Patients Live in Poverty despite Rich Countries Pouring Billions into Private Healthcare

Patients living in poverty in the Global South are being bankrupted by private healthcare corporations backed by multi-million-dollar investments from development finance institutions (DFIs) run by the UK, French, German and other rich country governments.

Across low- and middle-income countries, many private for-profit hospitals are systematically exploiting and abusing patients and denying them healthcare, causing hardship, suffering and impoverishment, according to Oxfam’s investigations into DFI funding of private hospital chains.

These private hospitals engage in practices that imprison patients who cannot afford to pay their medical bills. The study points to the denial of right to emergency care. It also states hospitals’ exorbitant treatment costs, placing a heavy burden on patients. Oxfam states that even those entitled to free care are forced into poverty due to high fees imposed to access essential health services.

Furthermore, some of these hospitals demonstrated unethical behaviour during the COVID-19 pandemic, taking advantage of people’s pain and fear in the face of the novel disease. This profiteering from the healthcare crisis further exacerbates the suffering and impoverishment of vulnerable individuals.

The development finance institutions analysed in the reports are the UK government’s British International Investment (BII, formerly CDC), Germany’s Deutsche Investitions- und Entwicklungsgesellschaft (DEG), France’s Proparco, the European Investment Bank (EIB), and the World Bank Group’s private sector arm, the International Finance Corporation (IFC).

“For decades, rich countries have been wedded to a theory that public funds can underwrite the private sector in order to help low- and middle-income countries develop their healthcare sectors,” said Oxfam International’s Health Policy Lead Anna Marriott. “This has proved to be an evidence-free, rich country bankers’ guide to global healthcare —a free-for-all of private greed over public good— where the big winners are the super-rich investors and owners of healthcare corporations, and the losers being the masses facing rising poverty, sickness, discrimination and human rights abuses.” 

SOME CASES

  • Extorting and imprisoning patients including new-born babies, even retaining dead bodies, for the non-payment of bills
  • Profiteering, including during the pandemic, and routinely over-charging patients into bankruptcy and poverty
  • Denying treatment to those who can’t afford it —even in emergencies— and pricing services and medicines wildly out of reach of most people in local communities
  • Being involved in tax tricks, price rigging, and medical negligence leading to deaths
  • Failing to prevent human rights abuses, including organ trafficking by staff and exploitative practices, for example by pressuring patients to have unnecessary and expensive medical procedures.

SOME FINDINGS

  • 358 health investments between 2010 and 2022, more than half (56 percent) of which went into private healthcare corporations operating in low- and middle-income countries
  • At least $2.4 billion channelled into health corporations that can be tracked, but Oxfam found at least another 269 health investments for which the value is not disclosed
  • Most of these health investments (81 percent) are being “lost from sight” —sub-invested out via a network of financial intermediaries, 80 percent of them located in tax havens like Mauritius, Jersey and the Cayman Islands
  • Little to no public accountability of these investments and no evidence as to whether they are improving access to healthcare for people living in poverty, especially women and girls
  • Extremes of private hospital chains offering 5-star hotel treatment for politicians, sports stars and celebrities at elite prices. 

“Half the world’s population can’t get essential healthcare. Every second, sixty people are plunged into poverty by medical bills. Donor countries and development banks have long promised that they can drive down healthcare costs for people living in poverty by investing taxpayers’ money into the private sector. Instead, costs are rocketing up and causing harm,” Marriott said. 

THE PROFIT

According to recent reports, four major hospital complexes in the Delhi-National Capital Region have been found to have profit margins as high as 1,737 percent on drugs, consumables, and diagnostics.

During the pandemic, the Maputo Private Hospital in Mozambique, supported by the IFC, allegedly demanded a $6,000 deposit for oxygen and a staggering $10,000 for a ventilator from COVID-19 patients. Similarly, in Uganda, the Nakasero Hospital reportedly charged $1,900 per day for a COVID-19 bed in intensive care, while the TMR Hospital billed a heart-breaking $116,000 for the treatment of a patient who succumbed to the virus. Nakasero Hospital receives funding from France, the EU, and the IFC, whereas the UK and France support TMR Hospital.

In Brazil, the Sírio-Libanês Hospital, which benefits from DFI investments from Germany’s DEG and France’s Proparco, primarily caters to wealthy elite, including Latin American celebrities and presidents. This institution boasts an impressive security setup consisting of 500 surveillance cameras, 250 electronic access controllers, 250 proximity sensors, and a team of 100 guards.

PREGNANCY AND CHILD BIRTH

Oxfam’s research reveals that the hospitals funded by DFIs are inaccessible to those in dire need of life-saving healthcare. The average cost of a straightforward childbirth in these private hospitals surpasses the annual income of an average individual belonging to the bottom 40 percent of the population. In the case of a caesarean birth, the cost exceeds two years’ income.

In Nigeria, a staggering nine out of ten impoverished women give birth without the presence of midwife or skilled birth attendant. Shockingly, even the most basic maternity package offered by these high-end private hospitals costs more than nine years’ income for the poorest 10 percent of Nigerians.

Oxfam is calling for a stop to all-future direct and indirect DFI funding to private healthcare. It also call for an urgent, independent investigation into all current and historical investments.

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