no surgeons to operate. The patient beds were empty. A small room was crowded with patients getting medications.

Allocation of scarce resources or show? This cost millions of dollars of the people's money.

To operate it takes at least four persons: the surgeon, the anesthesiologist, and at least two nurses. This is a minimum. Was the government planning to fly these people in from Nassau? Did the government expect these highly qualified people to stay on the small island where their skills are seldom needed? Or would it make more sense to fly the patient to Nassau where he/she would be treated by highly competent specialists?

For an operation the question is simple, fly four qualified persons to use the state-of-the-art facility on the island or fly one patient here? Which choice would be the allocation of scarce resources? It does not take a rocket scientist to figure that one out!

The choice is yours. A well-equipped ambulance, which is essentially a mobile medical facility with the back-up services of specialists in Nassau, or an expensive, beautiful, non-operative hospital?

My advice is to follow the definition of economics and you will not go wrong.

Note: Prime Minister Dr. Hubert Minnis appears to be doing a great job. Keep it up. But some recent appointments show that the present government may inadvertently find itself in some conflict of interest situations, which they will live to regret.

 

- Pierre V. L. Dupuch

 

 


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