The Tribune

SUPPOSE for a minute that you’re starting up a business. You go to the bank manager and pitch your business plan – you’re going to let people come into your business, use whatever services they need and when it comes to paying for them? Well, you’re not going to turn anyone away from your business, even if they say they can’t pay for what you’re selling.

How seriously do you think the bank manager would take your pitch? Why, you’d likely be laughed out of his office.

And yet that’s essentially Health Minister Dr Duane Sands’ proposal for paying for healthcare services provided at government facilities.

“The position of the Ministry of Health remains the same,” he said, “that if somebody is unable, those who are destitute, those who are struggling in order to make ends meet, nobody is going to be denied care in our facilities.”

That sounds all very laudable to reach out to care for the poor – but here’s the rub. How are hospital staff supposed to know? And if that’s the position of the government, what’s to stop any patient turning out their pockets when it comes to time to pay the bill? What’s to stop them shrugging and saying “Doctor, I can’t pay” and off out the door they go?

Dr Sands says it’s just the same as how people are mandated to pay real property tax – probably not the best example, Dr Sands, given how little of that seems to be collected. Indeed, in how many areas have we heard of people running up bills and government not bothering to chase them down? The government too often makes rules then fails to enforce them.

Routinely, over the years, we have seen cookouts being held to raise money for those needing to pay healthcare costs – indeed, the arrival of National Health Insurance was touted as bringing an end to cookouts. Sometimes we are surprised by the individuals in need, who might be people we thought were wealthy. It goes to show that one cannot judge who can or cannot pay at face value. Sometimes those we think are financially well off are not, and vice versa.

So unless Dr Sands has plans he intends to wheel out to show us how patients’ ability to pay is going to be assessed, then it makes us worry that it’s going be run on the basis of taking patients at their word, and that opens the door to all kinds of difficult areas – imagine if you were going into election season what the temptation might be to say to collection agencies not to go pounding on people’s doors for the money they owe, lest it cost the government of the time their vote. Or to not bother pounding on the doors of the politically connected or favoured at all.

If an entrepreneur was to run their business this way, then they would pretty soon be out of business. Let’s have some more detail, Dr Sands, on how you will establish someone’s ability to pay – or else anyone can claim that when they go in to hospital, no matter what the size of their wallet.

Make sure the ban is enforced

SPEAKING of ability to pay, people are having something of a rude awakening to the costs of eco-friendly alternatives to single-use plastics and Styrofoam products.

One example – of plastic straws costing $2.99 for 500 while paper straws cost $30 for 600 – has distributors scratching their heads ahead of the ban on plastic coming up at the end of this year.

The goals of the ban are laudable – as can be seen any time you walk down a litter-strewn beach or, worse, see the effects of plastics on marine life.

But while businesses struggle to adjust to the increased costs the change will bring, we hope that government will make sure those efforts are not in vain.

Let’s hark back to another deadline – the end of 2017 was supposed to mark a deadline for private and public buildings

to provide full access for disabled persons.

Just last month, Peter Goudie, of the National Commission for Persons with Disabilities, told Tribune Business that there were simply no inspectors or regulations to ensure the private sector and public buildings comply with the Persons With Disabilities Equal Opportunity Act.

If there’s no enforcement, there’s no need for compliance except out of the goodness of your heart – the same problem the healthcare system could face too, by the way, over its pay-if-you-can plan.

So there’d better be enforcement for the plastics ban – because if not, it’s the most diligent businesses who are properly planning now who will be hurt the most, and the cheap corner-cutters who will leave it to the last minute in the hope nobody bothers checking.