By NICO SCAVELLA
Tribune Staff Reporter
nscavella@tribunemedia.net
THE chair of the Bahamas Insurance Association (BIA) says National Health Insurance (NHI) could potentially cost almost $1 billion to implement, adding that a botched rollout of the scheme could result in “serious repercussions and consequences for the industry”.
Emmanuel Komolafe, also chair of the Insurance Advisory Committee, said on Friday the government’s proposed NHI scheme could cost between $895m and $965m to implement, based on studies conducted by the BIA. However, he said “an industry that we have actually built for years, decades, overnight become a shadow of its old self easily” if NHI is not implemented properly.
Mr Komolafe also said the government’s proposed implementation of January 1, 2016, is “not realistic” and embraced the possibility of the government imposing a new tax to fund NHI.
“(Sanigest Internacional) suggested or projected that (NHI) would cost between $363m on the low end and $633m on the high end,” Mr Komolafe told a meeting of the Rotary Club of East Nassau. “So we went back as insurers and as an industry and just looked at our data, using real figures now, based on our population. Currently about a third of the population we believe, and based on statistics, have some form of private health insurance. Almost 50 per cent have some form of health insurance. So where does that leave you? You have about another half of the population without coverage. What we don’t know is out of that 50 per cent, how much people can afford it.
“We believe as an association, based on our figures, that it will cost between $895m and $965m. We talk about this but we also know that this is in a controlled environment.”
According to a report done last year by Costa Rican consulting firm Sanigest Internacional, NHI could cost as much as $633 million if implemented as a comprehensive package.
Recently, Sanigest met with a group of religious leaders, including Bahamas Christian Council presdient Rev Dr Ranford Patterson, to make a case for NHI. However, Rev Patterson said those government-hired consultants were not able to give a definite figure of what taxpayers will spend to have the scheme implemented. Nonetheless, he expressed doubt that the government would be able to successfully roll out NHI by January 2016, insisting that the Christie administration advise Bahamians on how the health care scheme would be funded.
He said while he agreed that there is a need for NHI, he could not support the imposition of additional taxes on Bahamians who are already financially strained, stresses that could potentially be further exacerbated with the implementation of VAT.
On Friday, however, Mr Komolafe embraced the possibility of the government imposing a new tax to fund NHI, albeit expressing concern in the timing of in the timing of that (potentially) new tax and the rate at which it would be introduced.
“Every country that has implemented National Health Insurance or some type of Universal Health Coverage has had to tax, because its not cheap,” Mr Komolafe said. “The costs of health care continues to go up. However, how much can you tax? The government has to make the determination on how much its taxes its people.
“It’s not unusual generally to actually impose taxes. The question I think from the general populace is, is the timing right after VAT, meaning another tax? And can you look at other means where it doesn’t put too much burden on the public in terms of taxes? But ultimately the government has to make that decision.”
He added: “The question now is, yes you have figures from Sanigest, BIA has its estimates, but quite frankly we just don’t know. We’re looking at January 1, 2016. I understand there may be some talks surrounding potentially looking at kind of staggering the implementation phases. But as an industry we believe that’s just not realistic.
“You’re talking about a system. I don’t have to go into the details of the inefficiencies in the public sector, which I believe are hopefully being addressed, but you also have some significant upgrades that you require before you implement.”
There has been fierce debate over the implementation of NHI with criticism from some observers that the proposed January rollout is ambitious. The Free National Movement has also expressed concern about the possibility of a new tax being imposed to cover NHI.
Last month, Prime Minister Perry Christie said he was amazed by the direction of the debate surrounding NHI, adding that the government had not yet decided on whether it would introduce a new tax to pay for it.
Progressive Liberal Party MP Leslie Miller has also predicted that when the scheme comes on stream, private health insurers will lay off employees as they see their profit margins affected.
Those things considered, Mr Komolafe said: “The BIA and various stakeholders support the concept of universal health coverage. But what we’re saying is, it’s the right thing to do but lets do it right. And another thing is the timing ought to be right. It cannot be rushed.
He added: “If it’s not implemented properly, there could be serious repercussions and consequences for the industry. We could see an industry that we have actually built for years, decades, overnight become a shadow of its old self easily, if its not implemented properly.”
