The Tribune

By RASHAD ROLLE

Tribune Staff Reporter

rrolle@tribunemedia.net

HEALTH Minister Dr Perry Gomez yesterday hinted at how the government may decide to fund the National Health Insurance scheme as it expands in scope, noting that other countries have taxed “unhealthy substances” like alcohol and tobacco as well as high salt and high sugar products to fund healthcare.

It was the closest a government representative has come to discussing how it may fund the ambitious and expensive plan.

His comments came during tabling of the NHI bill, which would implement an NHI plan, establish a National Health Authority and a National Health Insurance Fund.

He positioned the NHI project in a long line of progressive accomplishments achieved by the PLP, similar to the establishment of the National Insurance Board (NIB) and the imminent establishment of the University of the Bahamas.

However, Dr Gomez did not say when the first phase of NHI––primary healthcare––will be introduced nor did he provide a timeline for events relating to the scheme.

It remains unclear, for instance, when the government will release requests for proposals to establish a public insurer, something the government’s consultants say will take about eight months to get up and running and will be critical to the roll-out of primary healthcare.

“Careful consideration is being given to the mechanism by which funds are acquired to be available to sustain the financing of healthcare,” Dr Gomez said.

“This pillar is critical because healthcare costs tend to escalate at a somewhat unpredictable manner globally, so as a developing country, the Bahamas must pay particular attention. In this regard, a decision has been made not to introduce any new taxes directly linked to healthcare. Innovative and creative adjustments are necessary to effect implementation within the present budget. With a particular focus on cost savings and changing of the model of healthcare delivery from a mainly in-patient system to a primary care out-patient system, this will be accomplished at the outset.”

“Some countries have levied contributions on unhealthy substances including alcohol and tobacco products. Also additional costs are added to food items with undesirably high salt and sugar content.”

Dr Gomez also expressed support for public-private partnerships as a means to help fund healthcare.

Elaborating on the role of the National Health Insurance Authority, he said the new “quasi-government” body will conduct the work of NHI.

“The Authority will be responsible for setting and policing the standards to ensure a high standard of healthcare and fiscal performance is maintained,” he said. 

According to the bill tabled yesterday, the NHI Authority will play a central role in the administration of NHI.

It will, for instance, enrol people eligible to receive benefits under the plan and register providers and administrators eligible to participate in the plan.

It will also settle the rate of payment for these groups.

Dr Gomez said the government spends about $400 million annually on “all aspects of healthcare in the country.”

To ensure that the pursuit of NHI isn’t accompanied by an initial increase in taxes, he said there has been a greater focus on oversight with a view toward “upgrading regulations and operational policy guidelines.”