THE RIGHT PRESCRIPTION

Panama 2019 | HEALTH & EDUCATION | FOCUS: HEALTH PACT

Panama's new president has already pledged to address the shortfalls of the national healthcare system, one being the lack of universal coverage.

Universal healthcare may not be enjoyed the world over, and yet the vertiginous cost of aging populations and vast savings to be reaped through the prevention, rather than treatment of chronic disease are registering on the economic radar. Meanwhile, ahead of the recent elections in Panama, presidential candidates were asked to confirm their commitment to the health of Panamanians about to vote for them by signing a Pact for Health, with some labeling it a human right.

Channeling the Patient

Panama has a two-tiered health system comprising state provision and the private option. Those able to opt for the latter do so in light of shortfalls of both medicine and facilities as well as the attendant delays to treatment and surgical procedures. Therefore, without adequate resources and access, the noble notion of universal coverage rings hollow. As World Bank numbers confirm, despite notable advances to curb poverty, Panama remains among the world's most economically unequal nations. Annual economic growth has at times been stellar, averaging 7.2% between 2001-2013, more than twice the regional average. And between 2015 and 2017 poverty declined from 15.4% to 14.1%, with extreme poverty dipping modestly from 6.7% to 6.6%. The government will need to tackle stubborn regional disparities given the realities of limited healthcare coverage and educational access among rural and indigenous populations. Given the costs involved, governments have realized that the public sector, comprising the Ministry of Health and the Social Security Fund, has its work cut out.

Previous Steps Toward a Rethink

In January 2016, a high-level commission was formed to chart key policy priorities for the nation. The resultant document at the time, consisting of 12 core principles, chiefly identified universal healthcare by the state as a human right. It also recommended a model based on primary care and the replacement of the traditional curative model with one promoting healthy living and prevention.

Pledge to a Healthy Constitution

Demand for the aforementioned election commitment came from Panama's High-Level Commission on Health (CAN), comprising numerous health associations, as well as the Social Security Fund, the Ministry of Health, and the United Nations Development Program (UNDP). The text encompassed key considerations of water quality, food security, health promotion, and the availability of facilities and medicines. The move was an attempt to secure long-term commitment to an urgent issue, not least given the disparity in quality between Panama's private and public healthcare models. A challenge wide in scope, it perhaps predictably drew limited candidate interest at first. Yet, ultimately promising words resulted from several quarters. Laurentino “Nito" Cortizo of the Democratic Revolutionary Party (PRD), Panama's largest, who went on to victory at the May 5 general election, committed to both depoliticizing and improving the public health system. He announced a policy working toward improved coordination and tackling irregularities without recourse to privatization. He also promised to ensure an adequate medicinal inventory.

Other candidates pledged a reduction in the cost of medicine and the establishment of additional local health clinics for primary and preventative care. Regardless of whose pledges they were, all of these valid individual items will be expected of the president during his tenure. Candidates inking the document also agreed to deliver citizens adequate surgical procedures and related supplies, as well as overhauling installed capacity that has become obsolete based upon a comprehensive health infrastructure master plan.

A Welcoming Policy

It is perhaps worth noting that prevailing private healthcare costs, while prohibitive for most locals, remain hugely advantageous in comparison with those in developed economies. It is no small wonder so many foreign nationals have chosen to retire in Panama. Moreover, this message is further apparent upon entry to the country, where tourists receive 30 days of basic healthcare coverage at hospitals and clinics. All this spells potential to generate tax revenue from lucrative medical tourism.