By NICO SCAVELLA
Tribune Staff Reporter
nscavella@tribunemedia.net
A LEADING surgeon is blaming the government's tardiness in meeting its universal healthcare coverage objectives on "piss poor planning and piss poor preparation," expressing doubt that the Christie administration will "be able to put together a proper NHI scheme any more than they were able to put together a proper Carnival".
Dr Duane Sands, the former Free National Movement senator, suggested on Friday that the government is "nowhere near" where it should be in its quest to facilitate a proper January 1, 2016, roll out of its proposed National Health Insurance (NHI) scheme.
And, in light of the government's recent admission that it is behind schedule on meeting its objectives, Dr Sands said the Christie administration's approach towards NHI is no longer about "transformation of the healthcare system", but is now about "achieving political points" in time for the next general election.
To that end, Dr Sands suggested that come January 1, the government's modus operandi in rolling out NHI would likely involve providing eligible persons with a "NHI card", something he suggested would essentially serve as a placeholder until the government manages to bring the rest of the scheme's components on stream.
On Thursday, Health Minister Dr Perry Gomez revealed that the government is "a little behind" on meeting the benchmarks set by itself and its international consultants for a successful roll out of the proposed scheme.
However, Dr Gomez suggested that the Christie administration was on schedule to begin registering eligible people for universal health coverage in January. He added that the benchmarks set by both the government and its hired consultant, Sanigest Internacional, for a successful roll out are still within grasp, stating confidently that the government will "catch up" to those objectives.
However, a review of the lengthy Sanigest report, of which The Tribune has a copy, highlights seven milestones on an "Implementation Roadmap", four of which have deadlines that have long since passed.
The first milestone, labelled "Decisions on Financing, BP and Administration", was supposed to have been completed by November 15, 2014. The third, "Decisions on changes to public health system structure", was supposed to have been completed by January of this year.
The fourth goal: "Decisions on PPMs. Begin contract discussions with providers", had a March 2015 deadline, while the fifth benchmark, "Modifications to NHI and related legislation", had a deadline of April 2015.
While it is unclear whether the government has actually met some or all of those objectives, Dr Sands said given Dr Gomez's revelations on Thursday, there is no need to "mince words in terms of how far behind the government is relative to the absolute timelines that are set out in the initial Sanigest report".
"When you read the report and the recommendations as to the milestones that ought to have been achieved and the dates by which they should have been accomplished, they are not a little behind, they are many, many, many months behind the implementation of many of the things that would make for a reasonable, feasible, functional National Health Insurance programme," he said. "But as I expect and as I have said frequently, this is not about transformation of the healthcare system now.
"This is about achieving political points. And so I think that the goal of this administration would be to get people a NHI card. That's going to be the goal, and whether or not there are comprehensive, even primary healthcare initiatives that are introduced to make that card meaningful, that isn't what this party is about.
"You could give me a card but a card is a promissory note, and a promise is a comfort to a fool," Dr Sands added. "The question is whether or not you will have a significantly improved healthcare product that makes that card have some value. I could have a very beautiful pretty laminated or plastic card sitting in my wallet that ain't worth a crap."
NHI is set to be phased in over a five-year period. The government has allocated $60 million for NHI in the current fiscal year.
According to Sanigest, the scheme could cost up to $633m annually if implemented as a comprehensive package. On the low end, NHI could cost around $362m.
However, some have questioned the government's capability to facilitate a January 1 rollout, with others questioning the government's ability to secure funding for the scheme, and the potential effects that would have on a successful implementation.
"They are more than a year behind, so I don't believe that they're going to be able to put together a proper National Health Insurance scheme any more than they were able to put together a proper Carnival," Dr Sands said. "You know they throw that together in a couple of weeks. They didn't have an international headliner, they lost millions of dollars of Bahamian money. So the problem is piss poor planning and piss poor preparation.
"We throw something together and then we put a nice pretty label on it and say 'y'all ought to be satisfied with that'. Well I'm sorry, but when you're spending millions and millions of the people's money, then it ought to be spent carefully, there ought to be minimum wastage, the execution should be expert, and you ought to at least attempt to adhere to your absolute deadlines that you were the ones that created.
"When we talk about mortgage relief, when we talk about jobs creation, it was supposed to happen. Baha Mar was supposed to happen November, 2014. It didn't happen. NHI is now the last frontier."
