The Tribune

By KHRISNA VIRGIL

Tribune Staff Reporter

kvirgil@tribunemedia.net

FREE National Movement Leader Dr Hubert Minnis yesterday questioned whether the implementation of National Health Insurance will end up to be another one of the Christie administration’s failed promises, saying the government has yet to inform Bahamians of key elements of the healthcare plan.

Dr Minnis said despite the government’s timeline to begin registration for NHI in January, there is still no clear indication of what NHI will cost and how this will impact working class Bahamians.

The Killarney MP is not alone in his criticism of the government over its handling of NHI implementation.

Prominent physician Dr Harold Munnings of Grosvenor Medical Centre agrees that NHI should not progress in the absence of public debate.

He added that he believes that no new taxes should be implemented to fund the scheme.

Dr Munnings shared his views in a letter, of which The Tribune has obtained a copy, responding to a position paper on NHI published by former Cabinet minister George Smith.

Meanwhile, Dr Minnis said while the FNM fully endorses a national health plan, it must be affordable and sustainable.

“Are we about to see another Christie promise fail? It would appear NHI is floating in cyber space with nowhere to land,” Dr Minnis said yesterday.

“Christie had promised that registration would commence in January but how is this possible when there has been no education process, (no indication) of what the registration entails, where it will occur or which doctors would be involved in delivering the healthcare under this registration drive?

“We have no resolution for the costing and with no resolution are we to believe the costing by (government consultants) Sanigest? Are we to believe the costing by the private insurance industry? We still await the costing by Pricewaterhousecoopers (Bahamas).”

He added: “It would appear that without resolution for costing, the Christie-led government would be placing their hands in the pot without Bahamians again just like what they did with VAT, causing extra pain and suffering. In terms of cost of living, will this be another burden for Bahamian taxpayers?

“Mr Christie must focus on strengthening the healthcare sector itself, having the proper medication in place, having the proper laboratory facility in place and the electronic medical records in place.”

Dr Minnis said these key elements of the process should have been made public months ago. He said the lack of information on NHI has also caused concern among health care professionals and insurance agencies.

“The doctors are still concerned. They have not defined what the medical benefit package will entail. How can you have a medical package and the doctors still are unaware? The insurance companies are concerned about the many job layoffs they would experience causing further shrinkage of the middle class and an increase of poverty.”

In his letter voicing his concerns over NHI, Dr Munnings lamented the fact the government is moving ahead with implementation without a public debate.

He added that until government shows “that it is serious about putting its house in order, I would be loath to entrust the management of our healthcare system to a newly created government-run entity.”

“There is another fault to what the government is proposing to do with NHI and this is a critical weakness,” Dr Munnings wrote. “The plan as outlined to the Medical Association, is to introduce a basic package of benefits, which will be built upon over a number of years. But Bahamians already have access to basic medical care in the private and public sector at a reasonable cost or no charge at all. Why do we need a new scheme to cover the care of asthma or appendicitis? It is the occurrence of a major medical illness that most threatens life and home stability.

“If, as is being put forward, under NHI advanced and expensive care will not be immediately available, what is the point of introducing it? People will not suddenly stop needing expensive chemotherapy drugs or pacemakers and they will not be able to wait years for the ‘expanded benefits’ package. The cookout and cries for handouts and help for money to pay for treatments will not stop.”

Dr Munnings said if he were given the mandate to introduce and manage NHI, he would create an oversight board that would invite established health insurers operating in the Bahamas to quote on a package of coverage.

“We would ask insurers to cover 300,000 people for advanced and expensive care. This means, for example, air-ambulance transportation, dialysis, pacemakers, joint replacement, stroke rehabilitation, organ transplantation and cancer treatment.

“Insurers will be told that the plan cannot exclude the elderly or persons with pre-existing illness. The government would accept a deductible of $10,000 and the plan would exclude payment for treatments currently available in the PMH for free.”

He added that it would be left up to the established insurance companies to negotiate the best possible rates they can find for the provision of care under the NHI scheme and to price it accordingly. He said this would allow the minister of finance to know up front what the real cost will be with the important task of research, negotiation and payments removed from government hands.

“That is where I would start. With all due respect to the foreign consultants currently crafting a new health care system for the Bahamas, I think they are going beyond the bounds of their expertise,” Dr Munnings said.