The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

Bahamian doctors believe it is “logical” for the private insurance industry to administer a Universal Health Coverage (UHC) scheme and its financing, urging the Government not to reject an industry responsible for 9 per cent of GDP.

The Medical Association of the Bahamas (MAB), in its formal position paper on the proposed National Health Insurance (NHI) scheme, urged the Christie administration to leverage the skills and expertise in the private sector to benefit its plans.

Backing the position and plans advocated by the Bahamas Insurance Association (BIA), the MAB said: “An important aspect of the development of UHC is diversity of funding and remuneration, and the professional administration of the system.

“The insurance industry within the Bahamas is the third largest industry in the country, and is responsible for 9 per cent of our GDP. Again, this puts us well ahead of many similar sized countries in our ability to harness local talent and expertise in this area, and recruiting our well-developed insurance industry to administer a UHC system should be the logical decision.”

This statement effectively backs the BIA position that the Government’s proposed NHI public insurer, Bahama Care, is not necessary. It also appears that the MAB agrees that the private insurance sector’s expertise be leveraged into determining NHI benefits packages and their pricing.

But, in a balanced outlook, the doctors urged that age and pre-existing condition obstacles to obtaining private health insurance coverage must be eliminated in their UHC model.

“The MAB believes that, as with all aspects of a good system, there should be well developed, agreed and legislated guidelines for the entity,” its position paper said.

“Guidelines should mandate that regulations, checks and balances be firmly in place, guarding against unfair manipulation of the industry, as well as guarding against unfair practises creeping back into the industry.”

The MAB then added: “For a UHC system to achieve its fundamental goal of health care for all residents, all residents must be eligible for care.

“This must begin with the elimination of all obstacles to coverage based on age and/or pre-existing conditions in all levels of coverage, and in all insurance packages offered, and physicians must strictly adhere to negotiated and agreed fee schedules for services supplied to patients....

“The details of this new era in MAB/BIA relations can be negotiated between the groups, but agreement to these principals, and legislation ensuring that these agreements are lasting, must occur before we proceed to the development of UHC.”

The MAB paper said the Bahamas had many public-private sector partnerships (PPPs) that were either not used or “under-used”, and which could be employed to strengthen the existing healthcare system and boost UHC’s effectiveness.

“The Bahamas possesses a unique, intertwined public/private system that is markedly underutilised,” the MAB said. “The old view that ownership is the only path way to service must be revised, and many more public/private partnerships should be forged to extend a wider range of health care services to our people.

“With a population of only 400,000 duplication of hardware is an unwise, inefficient, and unnecessarily expensive route to take for the delivery of service.

“We have, at the time of writing, many unused public/private partnerships we could utilise immediately, and enormous possibilities will open up to those persons and entities that are willing to combine their talents for the benefit of the patients of our country.”