In Sanigest’s report, which was handed over to the government last October, the firm explored the feasibility of NHI and presented options for financing universal health care. According to the report, the consultants suggested a payroll tax ranging from one per cent to five per cent to finance NHI.
The report further explored an array of revenue-raising options, including levying a “sin tax” on alcohol and tobacco. Another option identified was a tax on auto insurance premiums.
The government has maintained that there are too many Bahamians who die because they cannot afford health care.
Health Minister Dr Perry Gomez has said that details of the first phase of the NHI scheme will not be given until the 2015/2016 budget has been presented in the House of Assembly.
Comments
Tommy77 9 years, 5 months ago
More bad news.
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Chucky 9 years, 5 months ago
wondering what happens when all of a sudden everyone is covered, and then people start going to the doctors more often, how long will it take to expand health services to accommodate the increase in traffic. Have they estimated the increases in traffic, have the estimated the required increase in facilities, or will this become a joke like the Health Care in Canada where people wait a year to see a doctor?
wave 9 years, 5 months ago
Wait a year, who sold you on that ? If you know not what you speak of, then say nothing! You can be anywhere in the country and if you need medical attention you will see a doctor in a reasonable time frame , meaning 30 to 90 minutes.
ohdrap4 9 years, 5 months ago
which country?
this is not true in areas of Canada where there is a shortage of doctors. As some specialists retire, the remaining ones take on big loads and you wait time to see an endocrinologist can be 2 months.
OMG 9 years, 5 months ago
Who will often send you to a specialist or for expensive tests. Its you who are living in a dream world.
ohdrap4 9 years, 5 months ago
name the country. name the country where :
-no one goes to specialists -no waiting list for specialized health care.
Canada is not it. England is not it(some English have dental work done here in the Bahamas to avoid waiting lists
Name the country because i have google.
ohdrap4 9 years, 5 months ago
i feel sorry for this fella, having to do this dirty job.
the health insurance goes up significantly with age. people have it when they do not need it, ie when they are young and healthy.
as soon as you get a large claim, or reach the age of 60, they jack up the premium.
a person over 60 will be assessed $600 per month and takes up most of their national insurance pension, so they drop out.
for the evryday people, they get assessed extra for any preexisting condition: overweight, high blood pressure, you name it.
it is a ripoff.
duppyVAT 9 years, 5 months ago
In The Bahamas, there is collusion between insurers, bankers, doctors, pharmacies and lawyers ........ it is expected that BIA (Komolofe) will balk at any idea of the government cutting into their generous profit margins .............. this time the ordinary citizen will benefit but we have to be careful of the political "pork" involved ............. who bets the big medical contracts
ohdrap4 9 years, 5 months ago
komolafe was on TV saying the govt has to 'analyse what drives the cost of medical care".
Hello, the insurance companies do, for one.
he also is deathly afraid of capitation, because docotor will limit the amount paid per visit.
OMG 9 years, 5 months ago
So we propose a tax on vehicle insurance -- Is that before or after VAT. A sin tax, what a joke when you see DUTY FREE liquor signs all over the place when in actuality liquor is much cheaper in the States. Home brewed national beer at $53 a case is just unbelievable and we are reaching the point of diminishing returns whereby customers simply stop buying anything but essentials. How about a hook tax, given that Exuma normally has between 3-500 boats moored in and around the harbor during the winter months .Say $5.00 a night X an average of 400 boats is $2000 X 7 roughly$56,000 a month. Provide one or two people with A small power boat to collect and there is income for the country. Multiply that by other islands and it is quite sizable. How about enforcing a tax on holiday home rentals. OH I forgot this takes a real interest, some organizing and monitoring. Sorry so stupid lets just tax the working class again until all the lights are off and citizens are starving.
SP 9 years, 5 months ago
The insurance & Medical Industries Are Copartners To Ripping Off Insured Individuals
There is no secret that insurance companies and doctors universally work hand in glove to scam patients out of as much monies as possible.
Anyone regularly attending doctors knows every doctors visit registration form asks whether the individual is covered by insurance.
I've proven if you answer "yes" the doctor is apt to order more test, prescribe more medicines and generally beef up the bill more than if a "no" answer is given.
Local insurance companies are also guilty of grossly exorbitant rates and fraudulently charging premiums. When a person tries using the coverage the insurer claims the individual had preexisting conditions or finds any number of reasons which to exempt the insured from payments in as many cases as possible.
