The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

AN FNM Senator yesterday branded the Government’s comprehensive National Health Insurance (NHI) plan as “pie in the sky” given fiscal realities, and said his previous $750 million annual cost estimate for the scheme was “conservatively low”.

Dr Duane Sands warned that if the NHI plan was implemented next year, as the Government is proposing, it would have a “deleterious effect” on a Bahamian economy that was “barely afloat” currently.

Emphasising that NHI would have to be financed via taxes that reduced Bahamian families’ disposable income, Dr Sands questioned where the Government would find the money for its implementation, given that various agencies have already been asked to make 10-25 per cent budget cuts.

But, despite his criticism of the Christie administration, Dr Sands said he was not opposed “conceptually” to an NHI-type scheme - only the current proposal’s design and ‘one-time’ implementation.

Calling for the Government to follow its predecessor’s lead in implementing Bahamian healthcare reform in “bite size pieces that are digestible”, Dr Sands suggested that the next step should be the creation of an insurance programme specifically for catastrophic illnesses - a scheme that would prevent Bahamian families going bankrupt.

Voicing suspicions that the Government, sensing it was in political trouble, made Wednesday’s steering committee announcement to gain “a shot in the arm”, Dr Sands told Tribune Business: “Let’s be very candid.

“The motivation for the introduction of NHI is a reasonable one. But when you add to that the fiscal realities it cannot happen. Not if it’s going to be as comprehensive and inexpensive as promised.

“The Government has no money, and it’s unable to commit to any new debt. Already, all the government agencies have been asked to cut budgets between 10-25 per cent. Where are they going to find all this money? Are they going to raid NIB again?”

But, despite his criticisms of the Government’s current plan, the details of which have yet to be worked out, Dr Sands agreed that a phased approach to healthcare reform was needed.

“That [the Government proposal] should not stop the development of a programme. Taking it in bite-sized pieces that are digestible makes a whole lot of sense,” the Senator told Tribune Business.

Following on from the National Prescription Drug Programme, Dr Sands said the Government should implement a catastrophic health insurance programme - a long-held objective of the FNM.

This, he said, would prevent Bahamian families from being 
“wiped out” - going bankrupt or losing their homes in trying to finance life saving operations and treatments for ill relatives.

While a plan covering kidney and liver diseases, plus heart-related illnesses, was one thing, Dr Sands said an NHI scheme covering doctors’ visits, MRI scans and needle injections would be “a hugely expensive undertaking”.

“I support the concept, but let us do it in a way that does not destroy the Government,” he added. “These guys have been making promises, commitments that have loaded our grandchildren with debt.”

He described his previous $750 million estimate for NHI’s annual costs as “conservatively low if we are talking about the type of comprehensive healthcare that people have come to expect”.

To move forward, Dr Sands said the Government needed to create a bi-partisan committee to layout a 20-year approach to healthcare reform that would survive the transition to different governments.

As to the economic implications, Dr Sands told Tribune Business: “We’ll be taxing the Bahamian people. Dr Gomez yesterday referred to it as a tax. We’ve been saying it’s a tax from 2006. They may call it a levy, an excise, a contribution, but it’s a tax.

“The impact on the economy is likely to be striking, the impact on family disposable income is likely to be huge.

“Conceptually I’d like to make some inroads into a huge societal problem, I agree. But we have to do it in a way that is sustainable, has the impact intended, and does not have any deleterious impact on the ability of the economy to remain afloat. We’re barely afloat at this time.”