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Tuesday, 23 September 2008

Election 2008 : UPND Policies - Health (2)

You have guessed it, in the previous post, I had promised a look at the UPND policies on housing. Unfortunately after glancing at their housing commentary, I concluded it was inadequate to warrant discussion. So we skip that and move straight to health care:

Zambia’s Health Care system is pathetic. There are so many charges that the government asks from sick people when the same government is heavily taxing citizens all the time. All Zambians pay tax on almost every thing they purchase- Value Added Tax (VAT) and Pay-As-You Earn (PAYE). Fuel levy and duty costs are even causing the pump prices of fuels to be out of this world. Government never gets tired of collecting money from its citizens who they are failing to take care of when they fall ill. This government is heavily taxing everyone including the sick and the dead.

One patient suffering from kidney failure is now required to go on the dialysis machine three times a week to get his system cleaned, and University Teaching Hospital is asking for K400,000 per day, thereby asking him to pay K1,200,000 every week. In a month he is asked pay K4,000,000. This makes health care unaffordable to the majority citizens.who they are failing to take care of when they fall ill. This government is heavily taxing everyone including the sick and the dead.

UPND will provide:

  1. free quality medical care for the poor alongside private medical facilities for those who can afford to pay. Emphasis will be placed on providing health care for maternity, children, differently abled and the aged;
  2. improved and modern medical facilities (rehabilitation and building of more clinics and hospitals supported by good technical, research and development capabilities) close to the people. This would include having suitable clinics in busy places such as markets, main bus stops, large schools, compounds, urban and rural areas. In particular, there is need to ensure that high quality medical facilities are available to all citizens within Zambia in order to minimise the need to evacuate patients who are critically ill as is the case now where only the favoured few benefit;
  3. readily available and safe medicines in clinics and hospitals and not the current habit of only giving prescriptions to those seeking medical care;
  4. a vigorous fight against Malaria and HIV/AIDS, in particular, improved management and increased funding for prevention, treatment and care;
  5. improved but affordable medical schemes and insurance;
  6. better pay, housing, training, retraining and other conditions of service for doctors, nurses, medical assistants and other health workers.
Noble goals indeed. Unfortunately it is the perial twin problems all over again - lack of coherent vision and little detail on how these goals can be achieved. Its unclear to me whether UPND sees a government controlled health care delivering health for all or a private health care subsidised heavily government. Notice that there's no mention of the private sector as agents of change, so one assumes that the UPND model is government delivering everything. The only problem is that government has no money. Where will the money to fund the noble goals going to come from? The UPND policies appear so dissapointing, that I have decided to discontinue this column on their policies.

9 comments:

  1. The only problem is that government has no money. Where will the money to fund the noble goals going to come from? The UPND policies appear so dissapointing, that I have decided to discontinue this column on their policies.

    The government has no money??

    In 2004, they had $1.7 billion ($1.1 billion from taxes and $0.6 billion from 'donor aid') in income - and that was without taxing the mines.

    How much money do they need?

    I would agree that it would be helpful if all the parties included specific policies and at least an estimate of the costs and how it would fit into the general budget.

    To quote from the UPND website:

    Consider this:

    The Auditor General’s report covering the period 2001 to 2005 reviews that the MMD government has through their various forms of financial mismanagement misappropriation and related irregularities lost 14.7 trillion kwacha of public funds. This money alone could have financed the entire education and health sector. Each Minister and Deputy Minister in this Government has been consuming over 100 million kwacha per month. Each Minister has more than two motor vehicles with over 1 5 million kwacha worthy of fuel and over One million kwacha service costs per motor vehicle They also receive millions of kwacha worth of talk time. Yet they receive tax free salaries and allowances and live in free houses with free water and electricity.free medical services and their children have free education too.


    This would need major reform - auditing, budgeting, etc. and would also mean the UPND needs to keep in check rogue elements within it's own party.

    ReplyDelete
  2. I agree with Cho, there is not enough money for everything. If you divide $1.7 billion among 12 million Zambians, that is $142 per Zambian. To be used to pay for education, health, roads, agriculture, defense, etc. Only when the average Zambian starts generating the same income as mid or high level income countries will they be able to afford better services. So the focus should be on business and hence employment growth to enable this higher income.

