The Sun News

Between quality and pricing in healthcare

By Ezedi Udom

Welcome to the month of November, generally regarded around the world as World Quality Month, a period to bring to the front burner issues that border on quality. In the same vein, the United Nations in 1990 adopted the second Thursday of November every year as the World Quality Day.  According to the global body, this Day is to raise international awareness of the important role quality plays in ensuring nations’ prosperity. This celebration is an indication that the UN appreciates that, since a nation’s prosperity is a summation of its population’s individual prosperity, countries will prosper more if its people adopt good quality management systems than when they don’t.

This gospel seems to be targeted at Nigeria of today as we grapple with the challenges of recession. Given the economic realities of today, it looks like a miracle, especially for the majority masses, surviving each day. Unemployment has risen to a  record 24 percent, power generation dangles between one and three thousand megawatts – albeit high cost, while many companies have shut down, others are either cutting staff salaries or laying off staff, there is insecurity everywhere, and above all the uncertainty that pervades these tortuous times is making people do anything they could to survive.

And this is obviously no time to fall sick in Nigeria. I hope this does not sound as if there is a time to wish to fall sick. The irony of fate is that bad economic state drives more health challenges, unfortunately. As companies strive to survive the times by cutting cost, and some by cutting corners, people are now cutting costs to also survive. People are lowering their lifestyles – food, fashion, habits, recreation etc. – to suit the economic realities of today. They have now extended this cost cutting to healthcare. Many families now opt for self-management of the health conditions of their members, and manage to go to the health centres only when the conditions have worsened. Most times, at this time, it has become too late for complete cure or gotten to a stage that only specialist care will suffice.

Many people cite high cost of living as the reason for not seeking quality medical attention early but can we actually excuse poor health management of medical conditions on the account of the cost? We all know that when faced with some issue, it is always advisable to weigh one’s options before making a decision. We weigh the costs and benefits of these options to ascertain the value propositions of each of the options and determine the one that offers us the highest value, which will eventually become our choice.

It is unfortunate that, given the economic situation in the country, people, in determining value, tend to tilt the balance towards cost at the expense of quality. Generally, this balancing gives immediate returns but it is also a recipe for great danger in the long run. In healthcare, a condition that could only take the first line medication to treat when presented early, may require a more expensive second line medication, or even a tertiary level attention, to treat and manage when presented much later. A stitch in time saves nine.

Quality healthcare, everywhere in the world, comes at premium for obvious reasons. Quality management system is very expensive to deploy in the healthcare industry. It starts with the recruitment of highly skilled personnel and personnel training to achieve the desired manpower that can deliver on quality services. It also entails the deployment of cutting edge equipment and consumables that can achieve the international standards that the facility is guided by. Above all, quality entails the adoption of rigorous processes that will ensure that your results are definitive and meet the international best standards. Anyway one looks at it – manpower, equipment, consumables or processes – quality comes with huge additional costs, which frighten many health facilities away from adopting it.

A few health facilities that make the investment towards achieving a good quality management system have no choice than to adjust the prices of their services in such a way they would be able to recover their huge investments. This makes them appear more expensive than other facilities with little or no investment in quality. The fact of the matter is that quality facilities are actually no peers to the roadside facilities that offer “anything goes” level of services. Until the frog jumps into hot water, it does not know that there are two worlds. To the ordinary man in the streets, all health facilities offer the same services – run tests, treat patients, sell drugs etc.

A few people, who have had the misfortune of tasting the other side of healthcare management, truly understand what it takes to be victims of laboratory misdiagnosis or hospital mismanagement or of expired or substandard drugs. It is like being between the rock and the hard place.  As we celebrate this year’s World  Quality Day on 10 November, we should resolve to always go for quality healthcare, irrespective of the cost.  Although we could actually pay more today, we should be rest assured that it could save us a number of unpalatable circumstances including death, unnecessary and elongated treatment and the attendant high cost in the long run. It sounds like choosing the lesser evil.

Udom is the Corporate Communications Manager of Salveo Healthcare Management Company Limited

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