Health, productivity improved with no-fee policy - IDB study

The general health of the Jamaica population, as well as productivity, improved under the no-user-fee policy in public health facilities implemented in 2008 by the Jamaica Labour Party administration of then Prime Minister Bruce Golding, according to a study by the Inter-American Development Bank.

"Evidence suggests that the policy improved overall health status, as the likelihood of suffering illnesses associated with inability to carry out normal activities decreased by 28.6 per cent. In addition, the number of days where people were unable to perform normal activities, because of illnesses suffered within the previous four weeks, decreased by 34 per cent," read a report on the study titled 'Universal Public Health Insurance, Adult Status and Labour Supply in Jamaica.

Regarding labour market dynamics, the researchers said no effects were found on the likelihood of being employed or contributing to the National Insurance Scheme. "However, consistent with a reduced number of days lost due to illnesses, we find a positive effect of 2.15 additional weekly labour hours."

The researchers said all of the positive effects were concentrated within adults in the 40-64-year-old age range. "Overall, these effects suggest that the policy added a yearly average of US$PPP (purchasing power parity) 26.6 million worth of net real production to the Jamaican economy during the period 2008-12."

Quality of service seemed not to be optimal

Meanwhile, the study noted that for the five years leading up to the implementation of the policy, the Government spent a yearly average of real US$PPP 546 million in the public health system. The expenditure for the first five years of the policy rose to a yearly average of real US$PPP 623 million.

The no-user-fee policy was an election promise that Golding implemented amid significant outcry from the Opposition and other key health stakeholders that the health system would be burdened.

The issue of quality was addressed in the research conducted by Diether Beuermann and Camilo J. Pecha and released in April. "The average real expenditure per medical service provided in public health facilities dropped by 19 per cent between 2006 and 2009," they said.

"Therefore, the increased demand outweighed the extra public funds invested in the health system after policy adoption. As such, it appears that the quality of public health services freely provided after policy adoption was not optimal."