A Dirt-Poor Nation, With a Health Plan

[babylonsister]

A Dirt-Poor Nation, With a Health Plan

Marc Hofer for The New York Times

COVERAGE A 68-year-old who gave her name as Clementine got treatment and medicine at a Mayange clinic under Rwanda’s national health plan.

By DONALD G. McNEIL Jr.
Published: June 14, 2010


MAYANGE, Rwanda — The maternity ward in the Mayange district health center is nothing fancy.

It has no running water, and the delivery room is little more than a pair of padded benches with stirrups. But the blue paint on the walls is fairly fresh, and the labor room beds have mosquito nets.

Inside, three generations of the Yankulije family are relaxing on one bed: Rachel, 53, her daughter Chantal Mujawimana, 22, and Chantal’s baby boy, too recently arrived in this world to have a name yet.

The little prince is the first in his line to be delivered in a clinic rather than on the floor of a mud hut. But he is not the first with health insurance. Both his mother and grandmother have it, which is why he was born here.

Rwanda has had national health insurance for 11 years now; 92 percent of the nation is covered, and the premiums are $2 a year.

Sunny Ntayomba, an editorial writer for The New Times, a newspaper based in the capital, Kigali, is aware of the paradox: his nation, one of the world’s poorest, insures more of its citizens than the world’s richest does.

He met an American college student passing through last year, and found it “absurd, ridiculous, that I have health insurance and she didn’t,” he said, adding: “And if she got sick, her parents might go bankrupt. The saddest thing was the way she shrugged her shoulders and just hoped not to fall sick.”

For $2 a year, of course, Rwanda’s coverage is no fancier than the Mayange maternity ward.

But it covers the basics. The most common causes of death — diarrhea, pneumonia, malaria, malnutrition, infected cuts — are treated.

more...

http://www.nytimes.com/2010/06/15/health/policy/15rwanda.html?hpw

[stray cat]

1. They also have copays of say $5 which turns many away

and Partners in Health and outside organization subsidize it by almost 75% but its still an excellent start.

[madrchsod]

2. so does Ghana...

they have a very good health care system based on the best of the us and british healthcare.

[gorfle]

3. Yeah right.

Exactly what kind of health care can you get for $2 a year plus copays?

"Local health centers usually have all the medicines on the World Health Organization’s list of essential drugs (nearly all are generic copies of name-brand drugs) and have laboratories that can do routine blood and urine analyses, along with tuberculosis and malaria tests."

I wonder where they are getting those drugs? Someone is subsidizing them for sure.

"Since the insurance, known as health mutuals, rolled out, average life expectancy has risen to 52 from 48, despite a continuing AIDS epidemic, according to Dr. Agnes Binagwaho, permanent secretary of Rwanda’s Ministry of Health. Deaths in childbirth and from malaria are down sharply, she added. "

Wow! Average life expectancy has risen from 52 to 48! Looks like New York could use some universal education coverage...

"Still, even with rationing this strict, how can any nation offer so much for $2 a year?

The answer is: It can’t. Not without outside help.

Partners in Health, the Boston-based health charity, which runs two rural hospitals and a network of smaller clinics in Rwanda, said its own costs ran $28 per person per year in areas it serves. It estimated that the government’s no-frills care costs $10 to $20.

According to a study recently published in Tropical Medicine & International Health, total health expenditures in Rwanda come to about $307 million a year, and about 53 percent of that comes from foreign donors, the largest of which is the United States. "

Ah, here we are.

This is not sustainable, universal health care, folks. This article is set up to chastise the US for not having universal health care as if Rwanda was so much more socially responsible. The fact of the matter is half of Rwanda's "universal health care" is simply US charity.

Look, the US needs Universal Health Care. The people deserve it with all the money blown on wars and bailouts.

But let's not hold up Rwanda as the some kind of poster child for it when half of their pathetic program is paid for by international charity.