The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

Bahamian insurers yesterday slammed the Government’s “misleading assertion” that all stakeholders had come up with similar cost estimates for National Health Insurance’s NHI) first phase.

The Bahamas Insurance Association (BIA), in its latest missive on the scheme, effectively suggested this was an impossibility, since no agreement had been reached for the sector to supply its data to PricewaterhouseCoopers (PwC).

The accounting firm is supposed to review the NHI cost estimates produced by both the BIA and Sanigest Internacional, the Government’s Costa Rican consultants, but the insurers and the Government have yet to agree a Non-Disclosure Agreement.

While the Government wants to surround the process with complete secrecy, the BIA is seeking provisions that allow PwC to share its report and findings with the industry, and for the sector to be able to release it to the Bahamian people.

“After much debate and an initial expression of reluctance by the Government to the proposed amendments to the agreement, the BIA received a revised draft on November 12,” the Association said yesterday. “Regrettably, not all of the revisions we suggested were included.

“Weeks later, the BIA is still not in receipt of the final agreement, which is needed to move the matter forward. BIA members are anxious to assist with this important project, and to provide the requisite data to PwC so that the proper costing of NHI can begin.”

The BIA then referred to Tribune Business’s December 2 disclosure regarding the Government’s briefing notes for a meeting with the Medical Association of the Bahamas (MAB), which suggested that the estimates by PwC, Sanigest and the insurers were “broadly aligned” and that “the total cost of the first phase has been repeatedly estimated and the numbers all fall within a similar range.”

“The BIA has serious concerns about such inaccurate and misleading assertions,” it said yesterday. “Due to the delay in execution of the agreement with PwC, health insurers have been unable to provide claims data for analysis.

“In addition, we understand that the negotiations with the medical community regarding their fee structure for NHI reimbursement are incomplete, and the impact on utilisation has not been duly considered.

“Accordingly, we do not believe that PwC has conducted any actuarial assessments of the proposed cost of the first phase of NHI. Furthermore, the BIA has publicly expressed its view that Sanigest has materially underestimated the cost of the full NHI benefits package,” the BIA continued.

“It is apparent that the projected cost of the programme remains unknown, given the several pronouncements by government officials recently. Last month, the Prime Minister acknowledged the complexity of determining a cost but indicated that the Government’s accountants ‘will be very clear on what NHI will cost’.”

Expressing its frustrations and concerns with the lack of information coming from the Government as January 1, 2016, NHI implementation deadline approaches, the BIA said requests dating back several months had yet to be acted upon.

“These requests have included a response to the BIA’s universal healthcare proposal; a response to the derogatory comments made by its consultant,Sanigest Internacionale; details on the governance structure for NHI; the composition of the public-private task force referenced by the Prime Minister in May; the schedule of the meaningful consultation promised by the Prime Minister, and a copy of the detailed ‘Road Map’ intended to move the country towards the implementation of NHI,” the BIA said.