By RASHAD ROLLE
Tribune Staff Reporter
rrolle@tribunemedia.net
PRIME Minister Perry Christie insisted yesterday that his administration’s roll out of National Health Insurance won’t cause job losses or destabilise the economy as he defended his confidence in consultant Sanigest Internacional and promised a ramping up of efforts to educate Bahamians about the proposed scheme.
With three weeks before NHI’s scheduled implementation, numerous questions remain, including how much the scheme will cost, how the government will secure the crucial support of the health insurance industry and what the primary healthcare package - slated to be rolled out in April - will entail.
As for what NHI will cost, Mr Christie offered nothing definitive yesterday saying only that consultant PricewaterhouseCoopers (PwC) is “doing a special exercise” on the matter.
“In any event, the first phase we will roll out will be primary care and we’re projecting what that would cost because you’ve noticed that in my budget communication I indicated we’re not going to charge any rates at this stage because I wanted to ensure that people will know that they are being accommodated and know why they are being asked to pay for what,” he said. “All that will come later in to next year.”
Meanwhile, Mr Christie said stakeholders would support NHI just as they supported value added tax (VAT).
However, a key difference between the two issues is that even though stakeholders have called on the government to postpone NHI’s rollout to increase support and get it right, as was done with VAT, the Christie administration refuses to capitulate this time.
Health insurers have warned that job losses will occur if NHI is rolled out without incorporating their recommendations, which include scratching plans for a public insurer and enforcing a health insurance mandate.
Mr Christie, however, said there are no anticipated job losses, adding “let’s wait and see” when told about the health insurance industry’s job loss concerns.
“I think people misunderstand what governments do,” he said. “I have personally taken the chair of National Health Insurance. I have personally indicated that I would rather not play an adversarial role in fighting anyone on this. I want the same process as VAT. I met with representatives of the medical fraternity, a very significant number and most certainly specialists, and I was very encouraged by that meeting because without exception they committed themselves to National Health Insurance.
“The question for all of us is do they believe that the government would take action to plunge the Bahamas’ economy to a level of jeopardy where every effort we’re making is to ensure that the economy succeeds and goes to another level? We are not going to do that.”
Mr Christie also defended lead consultant Sanigest Internacional, a Costa Rica-based firm, saying the group is “doing an excellent job in advising us.”
However, a recent PWC report has questioned the validity of Sanigest’s estimates for various elements of the NHI scheme, including overall cost and the price of capitation per person under the primary healthcare.
“I don’t know why stakeholders have lost confidence in Sanigest,” Mr Christie said. “My point is Sanigest and PricewaterhouseCoopers PwC are employed, both of them employed, by the government and at the end of the day the government will make a determination based on what is submitted to it. Right now Sanigest I think is doing an excellent job in advising us. We change, we listen, we argue; at the end of the day all Sanigest is, is what PwC is, they are consultants, they are advisers, they worked in other countries before, they’re working for us now and the government will have to take responsibility when Sanigest falls away.”
First phase
Phase one of the government’s scheme involves registration for the programme and improvement in public health infrastructure.
Mr Christie said contractors would soon be hired to begin additional works in this regard.
“From our point of view, we have a comprehensive programme that we are launching where we’re going to give contracts now to remediate and confront (challenges and bring institutions) to a level of comfort that insured payers would want. That means the public wards being made into smaller bed units; we’re making major efforts to ensure that the central parts of the Princess Margaret Hospital, the Rand Memorial Hospital, are ramped up in terms of renovations and we are committing ourselves to a programme that will be the hundreds of millions of dollars in (a) new hospital plant that we will show renderings of, similar to the Critical Care Block.
“So ours is a comprehensive programme created to ensure that the hospitals and clinics in our country match what people would expect when they are paying for health insurance. You will see that in the coming weeks, renderings of all that we are doing. You will see and hear about the contracts that we are going to do now for the renovations of the hospitals and the clinics to which we go, to be able to accommodate people outside of PMH to clinics where the evidence shows that when the numbers of patients increased at the Eight Mile Rock clinic the numbers of people using the Rand Memorial Hospital lowered. “And so we expect to begin our efforts. Me, for example, I expect a major commitment through the educational establishment, pre-schools to The College of The Bahamas on healthy lifestyles. You are going to have a major comprehensive effort to get people to understand that the process has started and they are going to be a part of a process to be registered for National Health Insurance.”
Comments
sheeprunner12 8 years, 11 months ago
No Perry...................... it won't destabilize the country but it will destroy several private sectors
If this was so grand................... why keep it such a secret??????? ............ is Perry and the Cabinet a Freemason grandmaster and lodge as well?????????
Honestman 8 years, 11 months ago
Pride comes before a fall !
TalRussell 8 years, 11 months ago
http://tribune242.com/users/photos/2015…
Tarzan 8 years, 11 months ago
Tal, No one can defend the imposition of a program of such overwhelming economic and social significance absent full prior disclosure and an adequate opportunity for open discussion and comment prior to its implementation. This makes a pig in a poke look like total transparency.
Has the Obamacare debacle taught us nothing?
TalRussell 8 years, 11 months ago
Comrade Tarzan don't you think after 42 years independence we have done been too much prepared with not much to show in terms of progress but undelivered and unfulfilled promises by politicians of all party stripes and skin colours.
Is it not a ripe time to introduce Universal BAHAMACARE?
If not January 2016, do you really want to risk the health care of a new generation of citizens to a new new generation of politicians for another 42 years?
