The Tribune

By RASHAD ROLLE

Tribune Staff Reporter

rrolle@tribunemedia.net

BAHAMAS Insurance Association Chairman Emmanuel Komolafe has questioned how the government determined it would cost $100m for the first year of primary care services under National Health Insurance, telling The Tribune the BIA has yet to provide the Christie administration with its costing data.

He said the BIA hopes to meet with government officials and consultants this week to determine if efforts towards implementing NHI are headed in the right direction, adding that the “devil is in the details”.

The insurance industry is still seeking details from the government about a proposed structure for NHI, the make up of the proposed public-private task force and a detailed road map for NHI’s implementation.

The BIA is also seeking a response from the government to comments Etoile Pinder, who works for NHI consultant Sanigest Internacional, made on Facebook several weeks ago when she labelled NHI opponents as “morons and money-grubbing asses,” a comment widely interpreted as a dig at insurance industry stakeholders.

Last week, Prime Minister Perry Christie stood by the Costa Rican firm, telling reporters the consultants were “excellent.”

As for Deputy Chief Medical Officer Delon Brennen’s statement last week that the first year of primary care services under NHI will cost around $100m, Mr Komolafe said it is unclear how the government arrived at this figure since the insurance industry has yet to provide secondary consultants PricewaterhouseCoopers (PwC) with the industry’s data on costing.

“I don’t know where that figure came from,” Mr Komolafe said.

“We were told by PwC and the permanent secretary that our data would help them (determine cost).”

To help estimate the cost of NHI, the industry has been preparing data to give the consultants once all parties sign a non-disclosure agreement.

Mr Komolafe said he could not offer a timeline for when this process will be completed.

In a press statement last week, he said: “A draft non-disclosure agreement (NDA) with PwC was provided to the BIA on September 28, 2015. We responded on September 28, 2015 with proposed amendments that included confidentiality provisions, an obligation for PwC to share the resulting report with the BIA and the insurance companies that provide data and the removal of any impediments to the BIA sharing the report’s findings with the general public.

“After much debate and an initial expression of reluctance by the government to agree to the proposed amendments to the NDA, the BIA received a revised draft on November 12, 2015. Regrettably, not all of the revisions suggested by the association were included. The BIA is still not in receipt of the final NDA and is awaiting the document in order 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.”

As a guest on 96.9FM’s radio show “The Revolution” on Thursday, Mr Brennen suggested that the full vital benefits package – which would include catastrophic coverage services – won’t be implemented until the will from the public emerges to agree to the financial means of funding such a package.

This makes the timeline for the full implementation of NHI unclear and helps explain why the prime minister has stressed that it has taken some countries years to fully implement NHI.

In response to this, the FNM has said that what the government will offer next year is not really NHI because it does not provide catastrophic healthcare coverage.

The first phase of NHI is slated to begin in January and will entail registration and upgrades to public health facilities. Primary health coverage is expected to come on stream in April 2016.

Mr Komolafe yesterday declined to say if the insurance industry would be comfortable with just a simple roll out of the first two phases of NHI, saying details for the primary healthcare coverage are unknown and there is concern that the rollout of this phase will cause some Bahamians to drop their existing plans.

However, his language was reminiscent of the government’s statements on the matter rather than the FNM’s, saying that NHI must be phased in.

“Primary healthcare is important,” Mr Komolafe said. “You get annual checkups and the chance to diagnose things early. People seriously ill need catastrophic coverage now, but in terms of the overall scheme, you have to start somewhere first.”