I could tell something wasn’t quite right with the electrician. He was standing stiffly, poking at the wires in the circuit breaker panel, his face pale, his breathing labored. My wife offered him a cup of tea and asked if he was OK.
“I’m fine,” he said. “I just had a little surgery yesterday.” He kept working until he fixed the wiring; only then did he accept the tea. Then he told us his story.
My Russian wasn’t good enough to understand everything, but apparently he had fallen down some stairs and needed surgery. But at the hospital, the doctors wouldn’t look at him until he coughed up the equivalent of $600. To get treatment, he borrowed the money from friends. One day later, seeing an opportunity to make a little money, he nipped out of the hospital to my apartment. Luckily, I had all the tools he needed—he hadn’t brought his own to the hospital.
The story shocked me. Ukraine, in theory, offers free health care to its citizens. But in practice, patients have to pay for everything. The system is in bad shape: hospitals are crumbling, and lack both modern equipment and basic medication (patients are usually asked to buy it themselves). Private healthcare services exist, offering much better services, but they are unaffordable to most people.
Unfortunately, Ukraine isn’t the only place with healthcare services issues. It’s a problem throughout the developing world, and in wealthy countries too (just look at the fuss over Obamacare in the United States). The problems may vary from place to place, but they all basically boil down to one thing: costs. Healthcare is getting more and more expensive, and the money just isn’t there.
Can the private sector help? Private clinics at least provide an alternative, even if their services are out of reach for many people. But there are other ways the private sector can get involved. Governments can tap into private sector expertise (and financing) through public-private partnerships (PPPs). Not just for new facilities and equipment, but also for managing healthcare services. If done right, this means access to better healthcare for more people at a lower cost.
The latest issue of Handshake, IFC’s journal on PPPs, provides rich examples of how this has be done around the world, from Singapore to Ghana to Brazil. What’s clear to me is that pressing healthcare issues can be solved, and that they are best managed through government and private sector cooperation (epic political battles in the United States notwithstanding).
Hopefully, Ukraine will benefit from healthcare PPPs one day soon. Perhaps my electrician will be able to stay in the hospital the next time he has surgery.
Read the latest issue of Handshake on HealthcarePPPs, and watch this space in the next couple months for more posts on this subject. Also, check out the WorldBank’snewhealthblog, and meet the famous Baby Maya: