The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamian economy “cannot support” the Government’s proposed comprehensive National Health Insurance (NHI) scheme, a leading private sector official warning it would act as a barrier to reducing already-high unemployment and threatened to create a “dependency” culture.

Winston Rolle, the Bahamas Chamber of Commerce and Employers Confederation’s (BCCEC) chief executive, told Tribune Business that while the Coalition for Healthcare Reform - the private sector umbrella grouping that was formed to address concerns raised by the first Christie administration’s NHI scheme - had not met recently, its concerns had not altered.

The main fears, now as then, were the likely cost burden an NHI scheme would impose on the Bahamian economy and business community, and who will pay for it.

“Whether we like it or not, we’ve not returned to any degree of economic normalcy, and obviously it’s going to cost,” Mr Rolle told Tribune Business of NHI, referring to the extra cost burden it was likely to impose on an already-struggling private sector.

“The Coalition has not had any discussions or meetings since then [2007], but I don‘t see where we would have changed our position. Our position will still be the same; that our country cannot support it.”

He pointed out that healthcare costs, and the price of related health insurance, was continually increasing, despite private sector insurance carriers being able to spread those costs across large risk pools. There was nothing to suggest an NHI scheme would be able to escape the same increases.

The Government, in its election manifesto, promised vaguely to “renew the nation’s commitment to National Health Insurance” during its first 100 days in office, and is understood to have engaged the Pan-American Health Organisation (PAHO) as consultants on the project.

While the first Christie administration passed the NHI Act before it was voted out of office in 2007, the accompanying regulations were never devised.

The Ingraham government, agreeing with the Coalition and private sector, felt implementing a comprehensive NHI scheme in one go was more than the economy could bear, and decided to adopt a phased approach, starting with the National Prescription Drug Plan. But the 2012 general election outcome has brought NHI back on to the frontburner.

Expressing hope that the Government would consult the private sector on any proposed NHI scheme once it had determined the way forward, Mr Rolle said the impact on the economy and willingness of employers to hire was “one of the major concerns”.

“One of the major reasons it was a concern last time was there was a cost factor, and it was not clear how much it would cost or who was going to pay for it,” Mr Rolle told Tribune Business.

“When you consider we’re having a challenge with employment now, and increase in costs of this magnitude will negatively impact employment as opposed to enhancing employment.

“That’s not what we need to do. We need to encourage companies, anyone who wants to hire, to have the incentive to go ahead and do so.”

Acknowledging that costs would be incurred even under a private-public partnership healthcare model, Mr Rolle also warned against allowing an NHI scheme to create a culture where Bahamians became ever more dependent on the Government.

“The other concern is that we have to move away from making people more dependent, and make them more independent,” Mr Rolle told this newspaper.

“Whatever structure is finalised, it has to be a proactive one, where persons contribute to their own care. We have to be careful against moving people into a dependency society, which is not good at all.”