The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamas Chamber of Commerce and Employers Confederation (BCCEC) will oppose any attempt to ram National Health Insurance (NHI) into being without empirical evidence showing the scheme is sustainable, its chairman said yesterday.

Warning that many businesses and consumers were “tapped out” due to a combination of rising costs and taxes, and the weak economy, Robert Myers said the Government’s plan to implement NHI by 2016 was “completely unrealistic” in the absence of supporting data.

And he again expressed fears that NHI’s costs, coming immediately on top of Value-Added Tax and other fee/business cost increases, would further weaken the competitiveness of Bahamian firms and the wider economy.

Emphasising that the private sector was not opposed to healthcare reform and NHI by itself, Mr Myers said the scheme had to be assessed in a wider context to see if it was “affordable and sustainable”.

“Without empirical data, based on the existing economic climate and conditions, and the implementation of VAT, I think it’s completely unrealistic,” the BCCEC chairman told Tribune Business of the NHI plan.

“It’s going to put us in a non-competitive position....... We’re, at the Chamber, not against the NHI plan, but first and foremost it has to be something that’s sustainable.

“Everybody has to be able to afford it. If it puts the cost of business so high that, again, we continue to lose market share, it’s not a sustainable situation.

“We’re all tapped out. There is no money in the system. There’s just no more. We’ve got people that are paying Business Licence fees that are putting them into negative earnings. Where are those people coming up with the money for NHI? They can’t put up prices, because the consumer flees.”

Dr Delon Brennen, the Government’s chief medical officer, earlier this week promised that the proposed NHI scheme would “absolutely” be cost-efficient.

He suggested that it would lead to lower private health insurance and private healthcare costs, and spark increased workforce and business productivity.

Such statements are likely to be met with scepticism in the business community, and Mr Myers hinted as much, saying: “We’re definitely not anti-health plan, but we just can’t keep throwing stuff at the business community and consumers because we’ve reached the critical point of no return.

“For every $ in price that we go up by, it pushes consumers away to other destinations and the Internet. If it’s a local consumer, it pushes them to the US for shopping or the Internet.

“With less disposable income, businesses have more burden and will cut back. You put yourself in a predicament... it’s important for the Government to take a look from a competitiveness perspective.”

Mr Myers said the NHI proposal needed to tackle the fact that, on a per person medical cost basis, the Bahamas’ healthcare costs were twice those of other Caribbean nations.

Branding this as “unsustainable”, the Chamber chief added that NHI needed to show it could deliver efficiencies and economies of scale, and reduce purchasing costs associated with drugs, services and associated medical equipment.

Emphasising that NHI was “a wonderful idea”, Mr Myers said the steering and implementation committees charged with overseeing the scheme needed to “prove its sustainability” via statistical data before the Chamber and private sector would support it.

No details have yet been released on the NHI scheme’s likely total costs, and who will finance it and by how much. It is likely that the cost will be split between employers and employees, via an increase in National Insurance Board (NIB) contributions or some other method.

Urging the NHI steering committee to first prove the scheme’s viability, rather than simply treat it as a political directive from the Government and ‘rubber stamp’ it , Mr Myers said it would “start very much the wrong way” if it failed to do this.

“Figure out if it’s affordable, sustainable and, based on the data, figure out if it can be implemented,” he told Tribune Business.

“If it’s ‘let’s have a go at it chaps’, that doesn’t work. We will work against that if that’s the intent. That’s not good governance, not good management, and it’s fiscally irresponsible. It can’t go on like that.

“If that’s the intent, not to figure it out but to drive NHI through, we’re going to have problems. We’re past the point of no return, and consumers can’t take any more.”

Mr Myers said the Chamber had ordered its representatives on the NHI committees not to sign a non-disclosure agreement, arguing that the public and its members needed to be kept informed of progress.

He added that the Government’s seeming lack of transparency once again was a “negative”, with issues such as NHI needing to be debated by the Bahamian public and not involving national security matters.

Rick Lowe, Nassau Motor Company’s (NMC) director/operations manager, described the Government’s public statements on a cost-effective NHI as “poppycock”.

Calling on it to back this up with evidence, Mr Lowe said the costs of such universal access, socialised medical schemes were rising across the world, and questioned why the Bahamas would be any different.

“It may put the insurance companies out of business,” he said of NHI. “It’s not proven anywhere else in the world where these things are put in place that they are more cost effective, more efficient, and people take less time off their jobs.

“I look at it as another cash grab like VAT and everything else. They’re desperate. Are we witnessing the decline of our businesses and the entire economy? If they keep mounting on these taxes, fees and charges, it’s impossible to keep going. You might keep going for a while, figure out an alternative business plan, but sooner or later you can’t.”

With VAT looming, and another NIB increase set to follow this year’s wage ceiling rise in 2015, Mr Lowe said NHI’s impact on the economy was likely to be “fairly drastic”.

“You’ve got to have a major dramatic turn in the economy in another direction just to keep your head above water,” Mr Lowe told Tribune Business.

“It’s going to have a significant impact. They’re trying to chop businesses off at the knees. It’s like: Let’s take more money at the worst possible time.”