Policy for Securing the Health of the Citizens of the Khilafah
August 2013 CE - Shawwal 1434 AH

Hizb ut Tahrir / Wilayah Pakistan has issued a Publicized Policy Position (PPP) regarding ensuring health is a right and not a luxury, for all the citizens of the soon to arrive Khilafah "Caliphate", regardless of religion, school of thought, gender or race.

Preamble: Democracy has made good health care a luxury

The state of Pakistan's health care is appalling with widespread, preventable life-threatening disease, inadequate patient health education, poor unaudited treatment protocols that are not based on medical evidence, lack of an integrated health system with primary, secondary and tertiary facilities, poor local clinical training and the absence of strong, original medical research strongly linked to local disease and health requirements. Currently, the private sector accounts for approximately 80% of all outpatient visits. Domination by the private sector has converted health care from a service into a business and health care into a luxury, not a right. Increasing costs of private doctors' fees, medicines and diagnostic tests have made affordable treatment difficult for most people in Pakistan.

This awful state of affairs reflects attributes of the model for Pakistan's current rulers, the  foremost exponent of Democracy, the US. In the US too, Democracy has converted patients into customers and health into a luxury. Democracy has privatized health care and drug research to benefit a small elite, who now profiteer from the misery of millions. By privatization, both medical drugs and medical care is now unaffordable for most of the world and even for many within the Western world. Medical insurance companies were formed to help make medical payments, but they themselves have added to the problem, allowing the private hospitals to raise their prices further. Medical debt is now cited as the single biggest factor in 62% of all personal bankruptcy in the United States. Fifty million Americans do not have health insurance, as they cannot even afford that. Approximately 18,000 of this fifty million die every year because they did not have health insurance, so could not afford treatment. This is whilst a small elite represented by medical facility providers, drug companies and health insurance companies profiteer immensely from the misery of millions, through privatization of health, drug patency laws and insurance laws, all secured by Democracy, the "Best Revenge" of the gray-suited men on the masses.

This pitiful situation in the world is a far cry from the time of the Khilafah "Caliphate", where the state supported a strong predominately public health sector, in accordance with the commands of RasulAllah (saw); for example during the Battle of Khandaq, he came across wounded soldiers and he ordered a tent be assembled to provide medical care. Public hospitals, or "Bimiristan" (Abode of the Sick) were a great relief for the people. They served all people regardless of their race, religion, citizenship, or gender. The al-Mansuri Hospital, established in Cairo in 1283, had accommodation for 8,000 patients. There were two nursing attendants for each patient, who did everything for his/her comfort and convenience and every patient had his/her own bed, bedding and vessel for eating. This hospital treated in-patients and out-patients giving them free food and medicine. There were mobile dispensaries and clinics for the proper medical care of the disabled and those living in the remote areas.

Knowledge was free without restrictions or patenting, either of process or product, allowing reverse engineering as well as explosive innovation and development. Medical faculties had a strong representation within university as well as allied facilities for clinical research in hospital and out-patient settings. Muslims doctors preceded the world in medical research by decades if not hundreds of years in fields as diverse as ophthalmological surgery to cardiac care. With world leading health care centres, medical personnel and medicines, rulers of foreign nations used to migrate to the Khilafah "Caliphate" for treatment as the favoured destination, setting a strong precedent for the concept of medical tourism.

B. Political Considerations: Health provision under democracy is heath for the wealthy for the benefit of the extremely wealthy

B1. Democracy privatizes health, making it a luxury, not a right of the people upon the state

Democracy has privatized health care, allowing a small elite to profiteer from it through providing medical facilities and then create medical insurance companies to profiteer from the fact that most of the people cannot afford private medical care. Democracy separates religion from life's affairs, which is secularism. It hands over law making to the people of influence and wealth who can now make law to further increase their influence and wealth. The dominant aspect of capitalism is now freedom of ownership which allows the elite group to successively privatize the rights of the masses, so that they can benefit from them as the masses have nowhere else to go. So alongside privatization of energy interests, such as petrol and electricity, Democracy has added to the misery of the people by advocating complete privatization of medical care facilities and drug research. Under Democracy, people are financially crushed by private medical facilities, parasitic insurance companies and drug companies. It is privatization that has led to the huge concentration of wealth. Even through the current global economic crisis, the wealthiest 1% has become even wealthier, whilst hundreds of millions have become jobless and homeless. This fanatical drive for privatization without consideration of the people's right directly led to the Wall Street Movement with the people proclaiming "We are the 99%." As such the central pillar for Democracy, "freedom of ownership" is actually "deprivation of ownership" and its "privatization" is "usurping the right of the people."

B2. Democracy favours a small elite through patency laws

To further the profits of the small elite, democracy has also privatized knowledge, through patency laws as the result of Intellectual Property Rights (IPR), allowing the small elite to profiteer from it immensely through drug companies. The discussion on Intellectual Property Rights arose after the Industrial Revolution. After living in the shadow of the world's leading nation, the Khilafah "Caliphate", for centuries, and lost in its Dark Ages, Europe was making advances in science and technology. However, in Democracy, with freedom of ownership, the knowledge for the inventions is "owned." The issue was highlighted after a scientific exhibition in Vienna in 1873, in which many potential exhibitors withdrew because they were worried their inventions would be copied. Democracy sprung into action to protect its sponsors and now jealously protects the intellectual activity of these companies at arriving at that idea or invention. It secures the company the right to control access to the invention and prevent others from using the invention. Therefore, no-one can use the invention, and improve on it, taking science forward. Rather they have to re-design and re-invent from scratch.