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  3. Which is why the government doesn't pay out $142 to everyone.

    The government can use that money in a way that multiplies it's effects on the economy.

    They could be building roads, schools, and provide education and healthcare to everyone.

    Instead, it is spent on 30 ministries, political positions, boondoggle projects. Minister's emoluments where $300 million in 2004, but the government charged parents for their children's education.

    It is not a matter of there being too little money, but of priorities, and the political will to turn away from corruption as a way of running the government and political system.

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  4. Only when the average Zambian starts generating the same income as mid or high level income countries will they be able to afford better services.

    I disagree. There were better services under UNIP simply because it was government policy to provide everyone with education. It was the neoliberal idea to stop that.

    Business does not bring money to Zambia. They only bring enough for their operations, after that they take money out of Zambia if they go untaxed and share no profits. Only some of their costs are actually spent in the country.

    Trickle Down economics has failed, and it is time for demand side economists to take over.

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  5. Mr K,
    "I disagree. There were better services under UNIP simply because it was government policy to provide everyone with education. It was the neoliberal idea to stop that."

    Better services under UNIP were provided by drawing off revenue from the mines and running the mines down. This is why the mines had to be privatized, because the government did not have money to rehabilitate them. Using revenue from mines for public services was not sustainable, which was why it was stopped.

    http://query.nytimes.com/gst/fullpage.html?res=9500E2DD1330F930A35752C0A9649C8B63&sec=&spon=&pagewanted=1

    Mr K,
    "Business does not bring money to Zambia. They only bring enough for their operations, after that they take money out of Zambia if they go untaxed and share no profits. Only some of their costs are actually spent in the country."

    Business does bring money to Zambia. Just look at China and see how many jobs foreign investment has created there. So the focus should be on attracting even more business to Zambia.

    Mr K,
    "The government can use that money in a way that multiplies it's effects on the economy. They could be building roads, schools, and provide education and healthcare to everyone."

    There is only so much the government can do. By attracting more business to Zambia, incomes can rise and its spending effects can benefit the population.

    ReplyDelete
  6. Kafue001,

    Better services under UNIP were provided by drawing off revenue from the mines and running the mines down. This is why the mines had to be privatized, because the government did not have money to rehabilitate them. Using revenue from mines for public services was not sustainable, which was why it was stopped.

    If you have greater details on that, that would be great.

    The mines never had to be privatized. The UNIP government was forced to privatize because the IMF told them to. There was no other reason.

    Remember that many profitable parastatals 'had to be' privatized too.



    Business does bring money to Zambia. Just look at China and see how many jobs foreign investment has created there. So the focus should be on attracting even more business to Zambia.


    If you look at the net result, they are going to take far more money out of the country than they have brought in to start their operations. Of course some of the money they make is going to be paid as salaries to workers. However, that would just as true if the state owned the mines.

    They are not bringing money to Zambia, they are taking money out of Zambia.

    We are exporting $4 billion per year at least in copper and cobalt - and 70% of the population live in less than $1,- per day.

    That is not because foreign investors are bringing money to Zambia, that is because foreign investors and mine owners are taking $4 billion (or at least $2.4 billion in profits) out of Zambia.

    ReplyDelete
  7. Mr K,
    "If you have greater details on that, that would be great. "

    From below article:

    http://query.nytimes.com/gst/fullpage.html?res=9500E2DD1330F930A35752C0A9649C8B63&sec=&spon=&pagewanted=1

    "Zambia nationalized the mines in the 1970's, then drew off revenue to subsidize public services while the mines themselves ran down."

    Obviously with the mines run down, it was necessary to borrow from IMF/World Bank to keep the mines operating and to subsidize services. The IMF is not in the business of subsidizing mine operations, so that is why it told Zambia to privatize them. By the way, aid from the IMF is not a right, it does not have to lend to a country if it does not want to.

    Mr K,
    "If you look at the net result, they are going to take far more money out of the country than they have brought in to start their operations. Of course some of the money they make is going to be paid as salaries to workers."

