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Thursday, 27 January 2011

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Think again

The Health Ministry has done it again. Hardly has it decided to charge a fee from those seeking treatment at State hospitals for alcohol related diseases or injuries resulting from alcohol driven incidents now comes the news that it is planning to similarly charge those seeking medical treatment after attempting suicide.

Addressing a function in connection with the opening of a dispensary in Borella the other day Health Minister Maithripala Sirisena said he is planning to suggest a move whereby all those who failed in their suicide bids and seek medical treatment would have to pay for their trouble.

The Minister’s move to charge patients with supposedly alcohol related ailments have already drawn flak from the medical fraternity. The GMOA the other day issued a statement pointing out that it is against their Hippocratic oath to deny patients seeking treatment whatever the cause of their ailment. They also claimed that the matter would degenerate into an exercise in hair splitting when it came to identifying whether or not such ailments sprung from alcohol related causes or otherwise. There is also the issue of fundamental rights, they point out.

Besides as a reader pointed out the other day the Treasury depends on excise duties for the bulk of its revenue going on to question the ethics of the whole issue. Isn’t this also not case of double taxation? It also reflects the pithy Sinhala saying Gahen wetunu minihata gona enna wage (The man who fell from the tree being goaded by the bull) where victim groaning in pain is shoved a Bill under his nose which as the Minister reveal will amount to Rs 2,000 per head.

Laudable as the Minister’s proposal aimed at controlling the mounting suicide rate in the country it is fraught with many flaws. To begin with the suicidee is normally an unbalanced individual who has come to the end of his tether and had he survived it would certainly not be out of choice. It would have to be a rescue act on the part of a third party such as in the case of an attempted suicide by drowning or self-immolation.

How is the Ministry planning to extract any fee from such an unbalanced character who does not care one way or the other and who in all probability would make another attempt at a future date. Can the doctors in hospitals force a fee out of a man who cares not for his own life? It is laughable to think that such a man who only just attempt to kill himself could be coaxed into paying a fee for treatment on pain of prosecution. This project therefore is a dead letter and it is advisable that the Minister abandoned any moves to introduce such a harebrained scheme and invite the ridicule of the public.

Besides how will the doctor decide whether the injuries were the result of an attempted suicide? There is always the possibility of those accompanying the victim of an attempted suicide say by setting oneself on fire who will present the case as a victim of some misadventure or accident. Are the medical authorities going to play the part of insurance investigators by visiting the site of the incident to determine if it indeed was a suicide attempt?

Unlike a case of an alcoholic where treatment will be a prolonged one the damage caused by an attempted suicide would need instant attention. Will this present itself for argument by the medical staff and relatives over the question of a fee. What if the suicidee refuses to pay after being treated? Is he going to be hauled before court? Will this too not be an exercise in futility given the mental state of the victim who cares not one way or the other? Will the Government be able ever collect anything from such cases?

And what next? Will there be a whole host of categories of ailments for which a fee will be charged at Government hospitals that are the result of human folly? Will State hospitals charge a fee for ailments that have their genesis in obesity in order to enjoin people to desist from over indulgence in fast foods in a bid to provide a shot in arm to current campaign to consume more and more homegrown food?

It is pertinent for all concerned to realize the futility and impracticability of such projects. What should be done is to address the root causes that give rise to suicides and alcoholism. The Government needs to tackle the socioeconomic issues that are the basis for such acts. No amount of regimentation or deterrents to pay for one’s follies is going to solve the problem.

Way forward in India-Pakistan relations

Seven steps towards achieving an uninterrupted dialogue:

Fifteen years ago, in a book called Pakistan Papers, largely comprising a long despatch I wrote in my last days as Consul-General of India in Karachi, which I was surprisingly permitted by the government to publish as representing my “personal views”, I had first suggested a process of “uninterrupted and uninterruptible dialogue” as the only way forward for our two countries. My suggestion had no takers then. It has no takers now. Yet, I see no alternative to structuring such a dialogue if we really are to effect a systemic transformation of the relationship.

Full Story

Time for sit-back, deep breath-take and self-assessment

The Morning Inspection - Malinda

I made the following observation on the state of the nation recently: ‘I don’t believe, as some do, that things are bad. I think, on the contrary, that things are pretty good, all things considered. We haven’t had to sell our national assets. The space has been cleared for development, investment and innovation. Income-earning opportunities have expanded. The cost of living has come down. People are not starving. Times are not easy, but they are not so tough as to warrant food riots.’

Full Story

Convincing mandate quashed regime change bid

PARALLEL Perspectives - Phillip Fernando

Spotlight falls back on the election of 2010 and the convincing mandate won by President Mahinda Rajapaksa with over a 1.5 million vote margin. The challenger Sarath Fonseka failed far short of securing a majority to cause the promised regime change. The reasons are discernible loud and clear now than during the raucous campaign stretch.

Full Story

 

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