Patents on pharmaceutical products and processes provide drug companies with monopolies over the production of medicines, allowing them to fix prices at high rates to maximise profits. The WTO-TRIPS (Trade Related Intellectual Property Rights) Agreement is being used as a basis for enforcing patents. The cosignatory nations are obliged to implement high standards of intellectual property protection, including the minimum 20-year protection for patent rights, effectively eliminating competition from local companies and allow for increased prices of medicines beyond the reach of even more patients in the developing countries. Life-saving drugs now cost thousands of dollars, which is beyond even the dreams of millions in most of the world, who do not even earn a thousand dollars in an entire year. And drugs related to diseases of wealth such as obesity, Type II Diabetes, took precedence over diseases of poverty such as acute life-threatening chest infections and diarrhoeal illness.

C. Legal Injunctions: Health and medical care is obliged on the state for all the citizens, regardless of race, school of thought or gender

C1. Medical care is a right of the citizens upon the Khilafah "Caliphate" state

In its Introduction to the Constitution, Hizb ut Tahrir has adopted in Article 125, "Health and medical care are from the obligations of the State such that they must be readily available for the citizens, from the angle of clinics and hospitals, and public utilities used for treatment by the Muslims. So, medical treatment from this angle is part of the interests and public utilities. The interests and public utilities must be undertaken by the State since they are from the issues that the State is responsible over, in accordance with the words of the Messenger : «الإِمَامُ رَاعٍ وَهُوَ وَمَسْؤُولٌ عَنْ رَعِيَّتِهِ» "The Imam (ruler) is a guardian,  and responsible (and will be questioned) for his subjects." (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...  In his capacity as a ruler, the Messenger sent a doctor to Ubay, and Umar (ra), the second righteous Khalifah, called a doctor for Aslam to treat him, which are two evidences that health and medical care are from the essential needs of the citizens that the State must make sure are readily available for whoever needs them."

To fund this explosion in health care, the Khilafah "Caliphate" will restructure revenue generation according to the Shariah rules to accelerate educational progress. It will generate huge revenues from public properties such as energy and state enterprises such as large scale construction and manufacture of machinery. It will establish Kharaaj and end the oppressive income and sales tax that has strangled economic activity. It will also refuse to pay the interest based loans from the colonialists and others, which eat a third of the expenses of Pakistan as debt-servicing, in the knowledge that the loans have been paid many times over due to interest. So, whilst the Khilafah "Caliphate" dominates the health sector, Islam does allow private facilities to provide health care for profit. Thus the Khilafah "Caliphate" will restore the correct balance to securing the health of the people.

Hizb ut Tahrir states in its Introduction to the Constitution Article 164: " The State provides free health care for all, but it does not prevent the use of private medical care or the sale of medicine... As for the permissibility of hiring a doctor, and paying him a fee, this is because seeking treatment is permitted (Mubah); as mentioned previously the Prophet  said: «يَا عِبَادَ اللَّهِ تَدَاوَوْا» "O Slaves of Allah seek treatment", and since treatment is a service that the one paying for can achieve, therefore, the definition of hiring is applicable to it, and there has been no prohibition narrated regarding it."

C2. Knowledge is free for the people to benefit, including medical research

Islam defined what can be owned privately and what cannot, the existence of a thing or a benefit does not mean that it can be owned. Islam explained who can own what, so for example, an individual cannot own an energy resource, such as electricity generation plant or oil field. It also defined the limits of ownership, how an item can be disposed of. Regarding knowledge, it is not a matter for privatization, allowing great development and excellence in research.

Hizb ut Tahrir states in its Introduction to the Constitution, Article 180: "The exploitation of writing books for educational purposes at whatever level is strictly forbidden. Once a book has been printed and published, nobody has the right to reserve the publishing and printing rights, including the author. However, if they were ideas he had, which were not yet printed or published, the owner has the right to be paid for transferring these ideas to the public as he paid for teaching. However, if the teacher imparts something verbally or through writing, the knowledge that the learner took becomes possessed by him, and so he has the right to impart that knowledge to anyone else whether verbally or through writing, and he has the right to take a fee for it."

With regards to trademarks, these are specific identifying marks to a particular person or company, like a company name such as Glaxo, or a product produced by a particular company like Zantac. The name is an identifying feature, so this cannot be copied, as this would be deception, and the Khilafah "Caliphate" would prevent this.

Note: Please refer to the following articles of Hizb ut Tahrir's Introduction to the Constitution for the complete evidences from Quran and Sunnah: 125, 164, 180. To see relevant articles of the constitution for the Khilafah "Caliphate" state please visit this web link: http://htmediapak.page.tl/policy-matters.htm

D. POLICY: The Khilafah "Caliphate" is to set world standards for health care and medical research

D1. A state dominated health-care system that secures the medical needs of all citizens, regardless of race, religion, school of thought and gender

D2. Abolition of the privatization of knowledge through patency laws that will lead to an explosion in medical research as well as allowing for easily affordable drugs.