The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

National Health Insurance (NHI) could force insurance companies “into extinction” via the same model that has undermined private Bahamian airlines, a Chamber executive yesterday branding efforts to implement the scheme as “socialism and dictatorship”.

Randy Butler, Sky Bahamas’ president and chief executive, told Tribune Business that the proposed NHI model amounted to “a hostile takeover of private enterprise” by the Government.

Mr Butler, also the Bahamas Chamber of Commerce and Employers Confederation’s (BCCEC) vice-chairman, said there were uncanny similarities between the Christie administration’s NHI model and what currently exists in the Bahamian aviation industry.

The Government, via Bahamasair, acts as an airline owner and operator, as well as sector regulator - creating a potential ‘conflict of interest’.

Mr Butler explained to Tribune Business that exactly the same ‘conflict’ and model was now proposed for healthcare financing, where the Government-owned public insurer, Bahama Care, will compete with private health insurers in a market that is also subject to government regulation.

The Chamber vice-chairman’s airline already knows what it is to compete against a government-owned, taxpayer funded, entity, and he drew this comparison at last Wednesday’s meeting between the private sector, healthcare industry stakeholders and the NHI Secretariat and implementation team.

“If you allow the Government to get into the insurance business, while also regulating the insurance industry, private business will suffer or go into extinction,” Mr Butler said of the message he delivered last Wednesday.

“This is the same that has happened with the private airlines. What is happening with Bahamasair is now happening with NHI and the private insurance industry. It’s a hostile takeover by the Government of private enterprise.”

The Bahamas Insurance Association (BIA) has said as much, and Mr Butler questioned whether political motivations and the impending 2017 general election were driving the Government to force through its preferred NHI model.

Joining the BIA, Medical Association of the Bahamas (MAB) and others in backing the concept of universal healthcare (UHC), Mr Butler said the Government’s failure to-date to publish a comprehensive plan for its NHI scheme concerned him.

“How much is it going to cost?” he asked the Christie administration. “You’re going into a business where you’re going to be taking on 160,000 people, half the Bahamian population, under Bahama Care.

“How are you going to pay for that, where is the money is going to come from? You’re telling doctors they have to take 3,000, 5,000 patients. What is going to be the cap on payments to doctors?

“How do you implement something without the laws and regulations? All these things we’re hearing about, but there is no legislation and regulations in place to say these are the terms of reference,” Mr Butler continued.

“It’s looking like socialism and dictatorship at its best. It’s saying: ‘I’m in charge, and this is the way it’s going to go, and how we’re going to do it’. There’s no checks an balances.”

Mr Butler’s comments took on new meaning last night, after suggestions were made to Tribune Business that the NHI Act passed by Parliament in 2006 was never published in the official Government Gazette - meaning it has yet to become law.

The Christie administration currently seems to be relying on this to give legal effect to its NHI plans, which are due to start with registration in the 2016 New Year.

However, a cursory glance at the 2006 Act shows there is nothing that makes the proposed NHI registration - due to start on Monday, January 18 - compulsory by law.

Mr Butler, meanwhile, suggested that backed by never-ending taxpayer support, Bahama Care, could copy Bahamasair’s tactics of rate cuts and flooding profitable routes to seize market share from private health insurers.

“It’s almost identical,” he added. “If the Government’s coming into the insurance business, the insurers must make sure that the playing field is level, where the public insurer is required to comply with the laws and regulations put in place.”

Mr Butler also called for the National Health Insurance Commission, which will regulate NHI, to not be required to report directly to a Cabinet minister.

He emphasised that virtually all business ventures owned, controlled and/or managed by the Government had become financial disasters and burdens for the Bahamian taxpayer, citing Bahamasair as a prime example of “taking taxpayer money and throwing it down the garbage bin”.

Under NHI, Bahamian employers and individuals - roughly 50 per cent of the population - will have to give up their existing medical insurance coverage.

They will instead be registered with the NHI scheme, and have to purchase its Vital Benefits Package whenever it is introduced. These packages will be sold by both Bahama Care and the private health insurers in competition with one another.

Echoing Mr Butler’s concerns, Emmanuel Komolafe, the BIA’s chairman, said on Monday: “The Government is determined to enter into the sphere of the private sector via the establishment of a public insurer at the expense of taxpayers.

“We disagree with the explanation provided to justify the motivation to deviate from the traditional role of governments to legislate, regulate and enforce established rules. The BIA ‎remains vehemently opposed to the attempt to nationalise the healthcare system, and the creation of an uneven playing field which has the potential to destabilise the healthcare system and displace private sector workers.

“How can the playing field be fair where the Government passes the law, regulates and serves as a service provider, which has the perceived infinite backing of taxpayers? The primary driver of employment and economic activity should be the private sector, and entrepreneurship should be encouraged not discouraged.”