He added: "This is the issue that is intended to win the next general election. When you look at the government's record on the various promises, whether its crime reduction, mortgage relief, jobs creation, economic empowerment, Bahamas for Bahamians and so on and so forth, they have failed on every single one of them. I don't think that's even a debatable issue. They have not been able to deliver."
In Sanigest's NHI report, presented to the government last year, the consultants suggested a payroll tax ranging from one per cent to five per cent to finance NHI. The report also explores various other revenue-raising options, including levying a "sin tax" on alcohol and tobacco.
Another option identified is a tax on auto insurance premiums and increasing the wage ceiling for National Insurance Board contributions. The government, however, has said there will be no new tax to fund the roll out of NHI.
Comments
OMG 9 years, 2 months ago
This man has talked more sense in this one article than every politician from both sides of the house has in the last 20 years. He is absolutely on the ball-everything in this country is show including education and to quote another common phrase the government and their appointed underlings "couldn't organize a piss up in a brewery with free beer.
Cobalt 9 years, 2 months ago
I agree with Dr Sands.
But I don't feel sorry for the Bahamian people. We're getting exactly what we deserve.
A bungling, incompetent, bush-league, failure of a people, deserve a bungling, incompetent, bush-league, failure of a government. Bahamians need to suffer! Thats what you get for voting PLP! Like the song writer said, "das what ya does get when ya tired ah what ya gat!"
Stapedius 9 years, 2 months ago
Dr. Sands makes some good points and I would agree that the NHI is not well planned. The issue I have with people like Sands and other doctors in this country is that they have been content to sit in a broken, run down system for the past 50 years. They've complained that PMH is not up to standard and that this and that doesn't work. But as professionals in the healthcare industry none of them have really endeavored to change much. In this country its all about lining ones pockets. We've had doctor after doctor as minister of health and still nothing has been achieved. It indicates to me that doctors should stay out of the political business and try to improve the industry from within. They pontificate about how skilled practioners of medicine they are and what they've achieved in their personal practice. I'm sorry but personal achievement in your small practice does not translate to the knowledge and capability to manage a health system. No one appears to have the guts to say they're out of their league and ask for help from those who know what it takes. Plain and simple we don not have the human resource to run this system. Healthcare is more than just doctors and nurses. That hospital in Exuma is going to be another classic example of government waste without planning. Where are the doctors, nurses and support staff coming from the run that facility?
Cobalt 9 years, 2 months ago
Very true. Well said.
sheeprunner12 9 years, 2 months ago
Yep we voted for the piss poor PLP ........... now we have to grin and bear it until 2017 ...... except Perry dies ..............because the others will prefer to have an election than follow Brave, Obie or Fred
TalRussell 9 years, 2 months ago
Comrades this story is misleading. Dr. Duane was against Universal Healthcare, from the get go, having absolutely nothing to do with the recent delay announcement. The medical profession should all be nationalized. Likewise the employers are opposed to paying their workers the minimum age of $250 week. I wonder how many of Dr. Duane's patients will be afforded an opportunity to have their tickers fixed, by issuing a promissory to pay him note for some time in the future? Who among the poor needs to be remained, who's the one playing red politics now?
birdiestrachan 9 years, 2 months ago
Doctor Sands should be ashamed of himself for using such language .I suppose this is a result of being very desperate, Now: Dr: Sands does not care about people. His only concern is how rich he can get. and he may feel this will steer some money else where . May the Good and Gracious God spare me and mine from all heart ailments. The man is heartless.,
birdiestrachan 9 years, 2 months ago
Does Dr: Sands know how to put together a proper carnival? But he sure does know how to lose elections.
ThisIsOurs 9 years, 2 months ago
Losing elections is beside the point. The point is whether the government has once again bungled the execution of another sparkly project. The answer is yes. Late again
Stapedius 9 years, 2 months ago
True losing elections has nothing to do with it. Dr. Sands' inability to win an election is not the issue. The challenge is to get an effective NHI system going which will be of benefit and not a burden to the Bahamian people. Though I reiterate the point that Dr. Sands and other senior physicians in this country have a lot to be ashamed of. They've grown their personal wealth for years without thinking about how to change the system for the wellbeing of their patients and the less fortunate in our community. So don't come now telling me that you've had some Einstein lightbulb moment after pissing around in the system for years. Same goes for Gomez and Minnis.
