USC Project Jamaica: Day IV

Sunday, December 20, 2009

Today we were privileged to meet with the former president of the Caribbean Association of Pharmacists, Dr. Grizzle. She was leaving for a flight later in the afternoon, so it was nice of her to meet with us in light of her tight schedule. She came in pretty early in the morning and we had a lengthy discussion of pharmacy in the Jamaica and the Caribbean at large.

She explained the recent shift in the debate between Bachelor and Doctorate of Pharmacy degrees in Jamaica. While current programs favor Bachelor degrees in Pharmacy, the Caribbean is witnessing the introduction of Doctorate of Pharmacy programs. The Pharm. D. title would require more schooling and a more rigorous curriculum, but would enable the pharmacists to expand their roles as healthcare providers. Dr. Grizzle mentioned that pharmacists tended to be more soft-spoken than doctors and nurses. Consequently, pharmacists were less active in politics. However, Dr. Grizzle was hoping this would change. After all, the more involved pharmacists were, the more likely policy changes would reflect their opinions.

As she discussed this, the pharmacy students chimed in, agreeing with a similar phenomenon in the US. They expressed their goals of serving in Congress or as industry leaders to better represent the pharmacist’s needs. The discussion illustrated how interrelated politics were with healthcare. We then discussed the Jamaica’s strides towards healthcare for all. Dr. Grizzle expressed the need for integration between the public and private sectors of health. She explained, “It seems to me that there is some discrimination [against lower classes] because they are poor.”

However, she noted that free healthcare was better than nothing. She was grateful that the poor now had access to what Jamaica’s new administration considered a human right. Still, she pointed out that this new policy proved an unexpected burden on doctors and other healthcare professionals. “We call it free, but someone is paying for it,” she said. Her comments soon reminded me of similar statements that Dr. Fray made about the long lines and limited supply Cornwall Regional Hospital faced.

As we discussed this issue, Dr. Grizzle introduced a new side of the free healthcare debate we hadn’t considered, thus far. She explained that individuals with health insurance often utilized the public healthcare facilities instead of the private facilities they were entitled to. Thus, the government found itself paying for expenses that would normally be charged to insurance companies, if the patients used private facilities. In light of this, and with the growing healthcare demand of the uninsured, Dr. Grizzle felt as though free healthcare could not be sustainable in the long run. At the moment, she informed, the government had been trying to regain money that was allocated for private health insurance, since health insurance companies were profiting by technicalities in policy. (In fact, Dr. Fray mentioned that these health insurance companies had been posting record profits since the inception of the free healthcare reform.)

After our discussion with Dr. Grizzle, we got a chance to attend a Jamaican church service. More than half of Jamaica’s population is Christian, so it was interesting to partake in a tradition so embedded in Jamaica’s culture. We met with Toni’s church pastor and donated some clothes and toys we had fundraised throughout the semester. The pastor was quite friendly and told us a little about himself and his career. After the service, we took a couple of pictures with him and, later, enjoyed a Jamaican meal on the beach.

That evening our reflection was quite interesting. We tried to synthesize everything we had learned about Jamaica’s healthcare system. By now we’d gone to a top hospital and met with some illustrious pharmacists. Over the past few days, we’d all grown to love our driver, Curtis. He had joined us for dinner that evening, which soon transitioned into the discussion. As we talked about the healthcare reform in Jamaica that provided free healthcare and drugs for the uninsured, he chimed in. He reiterated what Dr. Fray had mentioned several days ago: the length of time patients would have to wait to be attended to often cost more than the health insurance would. For example, Curtis had a form of health insurance covered by his driving company, but also paid for private insurance to cover his family. He said it was about $30 US dollars a month, not too expensive for someone with his income. He continued, he’d rather pay for health insurance out of his pocket than wait at a hospital for care, since he could easily make up the money if he were working during the time he’d be waiting. It was profound to hear his input because it was honest, real, and coming from someone outside of healthcare. His testimony only affirmed what we had learned thus far on the trip. And it shed light on the pending healthcare reform the US is about to witness.