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04.12.2020 Opinion

# Universal healthcare access in Ghana: a question of priorities

LISTEN DEC 4, 2020

Can Ghana afford a truly universal healthcare access program for all its citizens? I hope to convince the rational mind, that it is a question of where our priorities lie, but not necessarily whether or not we have the financial capacity to so do.

Even though indeed, we have the financial ability to achieve this end. Let us let the numbers speak for themselves in this very simple comparison with other OECD member countries.

Figures are in USD, from 2016

SWITZERLAND

GDP per capita - > 80,000

Cost of healthcare per capita - > 8,000

Healthcare to GDP per capita -> 8000/80000 = 0.1 *100 = 10 %

USA

GDP per capita - > 58,000

Cost of healthcare per capita - > 10,000

Healthcare to GDP per capita -> 10000/58000 = 0.1724 *100 = 17.24 %

GERMANY

GDP per capita - > 42,000

Cost of healthcare per capita - > 6000

Healthcare to GDP per capita -> 6000/42000 = 0.1429 *100 = 14.29 %

GHANA

GDP per capita - > 2,000

Cost of healthcare per capita - > 67

Healthcare to GDP per capita -> 67/2000 = 0.0335 *100 = 3.35 %

All these countries are members of the OECD, so this is a comparison of the priorities of 'peers' in this context.

If 2016 figures show that we can fund universal healthcare, then it stands to reason that our relatively larger economy can pay for it.

Switzerland had the most expensive healthcare per head, of all the countries with socialised healthcare(it could theoretically be argued that they are wasteful or lavish). Germany is of course the Gold standard of efficiency. The USA has the most expensive healthcare per head, campared to any category, whether socialised or not.

They all spend between 10 to 17% of the wealth per person, to provide him/her with healthcare that we in Ghana envy.

Ghana spends ONLY 3% of its wealth per person, to provide healthcare to the person. That is a massive minimum shortfall of some 70%, compared to 'peers' from the 'inefficient' Swiss/US to the efficient Germans.

Now a legitimate question could be asked about what the true cost of what socialised healthcare would be, and whether we can fund it in real terms. Now consider this; the minimum wage of the doctor in the US or Germany, is not the same as that of the doctor in Ghana. So the cost of a German doctor, will not be factored into the Ghanaian healthcare cost.

The wage of chemist manufacturing medicines in Ghana is much lower than his peers in Europe, so the cost factor is also much lower. This argument holds, throughout the majority of the value chain. So in real terms, the healthcare cost of the Ghanaian can ONLY be relative to the costs present in the Ghanaian value chain.

What is therefore at stake here, is a question of PRIORITIES. If we should realign our expenditure priorities as a nation, we can fund a truly universal healthcare program. So that mothers do not have to beg by the roadside, in other to save their dying babies. But to go from 3% to some 15%, with very minimal co-payments to discourage abuse, we will have to realign expenditure and RAISE taxes (because our revenue to GDP is among the lowest).

If we do what India did, and shift much of our currency to electronic currency, tax dodging will be a very steep climb for many, and raising taxes may not even be necessary.

It is a question of priorities.

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