Garth Rattray | Who is planning for our future? (Part 2)

With a growing and rapidly ageing population comes the need for medical care. The most available ‘ambulances’ are family members, friends, neighbours, taxicabs, and the police.

Our [public] ambulance service is abysmal and basically, unavailable to the general public. Our [private] ambulance service is expensive and occasionally unavailable because they are sometimes all busy. Getting to an emergency room in time can mean the difference between life and death, so we need to have ambulances for our everyday citizens. Is this serious problem being addressed?

Various administrations doggedly cling to the ‘no user fee’ healthcare policy although it was conceived during a political campaign and not thoroughly thought through. As soon as it came into effect, on All Fool’s Day, 2008, our already overstretched public-health system was thrown into disarray by the promised ‘freeness’ and sudden loss of critical revenue (now, billions annually). Everyone who used to pay whatever they could afford to the public hospitals and clinics stopped contributing.

By 2010, the Government began quoting a United Nations 2010 Report on the World Social Situation that encouraged underdeveloped countries to offer ‘no user fee’ healthcare. But no government has admitted that within that same paragraph of that same report was also stated, “At the same time, removing fees will entail additional resource requirements. It is, therefore, important to ensure that additional funding is available for countries that want to remove fees. To support the permanent removal of user fees and to ensure that the poor benefit from such actions, fee removal needs to be part of a broader package of reforms that includes increased budgets to offset lost fee revenue.” Jamaica cannot offset the lost billions; therefore, many citizens will continue to suffer, and some will die. Things are only going to get worse in the future unless apolitical decisions are made.

MASSES REMAIN POOR

In 2020, the World Bank rated Jamaica as an upper middle-class economy. However, very few are wealthy while the masses remain poor. People are desperate for financial and physical security. To improve the exchange rate and, therefore, the lives of our citizens, major merchants who require large sums of our foreign exchange (FE) to import goods should be required to invest some of their profits into production and/or export so that they can earn some of the FE that they utilise so heavily.

Aside from debt repayments, we spent US$7.73 billion on imports alone in 2022 but only earned just over US$1.9 billion from exports. Tourism earned US$3.64 billion, and a further US$3.44 billion came from remittances (which, in many households, are critical for basic needs such as food, shelter, clothing, medical care, and education). Is there a long-term plan to increase self-sustenance, production / manufacture, and exports to avoid possible economic implosion?

There is talk of constructing more prisons, but if we build more schools, we will have less need for prisons because there is an inverse relationship between education and incarceration. The same relationship holds true for occupation and crime. In my opinion, doling out reparation money will not improve our long-term lot as a people. Reparations for slavery should entail developed countries investing in us through production / manufacturing. Furthermore, the World Trade Organisation should amend its rules to permit preferential trade agreements for developing nations like ours. We need sustainable self-sufficiency, and that can only happen if we are given opportunities to earn for ourselves through export. We should be fervently lobbying for developed countries to base some of their manufacturing plants in Jamaica … that includes big pharma.

CORRUPTION

We all know that corruption is rampant; however, one of the reasons that it is so common and runs so deep is that some people sense a huge discrepancy between their earning power by honest means and the reality of trying to survive in a country where goods and some services are based on a dollar worth about 156 times our local currency. Our supermarkets are constant reminders of that discrepancy, and the toll rates also provide a shocking reality check. With the impending fare increase, anyone doing a round trip on the North South (Luxury) Highway only once each week in a class two vehicle (like a mid-sized pickup) will end up paying $464,360.00 per year.

Putting that into perspective means that if the driver of a class two vehicle is going to use the interest on a “high yield” commercial bank [regular] savings account to pay the round-trip toll once per week for one year, he/she will have to earn an interest of about $619,146.70 [before tax] per annum. That requires a minimum balance of $154,786,666.70!

The alternative route is rough, bumpy, potholed, unsafe in places, cratered and fissured in others. Imagine the cost to those who must commute five or more days every week. The toll rates are showing us that our money is worth very little and that generally, personal incomes are way out of synch with our reality. I wonder who will find a solution to our burgeoning despair.

There are other serious and growing problems like indiscipline and lawlessness that crave long-term solutions. These things facilitate and lead to the normalisation of antisocial behaviour and criminality. Garbage-strewn streets, overflowing sewerage, unkempt environs, crime, corruption, and the validated ‘eat a food’ mentality are defining us as a people. Is there a plan to ensure order and discipline in our society before anarchy prevails?

Garth A. Rattray is a medical doctor with a family practice. Send feedback to columns@gleanerjm.com and garthrattray@gmail.com.