Economist 8 years, 11 months ago
Tal, I want to know what it is the government proposes to do, in detail, how much it is going to cost and that the legislation will be 100% transparent as to how the money is spent and how effective the expenditure is.
I am for NHI but only a proper sustainable NHI not some blah blah BS.
TruePeople 8 years, 11 months ago
Thats the whole thing Tal, 42 years with little to no progress, little to alot of regress. tooooo much empty promises, and now the gov't thinks it can take the biggest bite and tell us there will be no digestive issues???
Common sense would say they ein even gone be able to Chew the NHI cake, and when everything spit up, it's us who got get lick, not dem
Well_mudda_take_sic 8 years, 11 months ago
That dingbat pro-VAT Gowan Bowe guy who is one of the owners of the PriceWaterHouse accounting company should have kept his anti-NHI trap shut as he has probably comprised the independence of his company's report. You can read between Christie's remarks that he is more fond of what Sanigest has to say about NHI than what PriceWaterHouse has to say. May be it's good that PriceWaterHouse don't want to scratch the PM's back like Sanigest, but that Bowe guy obviously ain't heard that "closed trap catch no fly"!
cmiller 8 years, 11 months ago
I can almost see this rolling out next year. First, we register. Then, money is taken from our salaries like with NIB Then, we get nothing more from PMH that we are getting now, but he says he wants to show us now what we will be paying for later!!!
Ours is a comprehensive programme created to ensure that the hospitals and clinics in our country match what people would expect when they are paying for health insurance, he says. Really???
asiseeit 8 years, 11 months ago
Who is going to believe this lying clown. Only a deluded PLP for life would take the word of the dancing clown as the truth (Birdie).
TalRussell 8 years, 11 months ago
Comrade Economists let's get the accuracy of your question right.
If we are to seek honesty you first must show me where at any time in Bahamaland's long colonial overlords times - nor under 42 years after declaring independence - our British Motherland, the three governing parties, or Bay Street Merchants and lawyers, have there been the slightest evidence of the transparency you talk of?
Governments by their very nature are strangers to anything more than paying lip transparency lip service - so that be the case you must come up new reason, not to kick-off Universal BAHAMACARE in matter of weeks.
TruePeople 8 years, 11 months ago
Was looking up what those evil overlords dem is saying now:
http://www.legislation.gov.uk/ukpga/200…
http://www.nhs.uk/pages/home.aspx
...... I'm sure the British people are longing for a gov't more like your PLP because obviously those in the UK only pay lip service........ o_0........
You dun get too used to these fool MPs at home, but don't think that they are in any way a reflection of gov'ts around the world, nor anything like what a properly functioning gov't should be.
Oh and as for our wonderful progressive years of independence, at what point was the QUEEN of ENGLAND not our HEAD OF STATE?! ..... Are our courts even full independent of the Privy Council yet??!?
You living in the Bahamaland or NeverNeverland?
sealice 8 years, 11 months ago
one thing we all know.... If Chrispie say's it won't happen then it definitely will happen so watch out....
TalRussell 8 years, 11 months ago
Comrades can you tell Tribune readers why a slim minority are so adamant to go about ways to destroy a nation's prime minister's commitment to bring Universal BAHAMACARE to all the people? To go about their destructive political ways with little more than misinformation and outright damn lies.
TruePeople 8 years, 11 months ago
was the pot or the kettle black? so much accusing i lost track
TruePeople 8 years, 11 months ago
another lie for the ocean of lies the PLP love to tell us
Nooooooooo 8 years, 11 months ago
OK. Here it goes.
Lets do the math.
100 million / 350000 people = 285.71 per person, per year.
285.71 / 12 months = 23.81 a month.
No way on Gods green earth that Bahamians will get any sort or real insurance package for 23.81 a month. If it does happen, this is what it will look like.
From the way that looks many people will be signed up but they will not use the insurance because they will not be able to meet these deductibles. All Insurance have some sort of copay an deductible.
Now lets say they dont insure 350000 people. Lets use 200000 people by 100 million.
100 million / 200000 people = 500 per person 500 / 12 months = 41.67 a month.
41.67 is still not good. I can see that payment for kids under 18. But we are talking about the Bahamas and everything is 4 times the price. So the 41.67 is something you can see in the US.
My projection at the minimum is 500 million.
500 million / 350000 people = 1428.58 per person annually 1428.58 / 12 months = 119.05 per month
119.05 sounds more like a realistice number that we can work with. Now if 350000 people dont take the insurance then there can be surplus funds to fix infrastructure etc,
500 million / 200000 poeple = 2500 per year
2500 / 12 months = 208.34 per month.
AT 208.34 a month is an excellent number where citizens would be able to get the best care and the best plan.
The 119.05 is also a good number but that will have alot to do with the age average beacuse people 35 plus will use plan more, seniors will use plan more and pre existing conditions cases will use plan more.
The insurance companies will not go out of business to make the Bahamas healthy.
So base on the number please dont let the government propaganda machines fool a population of humble people. Ask the serious questions. If they do have a budget of 100 million, it will be a pain in the ass plan with 80% denial rate on items not being covered with high deductibles and long appointment times.
Just look at what you are paying now for private insurance and with you are paying for job related insurance and see if the numbers makes sense. Listen under the Oama plan rates are not $23 a month and we are talking a bout a whole lot more people 100 million people plus compared to 350000 people
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