Page 36 - GHES-2-3

Global Health Economics and
Sustainability
Innovating sustainable specialized healthcare

implications for the tourism industry on which Jamaica
heavily depends. Indeed, the tourism sector also requires a
robust health-care infrastructure. With millions of tourists
coming to its shores, the Jamaican health-care system must
have the capacity and responsiveness to support their
needs. Yet, seen from the perspective of Jamaica’s history
of colonialism and slavery, the change in Jamaica’s health
metrics since its independence in 1962 has been nothing
short of remarkable. This progress applies across all aspects
of healthcare, including public health, primary healthcare,
more advanced tertiary care, and, health education.
However, much more remains to be achieved as the
sophistication and expectations of the population continue
to grow, leading to what has been described as “ a revolution
of rising expectations.” Ignoring these rising expectations
may be at a society’s great peril, as articulated by Alexis Figure 1. The principal drivers of additional health-care funding and
de Tocqueville in his book L’Ancien Regine et la Revolution their contextual siting
(1856). He noted, “First, a modest increase in prosperity
and freedom raises the average person’s expectation of
what is possible in life. Second, greater access to resources,
especially education, and information, raises that person’s
awareness of oppression and his unwillingness to tolerate
it.” (McElroy, 2016). As living standards, opportunity, and
hope rise, populations may no longer be willing to tolerate
suboptimal and unequal health care. Given the competing
demands in small economies such as Jamaica, it will require
innovative approaches and the involvement of all sectors
of the economy, both public and private, in partnership
to fund the continual advances that are now a feature of
modern specialized medical care (Figure 2 below). Figure 2. Sustaining equitable healthcare in low- and middle-income
Philanthropy, like income taxation in uncorrupt countries
countries, serves as a countervailing force against
economic inequality. Perhaps driven by noblesse oblige, well-being (OECD, 2017; “Quantifying Health Systems’
public goods are funded by wealthy donors. Furthermore, Investment. In Social Determinants Of Health, By Sector,
the more unequal the income distribution, the larger the 2017 – 2019,” 2020). This approach would further broaden
share of their incomes the rich contribute. If this is so, the range of opportunities for philanthropy to impact
then philanthropy mitigates income inequality by turning population health in a meaningful way. For the wealthy
the increased financial resources of the wealthy few into in Jamaica, philanthropy should not only be a mechanism
advancements in knowledge and public facilities that for lessening taxation but also for reducing social tensions.
raise the quality of life for everyone in society (Duquette, In the health-care space, it can create facilities that can be
2018). Facilitating philanthropy and other mechanisms, lifesaving in emergent settings for everyone, including the
as discussed in this review, should become a greater wealthy and their families, who presently prefer to obtain
focus of governments in countries such as Jamaica if their healthcare in nearby locations such as Florida.
they aspire to provide equal and fair access to advanced
specialized healthcare. This can only happen if policy Conversely, however, by reducing government revenues,
frameworks are established to make it happen. Indeed, tax concessions for philanthropy reduce the fiscal resources
the government’s active involvement becomes necessary at available to governments, potentially requiring other
an even higher policy level: to refine – and monitor – the taxpayers to bear an increased tax burden (or resulting in
balance of the social-health spending divide, recognizing less government expenditure on other policy priorities)
the major contribution of social determinants such as (OECD, 2020). A sustained commitment to understanding
income, housing, education, and social welfare programs, and creating a well-thought-out place for philanthropy and
including leisure, to overall population health and giving in Jamaica and similar countries must be developed

Volume 2 Issue 3 (2024) 8 https://doi.org/10.36922/ghes.2717