Islandgirl 9 years, 2 months ago
Spoken like a true PLP, birdie. Stick to what is germane, will you? He wasn't successful in elections. So what? That little side track effort had absolutely NOTHING to do with this thread. Your demigods are great at smoke and mirrors. You're not at that level yet. Fail.
TalRussell 9 years, 2 months ago
Comrade Dr. Duane is not unlike Minnis and Loretta. The Reds Shirts can't win come the 2017 General, since neither of the three isn't really playing the political game to win.
They are not political warriors engaged in a "war" willing to fight to their deaths, like the PLP enemy.
How could they when Dr. Duane knows, only how to strike at a topic then run from the battle. If you don't stick around to do battle, you are not equipped to fight the 2017 General war.
The doc flips from topic to topic and only sticking with it long enough get his name however briefly printed onto the pages of a newspaper, mainly the reds own journalists upstairs over at The Tribune.
Strange that the two MOST rejected, after we exclude former red chairman Darron, by their own red shirts at convention, are attempting to unseat their duly elected leader.
You go figure that one out how the three loudest, were convention embarrassingly rejected.
MonkeeDoo 9 years, 2 months ago
A leading South Florida surgeon has told the powers that be that if the United States with 400 million people contributing to Universal Healthcare can't make it work that the Bahamas with 400 thousand doesn't have a hope in hell. But fowad and onwad we go. Asses all.
Stapedius 9 years, 2 months ago
The US is unable to make an nhi work for a number of complex reasons. It is an over simplification and utter nonsense for such an assessment to be made purely on numbers. If it were that simple then ask this surgeon how small European countries are able to achieve it. True, they pay high taxes but there are multiple factors to the implementation and running of a health system. So tell him to keep is nose out of other people's business and fix the gross disparities in the US health system.
TalRussell 9 years, 2 months ago
Comrades stop believing the Republicans lies. If they could repeal America's Universal Healthcare, are you even aware, that overnight 1 in 2 Americans with "preexisting medical conditions" would have NO medical coverage?
You reds are also missing the another important point. The red party has no leader visible in the wings, who come the 2017 General, can set safe sail of the nation's mail boat of state.
Emac 9 years, 2 months ago
Duane Sands for leader of the opposition and Loretta Butler-Turner for DP. What say ThisisOurs?
TalRussell 9 years, 2 months ago
Comrade Emac, best your selection chief seaman's and seawoman's, which I might add were both just recently rejected at convention by their own red party members, don't dare attempt to navigate the red Mail Boat out the harbour - unless them have broughts with them a First Mate aboard - unless they has qualifications in steering non seaworthy bigger boats out Nassau Harbour.
In the case of Dr. Duane and Loretta, the also useless render them any sailing assistance as the Harbour Boat Pilot on duty, would be non other than their party's also rejected former chairman Darron.
But thanks for the early Monday morning political laughter.
Emac 9 years, 2 months ago
The red council members don't seem to know what the people want.
TalRussell 9 years, 2 months ago
Comrade, why would you say the red party members glasses are half empty but nothing about they're being half full on knowing they sure as hell, don't want Dr, Duane, Loretta, or Darron, in leadership roles.
Don't you has wonder what would be Papa Hubert's fate, if he should decide return? But him smart enough, not to put his popularity to a test before a convention - him will just try slip in under the red memberships radar. Sure looks likes the red membership got to Comrade former deputy prime minister Frank, to order him change his anti Minnis tune. Him sure seems has retracted so quickly to avoid red political blood flowing out windows their Mackey Street headquarters, right?
Emac 9 years, 2 months ago
@birdiestrachan-You say,"Doctor Sands should be ashamed of himself for using such language" Now what would you rather? Having a politician use the word 'piss' in a frank discussion, or having politicians piss on you like the current government??? Apparently you prefer the latter, don't you?
Sickened 9 years, 2 months ago
It is natural for Tal and Birdie to support this PLP pipe dream because neither of them have private health insurance and neither of them work or would have to contribute part of their salary to this scheme. They both line up a PMH simply to get some cough medicine. These two depend on free health care and only want their to be a bigger budget so that they can go see the better qualified doctors with clean offices and personable staff. The rest of us are used to going to a GP who's knows ours names and the names of our kids. We don't like the thought of having to contribute 3% of our salary for a health scheme knowing that we will also have to keep and pay for our private health coverage. This is just another burden on the middle class and another free ride for the poor.
Tal/Birdie - how's the line at PMH today? Are there any Bahamians waiting on line with you?
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