A world with free healthcare for all

The inability of government-subsidised healthcare infrastructure to manage growing demand in India has led to the rapid rise and spread of a variety of private options. Representation Pic/iStock

As Luigi Mangione fever takes over my TikTok timeline, I feel compelled to think about the global state of healthcare. One would have thought that after the dramatic circumstances around the recent pandemic, which exposed the fragile nature of our medical infrastructure, we would have collectively focussed on making improvements, amending our laws and policies in order to allocate better resources for hospitals. But this hasn't quite been the case. In Gaza, the occupying forces have been systemically destroying such infrastructure, deliberately targeting healthcare providers and making it impossible for the wounded to seek any form of triage. In the US, there are murmurs of deep class-related unrest as the recent murder of a CEO of a health insurance company has triggered intense debates about the sorry state of healthcare there, and the deep inequalities that exist that prevent large chunks of the population from accessing timely care. I read that most instances of bankruptcy happen after illness, in the US, because people cannot afford to pay their exorbitant bills. So wedded is the system to capitalism that the powers that be are unwilling to even imagine a social welfare system supported by free healthcare for all.

In India, the situation isn't ideal. The inability of government-subsidised healthcare infrastructure to manage the demand has led to the rapid rise and spread of private options. You enter a private hospital and suddenly you are tricked into doing a thousand unnecessary tests. If you need surgical intervention, you must check if it is insured by the company to whom who have been dutifully paying premiums, year after year. There is zero accountability, in many cases. Babies have died in ICU units because of a random fire and no one is held to task. Female doctors on duty are raped on hospital premises, but no one is really held responsible. Doctors and nurses are underpaid, and patients are forced to overpay if they want better services. I was fortunate that when I was working in India as a freelancer, I had the foresight to pay for medical insurance, so when I needed to have a fibroid removed, I didn't have to pay the almost Rs 1 lakh bill.

When I moved to Italy, I was shocked by the systems that exist here and frequently wondered if one of the reasons Western European countries are so anti-immigration is because they are afraid of sharing these privileges with non-white people. During my first pregnancy, I must have myself spent a total of €36 or so, for one test that determined the likelihood of our child being born with a genetic defect. This was also subsidised, as privately, the same test costs a few hundred euros. My consultations, ultrasounds, blood tests, dietician and diabetologist visits, C-section and three-day hospital stay were all state-funded. The quality of care was exceptional and I couldn't fathom why people who lived here even bothered to go via the private route where you pay a minimum of €100 per gynaecologist visit. The flipside, for sure, of accessing free healthcare, is that you are at the mercy of the system, so you take whatever appointment dates you are given, but that's not so different from the private route. My recent hospitalisation for 10 days was also free. In fact, my parents couldn't understand why my husband wasn't with me 24/7 at the hospital. They couldn't fathom that there was no need for him to be there, because if I needed anything, from medicines to a hot cup of tea, the nurses would provide it, and also that there were fixed visiting hours. When I was discharged, I was given dates for future controls, but no bill. As a freelancer, I don't mind paying taxes if this is what I receive because of it. However, these services are not conditional on your being a taxpayer. As long as you are in the system, you are entitled to free healthcare.

This is how it ought to be universally. This is what we deserve. Especially when it comes to reproductive rights. Pregnant mothers shouldn't have to pay a bomb to have safe deliveries. People shouldn't have to leave their borders in order to get better treatment. I always wonder what our societies would look like if we organised them from the prism of free healthcare for all. If we took this as our first and basic legal right and spent our collective resources on building systems to support it instead of splurging on weapons of mass and efficient destruction, would we not be staring at the climate apocalypse that is already at our door? If we could hold our governments accountable for this right, would we see lower levels of pollution, better labour conditions, healthier babies and lower post-natal mortality rates?

Deliberating on the life and times of every woman, Rosalyn D'Mello is a reputable art critic and the author of A Handbook For My Lover. She tweets @RosaParx
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