The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

A BISX-listed insurer yesterday said newly-appointed consultants had given it “a glimmer of hope” that the Government would not proceed with the comprehensive National Health Insurance (NHI) scheme that threatens to “eliminate” the industry.

Lyrone Burrows, Family Guardian’s president, told Tribune Business that initial meetings with the PricewaterhouseCoopers (PwC) accounting firm and a Canadian consultant suggested that private health insurers would still be able to provide “supplementary” coverage in an NHI environment.

He added that the Government’s fiscal constraints meant it would be 10 years before it could afford the most comprehensive NHI version proposed by its Costa Rican advisors, Sanigest Internacional.

And, given everything that needed to be in place to launch NHI, Mr Burrows suggested it would be a stretch for the Government to hit its January 1, 2016, target date with even the smallest NHI plan.

Acknowledging that the Christie administration’s NHI scheme was “the million dollar question” facing insurers and the wider Bahamian healthcare industry, Mr Burrows said the Bahamas Insurance Association (BIA) was set to ramp up promotion of its alternative to the Government’s scheme.

The BIA is planning to run several media advertisements and embark on several other initiatives, after suggesting that Sanigest had under-estimated NHI’s costs by around $300 million.

Mr Burrows then revealed that Family Guardian had met with PwC and a Canadian healthcare consultant, who the Government had seemingly brought in “above” Sanigest.

“The meetings we had, we see a glimmer of hope in the outcome,” he told Tribune Business. “We feel very positive in terms of where things are going.

“From what we understand, they are looking at moving from a single payer to a multi-payer system, which would allow health insurers to offer the NHI base plan along with the Government.”

Mr Burrows branded this as “a step in the right direction”, as it effectively agreed with the BIA’s proposal that private insurers offer a ‘basic’ NHI plan that would be enacted into law.

The premium for this plan would be capped, and the Family Guardian president backed the BIA proposal that private health insurers would, in return, agree not to deny coverage to persons with pre-existing conditions.

“We are looking at removing some of the current caveats we have in our contracts once the Government moves forward with national coverage,” Mr Burrows said, confirming that Family Guardian would agree to remove the bar on persons with pre-existing medical ailments.

He added that PwC and the Canadian consultant’s task was to review the report provided by Sanigest, assess the information provided and how it was gathered, and whether the “conclusions raised are feasible and workable in this environment”.

The BIA, unveiling its alternative universal coverage plan, called for a public-private sector partnership (PPP) to implement healthcare reform, and warned that the existing NHI proposal effectively amounted to a complete government takeover of the sector.

Mr Burrows echoed such sentiments yesterday, telling Tribune Business: “If they [the Government] went fully to the comprehensive plan, it basically eliminates the industry.

“Pretty much the only supplementary coverage it would make sense to offer would be international coverage, whereas the base plan is one that still allows us to offer supplementary coverage.”

Sanigest has given the Christie administration three NHI options, ranging in price from $362 million to $505 million and $633 million, depending on the breadth of the benefits package to be offered.

However, the BIA said that based on claims and membership data submitted by five of its health insurer members, the figures provided by Sanigest were likely a gross underestimate of NHI’s ultimate cost, and the burden it will impose on working Bahamians and their employers.

It pegged the total cost of the most comprehensive package at nearer $1 billion, saying: “The health industry believes that Sanigest’s NHI cost estimates may be as much as a third below the actual cost - a significant difference of some $300 million.

“Based on our analysis of insurance industry data and administrative costs for the National Insurance Board (NIB) in 2011 and 2012, we have estimated that the Government’s proposal will cost between $895 million and $965 million to implement, with the higher number being the cost to cover the entire population.”

Mr Burrows yesterday said the Government’s fiscal position, with a $6 billion-plus national debt and fiscal deficits still exceeding $300 million, meant it was unlikely to start NHI with more than the ‘base’ plan.

“I suspect that given the financial situation of the Government, the first step will be the basic plan, which will have a very low amount of cover but allow supplementary coverage to exist in that environment,” he told Tribune Business.

“You’re looking at 10 years before the Government has the ability to evolve to the comprehensive plan. Given the environment required to roll out system, administration and marketing, it’s going to be extremely difficult to hit January 1.”