Saving on Roma health rights is bad economy

Alphia Abdikeeva, CIDH Pro Igual

Analysis of various barriers for Roma access to health care in Southeast Europe suggests that money – for better or worse – is now rivaling discrimination, which traditionally was among the major deterrents.

For better, because at least money is color-blind (or so we believe). This means that a paying person is guaranteed access to the best available health care regardless of his or her background, as long as there is money to pay for it. For worse, because money denotes dehumanization of healthcare: a poor person can be left without vitally important treatments. Incidentally, the majority of Roma may fall into this category.

But paradoxes arise when some doctors or hospitals try to save money by refusing what seem to be expensive procedures for people who cannot pay, but then end up providing them much more expensive procedures for free, as a matter of emergency, since withholding necessary preventive treatments can and often leads to complications of all sorts.

A few examples follow.

  • A pregnant Roma woman in Romania was refused a Cesarean in an overdue delivery (Caesareans are evidently expensive). But after her unborn baby died, and a host of complications occurred, her uterus had to be removed (which is a much more expensive procedure than the Cesarean). Given it was an emergency operation, it was free. That, on top of potential charges for doctors/the hospital if the patient decided to sue for negligence and/or malpractice. Where exactly was the saving here is difficult to see.
  • A Roma boy in Macedonia broke his arm but the doctor didn´t do a very good job with the cast. When the boy´s arm swelled and the family brought him back to the hospital, the doctor did not find time (an expensive commodity) for giving it a better look. The arm subsequently developed a gangrenous infection and had to be amputated, with the boy´s life endangered. Obviously, there were no  bills for the boy´s family, and as soon as the court´s decision is out in this highly publicized case, the doctor/hospital might have to loosen their purse strings to compensate the boy for the life-long disability caused. Again, it is hard to see any savings here.
  • In Macedonia, Romania, Serbia, and other countries in the region Roma are routinely denied tests capable to detect health problems early on and to prevent the development of serious illnesses. State-provided mammogram, ultrasound, and other tests and specialists are systematically “overbooked” whenever Roma patients need or request them. (By the way, the same services are available at any time, for a fee, as “private.”) But as a result of withholding preventive treatments, the state often has to provide more expensive emergency and rehabilitation procedures, naturally for free.

The list can go on indefinitely, but the point is: saving on Roma health and health rights, shows to be bad economy.