Should Poverty Determine Who Receives Healthcare?

 

One of the most troubling questions in medicine is not always how to cure disease, but who gets the chance to be treated at all. In many parts of the world, especially in our various communities here in Nigeria, healthcare is often less available to the poor not because their illnesses are less serious, but because their pockets are less deep. And I believe this is largely part of the reason(s) the services of unlicensed practitioners are being sought after at high rates, especially in our local communities. This raises a difficult but necessary moral question, should poverty determine who receives healthcare? Think it through.

On humanitarian grounds, the answer is supposed to be "NO". Illness is already a burden; poverty should not become its punishment. Yet this issue is more complex than it first appears. Many patients cannot afford treatment because of unemployment, low income, inflation, poor insurance coverage(a large percentage of Nigerian citizens have no idea how health insurance works), and the rising cost of living. For such individuals, a diagnosis is often followed not only by fear of death, but by fear of bills. This should be a great deal. Some delay hospital visits, some abandon treatment halfway, and others never receive care at all, not because they do not need it, but because they simply cannot pay for it.

Still, it would be intellectually dishonest to discuss this matter without acknowledging the other side. Healthcare does not run on compassion alone. Drugs must be procured, equipment must be purchased and maintained, electricity must be supplied, laboratories must function, and healthcare workers must be paid.

Hospitals and clinics require funding for smooth and safe operation. In underfunded systems, even the most willing doctor cannot perform miracles without tools. Thus, healthcare institutions also face a legitimate reality: care has a cost.

This is where the ethical burden on doctors becomes especially painful. A doctor may know what is needed to save a patient, yet be constrained by a system that cannot offer unlimited free care. The physician is then caught between moral duty and material limitation—between what ought to be done and what can actually be done.

So, should healthcare be a right or a privilege? I believe it should be a right in principle, but one that society must deliberately finance and protect in practice. If care is left entirely to market forces, the poor are silently excluded. But if institutions are expected to function without sustainable funding, the entire system collapses.

Poverty should not determine who receives healthcare. However, ensuring that it does not requires more than sympathy, it demands policy, investment, justice, and collective responsibility. A humane society is one where both patients and healthcare systems are not abandoned.

®Ahmed Salim Jn ✍️ 

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