The state of health care services in Uganda has literally
collapsed. At least, from the experiences of Ugandans who are confronted by its
failures. The bad state of the healthcare is only symptomatic, something that
the public has consensus over. Painfully, nobody seems able to do anything about
it.
There is a pattern to this state engineered collapse of
public institutions. To understand this pattern, one needs to study the state’s
ability to balance public and private sector perfomance. The sole purpose of
the liberalization of the economy is to enhance the exploitation of the many by
a few. The “few’, may be corporations, or individuals who comprise market
players. Corporations are the key institutions of a developed capitalism. Corporations
become the new governors, per se, in a Uganda-type neoliberalism where
government has gone to sleep.
The market-based economy is a tricky one to follow because
of the complex market dynamics. It requires that government concede its’ control
of the market, thereby retreating from providing direct social services to its
people. This would allow private entities, and players such as international
corporations to take over these roles. Your water, power, health insurance and
healthcare, roads, etc to be provided by a private agent.
Governments are then
restrained by series of forced rules, to deregulate, implement structural
adjustments (retrenchment to reduce government workers) and institute tax
regimes that favor these corporations. In other words, government becomes a
passive player to an extent. This classical
liberalism does not work in most of the African continent where the World Bank
and IMF imposed it. Our people’s consumer mannerisms are still too remote to act
as a conscious consumer in a free market would. There might just be a handful
of conscious consumers in the free-market.
The World Bank’s recent poverty assessment report for Uganda
for 2006 – 2013, illuminates such gloom of free-market economy. Nearly 80% of Ugandans
are still poor to afford quality private healthcare services. Even the country
is unable to attract high-impact investors because of the nature of our
markets. As such, Uganda’s tax-base is not expanding as anticipated. Uganda is
now drowning in debts, with Shs 6,400 Trillions due in interests to foreign
debts payable in 2016/17 financial year. This is interest, not even the
principal.
Has the liberalization of economy helped us, Ugandans? What
else should Uganda do differently to benefit from this entrenched imperialism?
The answer to these questions calls for a debate by experts
and academics. What is clear is that liberalization of the economy, with
absolute lack of regulation does not, and did not benefit Uganda and most of
these African countries. Even the countries which we consider to be the mother
of capitalism, have developed social safety mechanisms to safeguard their
citizens. Most of these countries operate under welfare regimes where
healthcare, pensions, employment, education etc., are safeguarded from the
vagaries of free-markets a matter of citizenship rights. In Uganda, we left all
to the vagaries of the liberal markets.
The open market has allowed for proliferation of lumpen
businesses in cahoot with state agents to utterly rob Ugandans. Often, the
competition is not fair or just. Some businesses, in which state players have
interests, tend to benefit disproportionately than others. These benefits are varied,
from taxation waivers, tax evasion, kickbacks, low interest rate loans, state
bailouts, bribe seeking, and irregular contracting, money laundering, to
repatriation of profits and illegal offshore bankings .
On its part, the government has continued to withdraw from
offering quality public service in the pretext of non-interference in the private
sector.
It appears then that the decay in the healthcare services is
a method of state control over the citizens. The health Ministry in 2016/17
fiscal year received Shs 1.853Trillions in comparison to Security of Shs 1.588
Trillion and Agriculture, the backbone of the economy that got a paltry shs 824
Billions. How do we explain that security and agriculture are highly functional
and healthcare is not?
END.
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