June 20, 2010; Source: Dallas Morning News | Nonprofits and their charitable donors might not have imagined that providing low or no cost health services to post-earthquake Haiti might have a long-term downside. Foreign doctors and health-oriented charities came to Haiti to provide the care that the destroyed hospitals and scattered medical personnel of the country could not provide in the wake of the disaster. Because of their continuing presence, according to the Dallas Morning News, “health care here has never been better,” but at the cost of the local Haitian medical sector.

Because the foreign doctors and medical NGOs provide their services for free, local doctors and facilities are withering. “Free care is perfect,” a Haitian cardiologist explained, and others say that “prospects for patients have never been better.” But the thrust of the article is that little investment has gone into keeping the local health care system functioning by hiring local doctors and supporting local (private) hospitals. The NGOs and others say that the private health care system in Haiti pre- and post-earthquake wasn’t very good and was riddled with “poor management and widespread corruption.”

A World Health Organization (WHO) spokesperson acknowledged that fixing Haiti’s private health care system hasn’t been a priority for disaster relief organizations, indicating that only a very small proportion of “wealthy and well-connected” Haitians could even afford to seek help from private “exclusive” hospitals. For some hospitals, donor governments and charities provided supplies and equipment—sometimes rather sophisticated stuff—but little or no money to help local hospitals operate.

What is the solution? Haiti may well have to begin thinking about alternatives to privately owned hospitals—such as nonprofit hospitals—and alternatives to providing medical care only to the wealthy—such as a form of national health insurance coverage for Haitians who cannot afford to pay out of pocket. After the first six months of aid to Haiti, the second phase of a foreign donor medical response may be the design of a new system of health care to replace the system that existed prior to the earthquake.—Rick Cohen