Health inequality

M. Shahid

Like wealth inequality, health inequality in the society is also a crucial issue and need urgent attention.  The novel Covid-19 pandemic has exposed the inequality in access to health facility both in the industrialized as well as in the developing countries. The entire world is struggling hard to deal with the unimaginable human, economic and health costs of the current corona virus pandemic.

Access to top-notch medical facilities and excellent ventilators are restricted only to the rich. The less-privileged and disadvantaged working class in different societies is forced to experience low or even no medical facilities. The unskilled and lower-paid workers are at the higher risk of contracting the corona virus amidst of the struggles to contain the spread of coronavirus pandemic. Doctors also face difficulty in making choices about who get access to the limited number of ventilators and other health facilities across the globe. Due to the limited number of ventilators and scarce medical equipment, the aged victims denied the treatment in many countries which is inhumane and unethical but unavoidable at the same time.

Decades of economic inequality and wealth concentration caused inequality in access to health facilities. The low-wage earners and the poor segments of the society are not able to build up financial buffers for uncertain times. The current economic slump caused by Covid-19 has further widened the gap between the haves and have-nots. Responsibility of the state is to make impecunious and indigent citizens feel secure and less fearful. Poorly paid workers and daily wage earners cannot afford to stay at homes for long. Compare to the rich class, the economically vulnerable people are also at disadvantageous position when it comes to the use of technology to have access to resources and information related to their health. Providing good public health system and services to the needy and poverty-stricken population must be an important part of government health policy.

The low budgetary allocation and health expenditure have undermined the public health system in Pakistan as well.  The availability of health facilities in Pakistan is already overburdened. Evidence suggests that health disparities exist in Pakistan. The social and economic determinants including living conditions and resource ownership are critical factors that cause health inequality in the country. The geographical location and rural-urban divide are also crucial factors in access to health facilities. The health system is struggling hard to meet the increasing demand of the growing population in the country and access to scarce medical facilities and ventilators in the current scenario is not satisfactory. On the other hand, the private provision of quality health facilities is highly expensive. Price gouging is widespread and majority of the population cannot afford these expensive health facilities.

Affordability is obviously a key issue but there is also a racial and ethnic dimension to the inequality in access to health facilities. Many racial and ethnic groups are usually experience economic vulnerability, which then exacerbates their existing problems in this global pandemic. We have seen that corona virus is highly democratic in nature and does not discriminate on the basis of class and religion as it spread to both the rich and poor, Muslim and non-Muslim countries. In terms of deaths, corona virus seems gender biased as more men are dying of virus than women. Besides the gender sensitivity, corona virus also discriminates by age and by underlying health conditions.

Health system suffered from a wide range of problems and Covid-19 has further exposed the fragility of health services and systems across the globe. Keeping in mind the magnitude and severity of the current Covid-19 pandemic, even wealthy and the rich class in different societies failed to have access to quality health facilities and ventilators. Corona virus will devastate the marginalized sections in our societies if we don’t act now. Legislators and economic managers are forced to make difficult choices, address the issue of health inequality.

The health needs of the deprived and destitute population must be effectively addressed.  We should pay attention to the prevailing situation and must learn lessons from the failures particularly failures in the health system. Government intervention is necessary to address the issue and minimize the existing health disparities between the haves and have-nots.