The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamas’ relatively high private medical insurance penetration is an advantage this nation must “leverage” - rather than abandon - in developing universal health coverage (UHC), Tribune Business was told yesterday.

Emmanuel Komolafe, the Bahamas Insurance Association’s (BIA) chairman, told Tribune Business that with one of the highest private insurance coverage ratios in the region, the Bahamas was starting ahead of the likes of Canada in designing and implementing a UHC system.

Mr Komolafe’s comments are effectively a cry for the Christie administration not to ‘throw the baby out with the bath water’ via its current National Health Insurance (NHI) model.

NHI, which will largely take over healthcare financing and insurance in the Bahamas via the current proposal, currently requires all Bahamians and legal residents to sign up for its Vital Benefits Package (VBP).

This means that the near-50 per cent of Bahamians presently covered by NHI will have to abandon their existing policies for the VBP package.

But Mr Komolafe, describing the Bahamas as having “one of the highest levels of market penetration for insurance in the region”, told Tribune Business: “In implementing UHC, we have to leverage existing resources, and that’s what we’re seeking to do.

“That the Government leverage existing resources to help implement UHC in the Bahamas.”

Mr Komolafe said the Bahamas’ private health insurance penetration is higher than when Canada launched its own version of NHI, and he said of this nation: “Why do that if you have systems in place?

“We have an advantage, and we need to leverage that. We want to develop something that is affordable, sustainable and viable for the country.”

The BIA has unveiled its own ObamaCare-style alternative to the proposed NHI plan, arguing that requiring all legal residents to have insurance will be “less disruptive” to the economy.

The BIA said its proposal, which has been submitted to the Christie administration, would achieve the same universal healthcare objectives as NHI via the provision of government subsidies to ensure those who cannot private health insurance are able to do so.

Mr Komolafe said the BIA released its NHI ‘alternative’ to show that it was not just about criticising and ‘tearing down’ the Government’s plan, but also offering solutions.

Emphasising that the insurance industry was determined to be “part of the solution, not part of the problem”, Mr Komolafe said it was also urging the Government to use the deep well of experience built up among actuaries and other professional officers in the designing and pricing of medical insurance products.

He added that in designing its alternative, the BIA had benchmarked jurisdictions such as the Netherlands and Switzerland, as well as ObamaCare and the US, to design “something that works in the unique economic environment of the Bahamas”.

Mr Komolafe said the BIA proposal would cost “way less” than the Government’s NHI proposal simply because it was dealing with 50 per cent, not 100 per cent, of the population.

He added that only when analysts “drill down into the numbers” could the Bahamas determine how many people cannot afford private health insurance, as opposed to those who choose not to have it. As a result, the percentage of the population requiring subsidised private insurance - as per the BIA’s plan - could be less than 50 per cent.

Mr Komolafe also urged the Government to step back and start from the beginning in determining NHI’s total cost, and the level and number of benefits included in the VBP.

He explained that the ‘starting point’ should be what the Bahamas can afford from an economic and fiscal perspective, and that benefits packages and coverage levels be determined based on this. Private sector actuaries and others could then design and price products accordingly, as the Bahamas ‘cut its cloth to fit’.

Many observers are also wondering how the Government can proceed at full speed to implement its existing NHI model on January 1, 2016, when it has yet to determine what it will cost or what benefits will be included in the VBP.

Reports on the contents of the PricewaterhouseCoopers (PwC) assessment of NHI, which the Government has refused to officially release, suggest that the accounting firm was unable to come up with reliable cost estimates because these key variables remain unknown and uncertain.