The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamian insurance industry yesterday slammed the Government’s efforts to shroud its National Health Insurance (NHI) scheme in secrecy, explaining that this was delaying outside analysis of its own cost estimates.

Emmanuel Komolafe, the BIA’s chairman, told Tribune Business that wrangling over the non-disclosure agreement between the Association, its health insurer members and PricewaterhouseCoopers (PWC) had prevented the latter starting its independent review of the industry’s NHI cost estimates.

Asked to explain the hold-up, Mr Komolafe said that finalising the non-disclosure agreement had “stalled” because the Government had not agreed to transparency-related amendments sought by the BIA and its members.

“These changes, if agreed upon, would ensure that the BIA and contributing member companies receive a copy of the final report generated from the analysis of their data,” Mr Komolafe said.

“Additionally, the BIA had sought to incorporate a provision in the agreement that would allow the Association and specified member companies to reference the report in public pronouncements without any impediments.”

His comments will immediately raise further concerns that the Government is seeking to be less than transparent with the PwC review of both the insurance industry’s NHI cost estimates, and the ones produced by the administration’s own consultants, Costa Rican-based Sanigest Internacional.

Mr Komolafe also pointed out that, to-date, the BIA and Medical Association of the Bahamas (MAB) calls for the Government to release PwC’s first report on NHI’s likely costs appeared to have fallen on deaf ears, with nothing released to-date.

This will likely raise questions among many observers and critics of the Government’s NHI proposal as to what it has to hide, and why it cannot be more forthcoming with the Bahamian people and private sector over its plans and the scheme’s impact.

Differences over how much NHI will initially cost exploded into the open earlier this year, after the BIA argued that the scheme would cost $947.3 million to implement.

This produced s sharp riposte from Sanigest president, James Cercone, who accused the BIA of “comparing apples with oranges” because it had based its estimates on Aruba’s Expanded Benefits Package - not the smaller, less costly Vital Benefits Package that NHI will initially employ.

The Government has applied a $400 million price tag to the Vital Benefits Package, which it expects to finance from existing tax revenues in its Consolidated Fund and the ‘re-purposing’ of existing spending.

Mr Cercone previously told Tribune Business that the $400 million would come from the $260 million allocated to the Public Hospitals Authority (PHA) in the 2015-2016 Budget; the $30-$40 million received by the Department of Public Health; and the $60-$70 million currently spent by the Government on insurance premiums for civil servants and public sector workers.

Yet this does little to reassure Bahamian companies about having to fund NHI via increased taxation over the medium to long-term, especially given that Sanigest recommended that a payroll tax of up to 5 per cent be employed to finance the scheme’s $633 million expanded benefits package.

Mr Komolafe, meanwhile, told Tribune Business that recent interviews appearing in this newspaper confirmed that the BIA, MAB, Bahamas Chamber of Commerce and Employers Confederation (BCCEC), and the Grand Bahama Chamber of Commerce showed these organisations harboured similar concerns and reservations over NHI.

“It would be prudent for the Government to listen to the concerns of key stakeholders and take advantage of their expertise as we seek to achieve universal health coverage (UHC) in the Bahamas. These professionals are key partners and crucial to the successful implementation of UHC in our nation” Mr Komolafe added.

“What seems to stand out in all these is the consistency in the points raised by the various stakeholders. These include the state of infrastructure within the public health system and the capacity of the private health sector, the model being proposed to implement universal healthcare in the Bahamas, the actual cost estimates for NHI, the financing and funding of NHI, which speaks to the affordability and sustainability of NHI as proposed. Concerns have also been raised regarding the primary care framework and the utility of a public insurer at the expense of taxpayers.”