Thursday, November 09, 2017

The inadequate band-aid

What happens if everyone seeks a private solution to public problems? --
It is the year 2017, Current Era, and there is a wave that threatens to wash over the addle-minded enamoured of the intoxicating whiff of autocracy with their morning coffee or whatever it is the residents of Uthamakistan drink in the morning. This wave is known as critical thinking and I shall attempt to employ it as I take a stab at answering @Gladwellotieno's question.

We are reminded, usually in the form of a joke, that there are two things that are certain in life: death and taxes. Of the former there is no escape; of the latter, evasion invites (in normal states) the unremittingly unforgiving attention of the State. Taxes are the means of dealing with all manner of public policy issues; without the revenues raised by taxes, doctors and nurses will not be paid, and their patients will suffer. Many will probably die. A few patients, at least those with the wherewithal, will engage the services of private healthcare providers and probably escape suffering and death. That, in a microcosm, is a private solution to a very public problem. It is one that millions of Kenyans are familiar with for in the past one year, both doctors and nurses employed in the public service have gone on strike, patients have suffered, many patients have died, and a few have survived because they could afford private healthcare services.

However, what seemed to be a solution was only half that. The unseen ripples of the pebble thrown into the still, healthcare pool will continue for a long time, years perhaps. In the over 160 days of the nurses' strike, childhood immunisation was not done for hundreds of thousands of children, tubercular patients did not have their medicines administered to them, hundreds of cancer patients were forced to dig even deeper into their savings to access private oncology services, and so on.

What will be immediately apparent is that while suffering Kenyans had no choice but to pay their taxes lest they invited the attentions of the taxman, the services those taxes were supposed to fund were not provided and so they were forced to spend what little they had saved on privately-provided services. Family incomes have been decimated. Local economies have been stunted. Mini-epidemics are certainly on their way. Misery has been visited on families. Private solutions to public problems are no solutions at all. They are band-aids on involuntary amputations, that is, wholly and utterly inadequate.

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