The Rwandan constitution enshrined the "right to health" in 2003. Mutuelle de Santé — is nearly universal. Everyone has MANDATORY health insurance. Mutuelle adopted a sliding scale; the payment is based according to your income. The yearly rate can be from 1000 to 7000 RWfrancs; or $1.50 to $10 US dollars. It provides you the opportunity to have medical treatment. The Health Ministry says that the poorest 25 percent of Rwandans get free care. In the rural areas, there are district clinics. The clinics are available for everyone with a co-pay.
Each visit to a clinic has a co-pay of about 33 cents. [Rural farmers annual income average $150.] If you need to go to the hospital, you pay a tenth of your hospital bill. Typically, the consultations are done by nurses and a doctor visits the facility once a week. There is 0.06 physicians/1000 population; (2013) country population of 12,012,589 has approximately 720 physicians. [In the USA, you can have that many physicians in a university based teaching hospital.] The district clinics sends patients to the district hospitals; district hospitals send patients to the larger public or private hospitals for more advanced care [urban hospitals in Kigali].
King Faisal Hospital (Private) [BOTTOM]
In the last decade, improvements and influx of medical development has improved the life expectancy from 50.44 years in 2002 to 62.92 years in 2012.
In the USA, we see all that want to be seen in the Emergency Department whether you can pay or not. If I think you have a bleed in the brain, I order all the necessary tests [ie.,CAT of the brain]; and if my hospital does not have the services to take care of you, I will transfer you to a "higher level of care" without questions or payment. In Rwanda, if you are at one hospital that does not have a service or equipment-possibly a CAT scan, then you must be transported to the other hospital [even if it is across town] but you must pay for the transport in advance. If my family member has a possible stroke and needs a CAT scan of the brain, if the hospital they are at does not have the CT scan then I must PAY for them to be transported. If I do not have the money, then the doctors will treat my family member with "guestamation" medical treatment. A cerebral hemorrhage in Rwanda typically is not survivable.
While we were teaching our ACLS class, one of the nurses had to leave. He worked at the another hospital. A patient that was in a multi-car collision trauma needed a procedure [chest tube insertion to re-inflate the lungs]. He was only 1 of 2 persons at that hospital that could perform this procedure; the other person was unreachable. We were then told about another patient from the same collision was unconscious and needed a CAT scan; but the patient could not be transferred to another hospital because he was unable to pay and the family could not be found.
The health insurance guarantees you the opportunity for medical treatment. But if you are admitted to the hospital, it does not guarantee you food. See the next posting "One Meal A Day"
Hmmm. US healthcare system does not seem so bad now.
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