By NEIL HARTNELL
Tribune Business Editor
nhartnell@tribunemedia.net
A well-known physician yesterday expressed hope that the Prime Minister had “some remaining reason” to ensure that political objectives were overridden, and a National Health Insurance (NHI) “catastrophe” avoided.
Dr Duane Sands, the former FNM Senator, told Tribune Business that if the Government chose to proceed with the scheme as is, it would do so against “overwhelming evidence” in the PricewaterhouseCoopers (PwC) that there was a nine-figure funding gap inhibiting its plans.
“I certainly don’t believe it was a very supportive document of the costing analysis and pricing of the various plans as suggested by Sanigest,” Dr Sands told Tribune Business of the PwC report.
“So if the Government is minded to proceed, they would clearly be doing so in the face of overwhelming evidence that there’s a huge funding gap no matter what revenue sources are used to pay for this proposal.”
The PwC report, which the Government has yet to release publicly, estimated that the NHI proposal faced between a $110.5-$134.3 million ‘funding gap’ based on the initial $362.6 million costing for the Vital Benefits Package.
The accounting firm said the ‘gap’ was the difference between the latter figure and the $228.3 million and $252.1 million in existing public health spending to NHI that PwC believes can be re-allocated to finance the scheme.
However, given that both the Government and Sanigest subsequently increased the Vital Benefits Package ‘price tag’ to $400 million, Tribune Business estimated on Monday that the so-called ‘funding gap’ had risen by another $37.4 million based on the PwC findings - to $147.9-$171.7 million.
Dr Sands suggested that the Christie administration had effectively shelved, and ignored, the contents of the PwC report because it was desperate to have ‘an achievement’ it could use as part of its re-election campaign.
When asked why the Government seemed determined to forge ahead, he replied: “Because it is the only possible chance to salvage - to be frank, I don’t think there is much that can be salvaged - but politically this is the only thing that can be salvaged to maintain credibility for this administration.
“They have no choice; they have to put something on the table. Damn the torpedoes, ignore the naysayers; this is full of inconsistencies but we’re going to do this anyway.”
Dr Sands warned that the Government was going to make itself “hugely unpopular” among members of the security forces, teachers and other public sector workers if it went ahead with Sanigest’s proposal to switch them all from private health insurance to NHI.
This, he added, was likely to eliminate some of the benefits and health services coverage they currently enjoyed via private insurance.
“When you read the PwC report and you listen to the plan for NHI, it seems as if they’re looking at the dumbing down of the benefits of a significant section of the population in the interests of this nebulous, not well thought-out, not well-planed, grandiose NHI scheme,” Dr Sands told Tribune Business.
Apart from PwC, he added that the Christie administration was also ignoring the Medical Association of the Bahamas (MAB), Bahamas Insurance Association (BIA), private sector organisations and individual businesses, who were all warning it to “put the brakes on and let’s talk about this”.
Dr Sands said the Government’s rush to NHI meant it was missing an opportunity to involve healthcare industry players in developing a careful, well-planned reform scheme that could “do something wonderful for Bahamians:”.
He added: “I think this is going to be another missed opportunity, a squandered opportunity, in large part because of the way they have approached it.
“It is so inconsistent with what people think is wrong with the health system in the Bahamas, and we’re trying to bite off more than we can chew, more than we can digest.”
Dr Sands said PwC had used “pretty strong” language in warning that the proposed NHI scheme could “destabilise” both the Bahamian healthcare system and economy.
“I am hoping that the Prime Minister has some remaining reason in his administrative mind, and he does not do something detrimental and catastrophic for the country,” he told Tribune Business.
“It is my hope they put something on the table called NHI, but is not more than a figurehead programme.”
Comments
Economist 8 years, 11 months ago
Dear Prime Minister please defer this until AFTER the elections in 2017.
The impact of VAT is still being felt and we the people, indeed the Bahamian economy, can't take another hit.
NHI will spell economic ruin.
TalRussell 8 years, 11 months ago
Comrade Economists, the good doctor's opposition to Universal Health Care surprises few but yours is shocking.
However the economists profession from an economic perspective must know that medical care across our are increasingly out of the reach of thousands.at a time when health care costs have risen twice as fast as the out of paychecks workers have lost their jobs and that in itself is shamefully high.
Comrade Economist, the good doctor is not ashamed of his stand against UHC, are you too now joining the have-no-damn-shame club?
JohnDoe 8 years, 11 months ago
Tal your posts highlights the inherent contractions and lack of clarity of the proposed NHI scheme. Exactly what social or economic problem is NHI intended to solve. Is it being implemented as you state because medical care is out of the reach of thousands or is it because health care costs have risen twice as fast as the out of paychecks workers that have lost their jobs or is it because no Bahamian should have to plan a cook-out to cover medical costs or is it because poor persons should not be disadvantaged with no health care coverage or is it because access to health care is a fundamental human right. Economics as a discipline does not make value judgements, it is merely the study of the allocation of scarce resources in a society that have alternative uses. This means in simple terms that there are no free lunches in society. The reality is that transportation in a modern day society can also be considered a necessity and the price of a car is also out of the reach of thousands. Should the government also buy a car for every Bahamian? Further this debate, if you would call it that, has really only focused on the demand side, with little attention being paid to the supply side. When we increase the demand as this program is intended to, what happens to the supply. Every day doctors at PMH are playing God and sending people home to die because there are just not enough beds in PMH. In short whilst the goals of Universal Health Care may be laudable, public policy should not be evaluated on goals but on sober and concrete assessments about what societal problem we are intending to solve, what are the trade-offs inherent in our choices, what are the consequences of our choices and most importantly what incentives would the policy or program give to the various stakeholders to act in this or that way. This last point is critically important because it is my view that the free-rider, moral hazard and systemic corruption problems, which are already endemic in our Bahamian society, have not been fully captured in any NHI projections and will in my opinion lead to an explosion of costs to be borne by society and future generations.
Economist 8 years, 11 months ago
Tal, I am 100% for "real universal health", this is just a way to find more money to pour into a corrupt broken system by a group of people who either don't want to fix it because they are getting something at our expense, and there a quite a few of them, can't be bothered to fix it, or don't have the balls to fix it.
Publius 8 years, 11 months ago
Sands, just speak clearly man. You know exactly what Christie's agenda is about this. Stop playing games about you are hoping the PM has other ideas. You know he does not. Speak plainly about what is really going on and call the spade out fully instead of trying to soften the blow. The country and the healthcare system is at stake, stop being so concerned about offending these politicians.
Sign in to comment
OpenID