    Not really, if the business environment in a country is attractive, there will be a continuous flow of investment (like China for many decades) into the country from other industries besides mining, some may even set up their headquarters in the country (like Haliburton from Texas to Dubai). Dictating to business what they can or cannot do does not work, they will move to places where it is easier to do business.

    "We are exporting $4 billion per year at least in copper and cobalt - and 70% of the population live in less than $1,- per day."

    Look at Nigeria, not much difference, their business environment is not developed either.

    Look at Japan, not many natural resources, but very rich.

    ReplyDelete
  8. Kafue001,

    Mr K,
    "If you look at the net result, they are going to take far more money out of the country than they have brought in to start their operations. Of course some of the money they make is going to be paid as salaries to workers."


    Not really, if the business environment in a country is attractive, there will be a continuous flow of investment (like China for many decades) into the country from other industries besides mining, some may even set up their headquarters in the country (like Haliburton from Texas to Dubai).

    Really, yes. Billions of dollars have been taken out of the country by the mining companies, and we are seeing the results in delapidated infrastructure. In 2004, the mining industry paid only 6 million in taxes, but they took out at least $2400 million in provits.

    And that is just in one year alone. Since then, prices rose even more, as did their profits. And now, it seems the treasure can only collect $200 million in taxes.

    So yes, really, they are taking far more money out of the country than they ever put in. Which is why Zambia remains poor, even when copper makes historic record prices.

    "Zambia nationalized the mines in the 1970's, then drew off revenue to subsidize public services while the mines themselves ran down."

    Obviously with the mines run down, it was necessary to borrow from IMF/World Bank to keep the mines operating and to subsidize services.


    Not at all. There was a lot more going on than the fact that the government subsidized services with profits from the mines.

    There was a worldwide econmic recession in the 1970s (caused by the Vietnam War and the oil crisis), which didn't lift until the early 1980s. Copper prices were at record lows, which had nothing to do with how the government used mine profits.

    Look at Nigeria, not much difference, their business environment is not developed either.

    Exactly, my point entirely. Nigeria is also not benefiting from their oil wealth. Look at the poverty in the mining region, and yet they are exporting 10% of the world's oil.

    This is what happens when the people do not benefit from their resources - they remain poor. Handing profits to the foreign mining companies does only one thing - it makes the foreign mining companies rich.

    Look at Japan, not many natural resources, but very rich.

    And no foreign corporations running their economy. They actively discourage foreign ownership in their country.

    I think I've made my point. :)

    ReplyDelete
  9. Mr K,
    "Really, yes. Billions of dollars have been taken out of the country by the mining companies, and we are seeing the results in delapidated infrastructure. In 2004, the mining industry paid only 6 million in taxes, but they took out at least $2400 million in provits."

    What I am saying is that Zambia should attract investments for other industries and new mines, these new capital inflows will help offset the profit outflows from the present mines. The profits that mining companies are sending out belong to them under mining agreements signed with Zambia. As the agreements expire and new agreements are made, then new taxation rates can legally apply to them. If taxes are raised now on existing projects, then this will discourage mining expansion:

    http://www.africanews.com/site/list_messages/18871

    Mr K,
    "Not at all. There was a lot more going on than the fact that the government subsidized services with profits from the mines."

    Regardless of what else was going on, one should not expect mine operations at rundown mines to be subsidized by the IMF, these mines were the responsibility of the government which had taken controlling stakes in them.

    Look at Japan, not many natural resources, but very rich.
    Mr K
    "And no foreign corporations running their economy. They actively discourage foreign ownership in their country."

    There is quite a lot of foreign investment in Japan these days, also look at India, Malaysia, Brazil, Chile - they all have substantial foreign investments and are prospering

    http://www.boston.com/news/world/europe/articles/2008/09/24/un_foreign_investment_soared_in_2007_slowing_now/

    Mr K,
    "Exactly, my point entirely. Nigeria is also not benefiting from their oil wealth. Look at the poverty in the mining region, and yet they are exporting 10% of the world's oil.
    This is what happens when the people do not benefit from their resources - they remain poor. Handing profits to the foreign mining companies does only one thing - it makes the foreign mining companies rich. "

    It is not the foreign mining companies that is the problem in Nigeria, it is the way the existing wealth is managed there (the competitiveness factor) that is the problem.

    ReplyDelete

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