Some public officials are more equal than others

The Daily Trust reported that the Federal Government of Nigeria spent close to one billion US dollars ($1 billion) in the year 2014 on medical care for public officials abroad.

Correspondingly, in 2012, the Daily Monitor, a Uganda newspaper concurred that the government spends at least $150 million (about UGX 377 billion) on treatment of mostly top government officials outside the country.

Some have offered defeatist arguments that this is inevitable in corrupt-ridden poor economies anyway. But these are public taxes we are talking about, and it is many of us in the formal sector who are paying for these exclusive entitlements be afforded some, and not even all public officials.

It is not fair. To the rest of us.

Decisions to pay these cash outs are mostly informal, as in not supported by any formal policies. I do not see official government policy being stamped for approval by all national stakeholders, using taxpayer funds, to benefit the few senior public officials and their families.

Let’s say African national governments decided to formally institute inequitable policies that treated public officials better, healthcare wise, than the general population; then only a smaller percentage of this could be spent on health insurance just for these public officials. Our countries would lose less, just to provide healthcare for these privileged few using insurance not cash payments for whenever someone falls ill.

Needless to say, these privileged few can actually afford private health insurance to receive care almost anywhere in the world from their own incomes, or funds already looted from the public coffers anyway.

The Daily Monitor further adds that treatment abroad costs nearly half of Uganda’s health sector budget.

These extra, unnecessary expenditures should simply go back into the already under-funded national health systems. Mind, these are recurrent costs, year in, year out. And likely increasing with succeeding years. Imagine how much of the recurrent health sector budget would benefit from these wasted expenditures in terms of human resources, much needed drugs, equipment and other medical supplies or even infrastructure.

Rwanda on the other hand will offer ordinary citizens, not just senior government officials, medical care outside the country if this is required. A medical board in the referring health facility makes the decision to recommend to government specialised care outside Rwanda if this cannot be provided nationally. Rwanda’s health system is paid for by state funds (both from national tax and external donor support) and by individuals’ contributions through health insurance and direct fees for services.


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