The healthcare systems of many countries that are being ravaged by the current corona pandemic are at breaking point. Many of those brave doctors and healthcare professionals that are dealing with the crisis have long complained about the inadequacies of the healthcare systems that they work in.
Sadly, this pandemic has exposed those deficiencies that will in all likelihood needlessly cost lives. The unfortunate fact is that healthcare in most capitalist nations is dealt out on economic dogma and not on need.
In the Khilafah system, this would not be the case. The points that follow explain why the west has gone wrong and how the Khilafah would approach healthcare and pandemics differently.
- When the founding fathers of capitalist economics pondered the question of how should the needs of the people be met – they came to the following conclusions.
a. There are not enough resources to go around fulfilling all the needs of the people. In their minds needs were not the necessities of food clothing and shelter. Rather a need was thought to be anything that a human being could desire be it items or services. In this day and age things like sports cars, luxury holidays, cosmetic treatments, etc… would be viewed as needs from their perspective. This view of course is rejected in Islam, as Muslims, we consider the basic needs as those essentials to ensure survival. Beyond that are the luxuries that can be sought but are not essential. On this basis, the capitalist economists formed the view that there is not enough material or labour in the world to make this happen – i.e. they said that resources were scarce.
b. If there is not enough to go around for everyone they came up with a way to allow people to meet their needs. They came to the conclusion that there needed to be the production of goods and services and this would be driven by a profit motive. Adam Smith in his book The Wealth of Nations stated “It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest. We address ourselves, not to their humanity but to their self-love, and never talk to them of our necessities but of their advantages.”
c. This is the reason why capitalist politicians measure how society proceeding by growth in GDP as it measures production to be a sign of success and a reduction in it to be a catastrophe. So as far as they are concerned if production increases then they have been economically successful. There will be goods and services available for the needs and those involved in production will earn money to buy those goods and services
- Healthcare like the rest of the needs of the people is viewed in this way. As people become ill they will need medicine, the service of doctors and possibly hospitals if they are severely ill or injured. The logic of capitalist economists is that for each of these healthcare needs someone will enter the market to provide for the need if he can make a profit. As it is a need then people are compelled to use what this provider offers. This is the case in the USA today, in the UK, for example, there is the NHS which was introduced as free at the point of use, but is considered to be an aberration from capitalist economic dogma.
- In Michael Moore’s documentary entitled Sicko he gives an example of a non-insured man who cut the tops of 2 fingers off in an accident. When he went to the hospital he was given the choice to have his ring finger reattached for $8000 or his middle finger for $60000. It is not uncommon for those in the US that need an ambulance in an emergency to be presented with a bill for $1500. Using the principle of price the people are entitled to Medicare or Medicaid. Medicare costs those earning less than $87000 to get health care coverage at $144 per month. Considering that the federal minimum wage rate in the US is $7.25 an hour this is beyond the means of many.
- Some may think that it’s not so bad in countries like Canada or the UK as the healthcare is free to use. It is true healthcare systems in these countries save many lives and provide a good service to many. If one digs below the surface of how NHS in the UK operates we will find the same capitalist economic dogma is alive and kicking. Before the formation of the NHS people would need to pay for their healthcare. The original concept of the NHS was for the state to pay from central taxation for free healthcare for all.
- During the era of Margaret Thatcher, who was a believer in market forces and encouraging competition, and in all likelihood like many Conservatives ideologically opposed to the state providing free healthcare to the people. An internal market was introduced to the NHS. It was no longer simply a government-funded healthcare service provider to the public. The NHS was conceptually split to be a purchaser of services and provider of services and the use of commercial management metrics were introduced to evaluate how healthcare is provided. Healthcare needs are estimated by NHS commissioning groups and contracts are placed with providers who can only secure funding if they can demonstrate they are delivering service. This also allows some private sector suppliers to enter the market. Some doctors have complained that they are forced to do an hour’s paperwork for a half an hour consultation so funds can be claimed.
- Due to capitalist economic dogma, the NHS is failing to deliver a proper healthcare service to all the people. Austerity measures i.e cuts that were brought in by the conservative-liberal coalition in 2010 are estimated to be associated with 45000 deaths between 2010-2014 by the British Medical Journal. During the coronavirus pandemic, the internal market has been suspended with the government promising £5bn to the NHS as an emergency measure, showing that capitalist economic thought does not work.
