The Tribune

By NATARIO McKENZIE

Tribune Business Reporter

nmckenzie@tribunemedia.net

THE Bahamas Insurance Association (BIA) said yesterday that Sanigest International was operating in ‘conflicting roles’ as both government consultant and primary advocate for National Health Insurance (NHI).

In a statement, the BIA noted that it has as repeatedly expressed support for universal health coverage, while urging that such an important initiative be implemented with “minimal economic disruption”.

“The BIA’s concerns were allayed to some extent by the Prime Minister’s budget communication. However, recent comments by the Ministry of Health’s consultants - Sanigest Internacional - are disturbing. Sanigest called the Bahamian health insurance market ‘extremely dysfunctional’, and suggested that the health insurance sector, which has been contributing to the nation’s GDP for decades, was actually damaging the economy,” the association said.

It added: “The BIA believes that these preposterous statements are a consequence of Sanigest’s conflicting roles. On the one hand, Sanigest is acting as a technical advisor for the government’s proposed National Health Insurance system. This role should involve the ability to critique the Ministry of Health’s implementation plans for NHI, as well as to listen to and consider the views of stakeholders. However, Sanigest appears to also be deeply involved with the implementation of the NHI programme and is currently acting as the primary advocate for NHI.

“Sanigest’s recent public communications have arrogantly dismissed the Bahamian health insurance industry’s legitimate concerns. We suspect they would have been more thoughtful had they not had the burden of having to meet an overly ambitious implementation deadline. The government and the people of The Bahamas deserve independent technical advice on NHI, but Sanigest may be too conflicted to provide it.”

The BIA said that the huge disparity between the cost estimates for NHI calculated by Sanigest and the association warrants an independent review and opinion. James Cercone, president of Sanigest Internacional, the consultants charged with developing NHI, told Tribune Business that the BIA’s latest $947.3 million estimate was based on Aruba’s Expanded Benefits Package - something that the Bahamian NHI scheme will not be offering in its formative years. Mr Cercone said that NHI instead will be focusing on a Vital Benefits Package, the basic level of health insurance, which Sanigest has priced at around $400 million and believes is a sum that can be covered by the government’s Consolidated Fund.

Mr Cercone had been responding after the BIA, in a July 27 letter to the Ministry of Health’s permanent secretary, Marco Rolle, said it came up with an annual NHI cost of $947.3 million by using the government’s own healthcare example of Aruba.

The BIA said that Prime Minister Perry Christie had acted prudently in engaging the accounting firm, PriceWaterhouseCoopers (PwC), to review NHI costs several months ago. “We are aware that this cost analysis was submitted to government weeks ago. We call on the government to release the PwC report to all stakeholders in the NHI process, including the BIA. This is crucial for the economic prospects of The Bahamas going forward,” the BIA said.

“Achieving universal health coverage is far too important to be left in the hands of consultants that are so deeply involved that it prevents them from considering the realities and challenges that are apparent for all others to see. In his last budget contribution, the Prime Minister acknowledged that the ‘challenge of providing universal healthcare will require us to come together and work collaboratively in a way we have never had to before’.

“A contentious and blinkered approach from hired consultants like Sanigest is the last thing we need to contend with as we embark on this journey,” the BIA added.