How was the CLICO fiasco even remotely possible if insurance companies weren't actually scam artist in the first instance? And they got away with it too!
Unquestionable Mr. Christie has done a lot of dumb nonsense these past 3 years, but proposing a National Health Insurance scheme is by no means one of them, and a very badly needed program in our country.
Christie biggest problems selling NHI to thinking Bahamians is how he plans to deal with the Haitian element presently hogging up 75% of available medical services without paying for it today!
Whereas I totally and absolutely agree we must initiate a NHI scheme as soon as possible to better help those that cannot help themselves. I certainly am not going to agree to paying a NHI tax that benefits Haitians ongoing abuse of my tax dollars.
I strongly suggest Christie take a page from Britain P.M. Camerons' solution for immigrants accessing social services. Which is immigrants must show proof of paying into the system for 4 years before being considered eligible for social and or medical services.
Christie would do governments purse, Bahamians and all those legally entitled to social and medical services a tremendous favor by making it mandatory NOW for anyone receiving social services to firstly be legally in the country AND secondly a participant to NIB for minimum 4 year period.
This would put an immediate end to Haitians and other parasites abusing and overburdening our social services.
Lets see if Christie simply follows P.M. Cameron, or if he pulls another failed attempt of "reinventing of the wheel" with his usual dump stunts!
ohdrap4 9 years, 5 months ago
That is so true. I can get my prescription glasses withou insurance for $390, which includes special mad-to order lenses. With insurance, he charges $710 and the co-pay was $270. Do i save money? no cause the insurance rate is over $300 per month. i dropped it a while ago.
ohdrap4 9 years, 5 months ago
that irks evrybody. what irks me is that the bloody civil servants also hog the services and get it for free. no one remembers that.
asiseeit 9 years, 5 months ago
I can hardly afford groceries at this point and have cut back in a major way on EVERYTHING. If the government wants to tax me more I will be going to social services for a card and will end up on the dole. This makes no sense. Have these politicians seen the prices of goods in this country, who except a million air can afford to live a half way decent life in the Bahamas? I would bet that more than half the politicians out there have not been in a grocery store since before VAT! Someone even said it here a case of beer that is brewed right here is $53.00, that is madness!
FNM_Retards 9 years, 5 months ago
THEN STOP VOTING FNM AND PLP!! FNM WAS GOING TO BRING IN VAT ALSO = FACT. THEY ARE BOTH FCKING RETARDS AND SO ARE THEIR SUPPORTERS. BTW prices haven't changed much, customs and theft always made prices high here. And Beer was always expensive, in a city of drunks they should lower tax on beer and raise tax on hard liquor but they are retarded, the FNM AND PLP. I'm guessing you actually live in the Bahamas and know our cost of living has been ridiculous for years now? This high price sht didn't just magically start with VAT. Check the out islands, they even more expensive.
FNM_Retards 9 years, 5 months ago
FNM and PLP say they believe in Bahamians
the list goes on.
Foreign companies are laughing all the way to the bank. They say the Bahamas is a country of IDIOTS that cant do anything themselves. Except ofcourse run around a field and clean hotel rooms.
A country of slaves??? Maybe its time to WAKE UP BAHAMAS.
STOP VOTING FOR FNM AND PLP AS THEY THINK YOU ARE DUMB STUPID ANIMALS. THEY THINK YOU ARE NOT WORTH SHIT COMPARED TO A FOREIGNER. THEY THINK THIS COUNTRY IS FULL OF TOTAL IDIOTS WITHOUT ENOUGH BRAINS TO DO THE MOST BASIC THINGS. VOTE FOR ANYTHING BUT FNM AND PLP, JUST SAY NO TO FNM AND PLP, TELL FNM AND PLP ABOUT THEY STINK BACKSIDE. TELL THEM YOU HAD ENOUGH. SHOW THEM YOU HAD ENOUGH.
FNM_Retards 9 years, 5 months ago
The FNM and PLP couldn't run a lemonade stand let alone a country. They are so stupid they have to hire foreigners to tell them what to do. The FNM and PLP say fck you to ALL Bahamians. Vote FNM and PLP if you are retarded. Only a TOTAL retard would still vote FNM and PLP after the sht they been doing to this country and its people. And only a TOTAL retard would defend their sht - but watch some try, and to them I say fck off traitors and terrorists, tell your ma suck my azz.
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