- The way that the west approaches the eradication and treatment of disease is also based upon the profit motive. Only profitable drugs are developed and the focus is not upon eradicating the disease but ensuring shareholder dividends. As everything in healthcare is driven by the profit motive costs for healthcare are excessive and treatments quite often ineffective.
- The coronavirus pandemic has exposed the capitalist systems of health care by showing that they were ill-prepared for it and some places especially the US many will die as they do not have the finances to access healthcare. If there is a pandemic and many can afford treatment then why should hospitals provide it if the people have no means to pay.
- So how would the Khilafah deal with health care? The Prophet (saw) said, “The Imam is a guardian, and he is questioned over his responsibility” reported by al-Bukhari from Abdullah bin ‘Umar. This text is general regarding the responsibility of the State for health and medical care since they are part of the obligatory responsibilities of the State.
- One of the tasks of the state in Islam is to look after the affairs of the people; it must provide medicines and hospitals to people. Muslim reported from Jabir who said “Allah’s Messenger ﷺ sent a physician to Ubay bin Ka’b. He cut the vein and then cauterised it”. Al-Hakim reported in Al-Mustadrak from Zaid bin Aslam, from his father who said: “I became very sick at the time of (the Khilafah of) Omar bin Al-Khattab, so Omar brought for me a doctor who put me on a diet, that I used to suck on the date-seed because of the strict diet.” Therefore, the Khaleefah must provide individuals with health care and provide them with medicines and hospitals. Bukhari reported in Al-Adab Al-Mufrad “When the ankle of Sa’d was injured during the Battle of Al-Khandaq and he was unable to walk, he was sent to a woman called Rufaidah who used to treat the wounded people. The Prophet of Allah ﷺ used to pass by him and ask: “How are you feeling tonight?” and he ﷺ used to pass by him again in the morning and ask: “How are you feeling today?” and he (Sa’d) would answer him.”
- Islamic hospitals were different from other hospitals because Muslims were led to form bimaristans by the prophet (saw). Mobile hospitals were the first version of the bimaristans. According to hadith, the first mobile hospital was located in a tent to treat war victims from the Battle of the ditch (khandaq) . Mobile Hospitals consisted of medications, food and water, doctors, and pharmacists to aid the patients. These services from the mobile hospital transitioned into the other Islamic hospitals that were built as well. Bimaristans were generally located in urban areas like Baghdad, Damascus, and Cairo during the different periods of the Khilafah. The first bimaristan, built in 706 in Damascus by the Umayyad Caliph named Al-Walid, focused on treating individuals with leprosy. Around the same period the second bimaristan was built in Cairo. The third and fourth Islamic hospitals were built in Baghdad. The third bimaristan was built in 805 by Caliph Harun al-Rashid. This Islamic hospital in Baghdad was the first documented general hospital.
- The seeking of medical remedies and cures is a duty of the state and would be funded from the bait al mal. The evidence for this is The Messenger of Allah was treated with cupping by Abu Tayyibah. He commanded that he should be given two measures of food, and he spoke with his tax-collectors, who reduced his taxes.” (Extracted by Bukhari). Hijama (cupping) is a medicine that is used as a remedy, and being paid for it is an example of the permissibility of paying for doctors, therefore, it is not permitted for the State to prevent “the hiring of doctors or the selling of medicine”
- It can be seen that the approach of the Khilafah state towards healthcare would be far more effective than that of the capitalists. The focus would be on providing cutting edge healthcare to all citizens. It would base the distribution of this need of the people on its duty as a state, not use the false economic principles that are designed to accumulate capital in the hands of a few. Whilst private pharmaceutical companies would be allowed to operate the responsibility to ensure adequate treatments were developed would be the responsibility of the state.
- Today in countries like Pakistan where the capitalist economic system is implemented only the wealthy or those in the military can access health care. Even though the Muslims there are sleeping on top of far superior economic system.
- For pandemics like the coronavirus the Khilafah would have policies in place to deal with such eventualities. The experts within the state would not be influenced by commercial interests like big pharma or vested interests. The system aims to provide health care not ration it or provide it at a cost. This is what is happening in the West as they are not geared up to effectively treat all the people that will be affected by the Corona Virus, they will be killing many of their citizens and that is another crime amongst many that can be attributed to economic principles of capitalism.