Prostate Health, Pension Coverage And Prescription Drugs

“A nation’s greatest is measured by how it treats its weakest members.” Mahatma Ghandi
My dad is an octogenarian. He has been working from the time he was a teenager growing up in Mount Angus in the parish of St. Mary. My dad, Fitzroy is fiercely independent.  He still drives his white 1991 Nissan Sunny to church every Sunday and continues to be active around the house. My dad has a passion for agriculture and with every opportunity he engages his enthusiasm whether it is planting banana suckers, yam, calaloo, tomatoes or some other food crop.  However, like men of his age he has problems with his prostate. Recently, my dad asked me to fill a prescription.  I found this request uncharacteristic of him nonetheless; I did as I was asked. My dad worked for himself his entire working career and as such he does not have private health insurance. On the other hand, the government of Jamaica has in place the Jamaica Drug for the Elderly Programme (JADEP) and the National Health Fund insurance to those who qualify for same. The JADEP programme provides drugs at $40 per drug to beneficiaries who are at age 60 years and older for ten specific chronic illnesses. These illnesses are: Hypertension, Cardiac conditions, Arthritis, High Cholesterol, Vascular Disease, diabetes, Asthma, Benign Prostatic Hyperplasia (BPH), psychiatric conditions and Glaucoma. As you grow older the chances of ill-health becomes greater and as a result a significant portion of one’s pension goes to purchasing medication in order to keep you alive. Additionally, the older one gets the less disposable income one has. The reality is medication is costly with or without insurance.  One recent study conducted by the Inter-American Development Bank (IDB) reported that pension coverage in Jamaica in 2012 was 21.4 per cent of the employed workforce as compared with 68.2 per cent in Barbados, 62.1 per cent in Grenada and 54.9 per cent in Trinidad and Tobago. In other words approximately twenty five (25%) of Jamaica’s working population has access to a pension plan. In other words three (3) out of every four (4) Jamaican does not have a pension. Another reality is more than half of all Jamaicans do not have health insurance. Unfortunately, my dad falls in the seventy five percent (75%) without a pension. One month’s supply of this life saving drug Duodart costs $7,490.  While I am grateful that the National Health Fund Insurance paid a substantial amount ($3,924) of the cost of my dad’s medication, regrettably, many men are unable to afford the $3,209. 40 it costs for a month’s supply of this critical drug even with government’s health insurance. The cost of prescription drugs globally continues to increase as pharmaceutical companies are more concerned with satisfying this shareholders than providing affordable medication. We live in a society in which a significant portion of the working population does not have health insurance. Healthcare is quite costly and unfortunately insurance is rather prohibitive for many Jamaicans even among those who work.  The drug Duodart is used to treat moderate to severe symptomatic benign prostatic hyperplasia (BPH). Duodart is a combination of two medicines; Dutasteride and Tamsulosin Hydrochloride. Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland which is located at the lower portion of the urinary bladder surrounding the urethra. Unfortunately, in men with BPH the prostate gland becomes large enough to squeeze the urine tubes running through it.  When the urine tube it squeezed it narrows making it more difficult to pass urine normally.  Sadly, men who are diagnosed with Benign Prostatic Hyperplasia often experience the following symptoms: difficulty in starting to urinate, an interrupted, weak urinary stream, more frequent urination especially at nights, a feeling that you need to urinate right away, leaking or dribbling and a feeling that you cannot empty your bladder completely.  Men’s health is often not given the attention that it desires. As a result many men stay away from the doctor or suffer.  The government needs to develop a sustained programme regarding the health care of men.  The time to act is now! Our policy makers must ensure that our health care system is inclusive. Additionally, the State must ensure that medication can be sourced in a timely and at a reasonable cost.  The policies governing the public health care system must be revisited with a sense of urgency and steps must be put in place to ensure that more subsidies on medication especially for drugs for prostate health are available. It bares thought that until some circumstances impact you and or your family you cannot fully appreciate or empathize what those who are affected.  I am almost sure that many men suffer due to their inability to purchase this drug. We need to pay more attention to the elderly in the society.  Any society which fails to put in place an efficient and cost-effective health care system runs the risk of alienating a significant portion of its citizenry and opens itself to revolt not only from the present generation but the generation to come.   
Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues.
waykam@yahoo.com
@WayneCamo

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