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Which medicine is most important?

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I'm sitting here, typing this from my mobile phone because I just faced this question no person should ever have to ask. Let me paint the picture:
A man brings his wife who is in a state of sever dehydration. She needs fluids by drip, antibiotics, something to bring fever down and some tests to make sure her kidneys are fine and also to identify the causative agent. I work at a private firm for locums which only accepts particular medical aid schemes. Our patient is on none of them. The dreaded cash patient.
The husband goes to reception after my consultation and is told he has to pay $130 for everything. He comes back to me and says 'doc, I only have $50, which medicine is most important?'

Zimbabwe has become a very depressing place to work as a doctor. Forget our miserable pay issues. Patients are having to compromise their health because of the depth of their pocket. That is not fair. You might argue and say, well, couldn't this patient go to a government hospital? Our government facilities are plagued with drug shortages, long queues and lack of privacy. They are so crowded now because the old upper middle class is having to go there now.

So when a patient asks me, which medicine is most important...what am I supposed to say? A lot of creativity is needed. What will killbthem first? Dehydration or infection? Do they really need a full blood count? Can I use clinical signs to determine kidney function? These are things you are not taught in school. Or should I just tell them to seek care at the government hospital where its cheaper and stop making me make unorthodox treatment plans?

Health care should be free. Period. I don't care what your country's economy is like. I don't care what beliefs the people have. No one should have to make a health related decision based on how much money they have. You cannot put a price on life. Yes, someone has to pay for it somehow. There is enough wealth in the top 1% of rich people to look after the whole country. If there is an AIDS levy why can't we have a health levy. Can we borrowba leaf from ObamaCare, the more you have the more tax you pay. What about diverting some of the funds for military and defence to health? Im sure economists are better strategists than I am.

Things in zimbabwe are getting tougher for the average man. It seems we may be reliving the 2008 horror of economic meltdown, but this time feels like a much slower more painful death. We know what's coming and yet we keep walking in that direction.

As for me and my patient, she is on the drip. I had to remove fee for observation...but I will observe her anyway. My boss wouldn't like the sound of that. Well, too bad.

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