The Tribune

By RICARDO WELLS

Tribune Staff Reporter

rwells@tribunemedia.net

AS parliamentary debate on the highly anticipated National Health Insurance Bill started yesterday, several of the country’s foremost medical and trade unions claimed that they have committed themselves to a partnership that seeks to make the NHI vision a reality.

In a joint statement by the Trade Union Congress (TUC) and the Bahamas Independent Provider Association (BIPA), the two groups laid out the parameters of their newly developed Independent Provider Association (IPA) concept proposed to ease the implementation of the government’s NHI programme.

The two groups indicated that their IPA would seek to present a consensus for services to be provided through NHI, along with any and all fees that would be associated with those services.

Additionally, the IPA will look to present a consensus on the sharing of resources for optimising efficiencies of their practice; being accountable for the services they offer and ensuring the evidence of the best patient outcomes and satisfaction.

The groups claimed that they have reviewed and incorporated the lessons learnt from Managed Care Systems in North America, which despite shortcomings, reduced the rising costs of health care in the Americas.

Their statement read: “As the government moves forward to formalise the implementation process, the public can rest assured that Bahamian physicians are committed to participate as providers, citizens and patients. Doctors are obligated not only to care for patients but also to be mindful of the need for affordability.”

The statement continued: “An Independent Provider Association (IPA) functions to provide a holistic and co-ordinated approach to treating illness and maintaining and promoting health and wellness on the one hand, and on the other, ensuring that the health care provider delivers care that is efficient, timely and cost-effective.”

The IPA model put forth by the partnership supports the consolidation of the healthcare providers, the membership and the capital resources in a collective bargaining arrangement to meet economies of scale and to support health system strengthening.

“The IPA further recognises the wisdom in the phased approach to implementing the NHI Plan, but also the need for some element of Catastrophic Care from the onset of introducing the NHI Plan,” the statement added.

The groups noted that for the average Bahamian, the measure of value of the NHI plan is affordability and access to needed healthcare services.

The groups claimed the proposed IPA, through its alliances, would lend itself to public-private partnerships for services to be provided at lower cost without the government having the encumbrance of capital outlays.

As a result, the group said a number of secondary and tertiary care services, now cost prohibitive for many, can be accessed accordingly.

The statement added: “In so doing, catastrophic services can be introduced at the onset with the primary care introduction as well, thus allowing for one of the most fundamental tenets of universal care to be realized: equity – those who need care, can get the care they need, and those who need more, can get more,” the statement added.

“As a means of providing additional coverage for catastrophic care, the IPA supports private insurers’ participation in NHI where they can provide reinsurance and supplemental insurance to strengthen NHI, and to create safe risk sharing arrangements that will allow for financial solvency in a climate where there are no additional taxes to support NHI.”

The groups indicated that the IPA model was developed based upon the principles of managed care that emphasises the need for contractual arrangements; health education and prevention; and micromanagement and constant surveillance.

The TUC encompasses 16 affiliate unions and five observer unions representing more than 80 per cent of the country’s union population.

Moreover, the IPA is claimed to encompass eight provider organisations representing over 70 per cent of the Bahamas healthcare providers.