From the February 24, 2009 Campaign for Fighting Diseases Blog
February 24, 2009
by Jeremiah Norris
By Philip Stevens
I recently received an interesting email from Jerry Norris at the Center for Science in Public Policy.
Like us at the CFD, he was somewhat taken aback by the recent Oxfam paper attacking private healthcare provision:
The Oxfam study, "Blind Optimism", challenges so-called myths about private health care in poor countries. It is a contemporary re-statement of the decades-old argument for universal health care. This ignores the fact that as post-colonial nations emerged from Africa and the Sub-continent of Asia in the early 1960s, everyone of them had embedded in their new Constitutions the provision for free, universal health care.
The problem in bringing this provision into reality was that while everything was free, the governments had little or nothing to offer. Into this vacuum, the donor community found a ready receptacle for aid to the point where today some 55 of the poorest countries in the world have more than 50% of their government budgets provided by external assistance. Another 10 are at 75%!
This removes politicians from accountability to their own citizens for the enforcement of universal health care provisions. It is replaced with a dependence on non-tax revenue from overseas governments. In the absence of fiscal support from citizens, state elites retain power by converting their governance structures to wholly owned subsidiary organizations of foreign aid agencies.
Still, people in all societies have an insatiable desire for choice. As economies in developing countries improved, growing numbers of their citizens migrated to non-governmental or private provision, expressing in the process, a willingness to pay--if a service could be provided.
These citizens are not blind. Oxfam is railing against this evolution without understanding that it has been a participant in the failure of developing countries to sustain their Constitutional provisions for universal health care. By placing a greater reliance on aid agencies than on a general taxation of their own citizens, these countries have subordinated their sovereign responsibilities to the kindness of strangers.
Jeremiah Norris is a Senior Fellow and Director of Hudson Institute's Center for Science in Public Policy. He specializes in public-private partnerships in development assistance, trade and development, and global AIDS, tuberculosis, and malaria policies.
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