The Tribune

By RICARDO WELLS

Tribune Staff Reporter

rwells@tribunemedia.net

MEDICAL Association of the Bahamas President Dr Sy Coolidge Pierre has denied that the Trade Union Congress and the Bahamas Independent Provider Association has entered into a partnership to advance National Health Insurance discussions, calling the purported agreement “distasteful and deceptive.”

In a statement, Dr Pierre said that no major healthcare provider or stakeholders in the country had in any way or form signed on with any Independent Provider Association (IPA) as stated by the Trade Union Congress (TUC) and Bahamas Independent Providers Associaton (BIPA) in a joint press release last week.

Dr Pierre said that members of the BIPA had recently met with the major healthcare providers and were given a clear and unequivocal “no” answer to their proposal.

He said BIPA’s public statement that the “major physician provider groups signaled their commitment and agreement” with the BIPA is an “outright untruth.”

Dr Pierre said he had personally spoken with the major providers and stakeholder groups and they have gone on record as saying that they have not agreed to sign on to any IPA agreement, including the one put forward by BIPA.

He confirmed that some members of a few of the medical associations had agreed to look into the “viability” of an IPA, but he claimed that is as far as it went.

He said he has contacted the Consultant Physicians Staff Association, the Consultant Physician Group of the Princess Margaret Hospital, the Bahamas Association of Primary Care Physicians, the Bahamas Doctors Union, the Bahamas Dental Association, the Bahamas Physiotherapy Association, the Bahamas Medical Technologists Association, the Bahamas Association of Insurance Agents and Brokers, the Bahamas Insurance Association, the Bahamas Pharmaceutical Association, the Bahamas Psychological Association and the Bahamas Chiropractic Association - all of which have denied signing on to the IPA.

“If the BIPA has major provider and stakeholder groups definitely signed onto an agreement,” as they have claimed in their press release, “they should make it public as I fail to see where the 2,000 providers are located. Maybe they are located outside of the Bahamas,” suggested Dr Pierre.

He further questioned BIPA’s credibility, saying that if the organisation planned to be recognised as legitimate, it had to first provide answers to several questions.

“Who are the executives of the organisation? What is the organisational structure? Is it a for-profit or non-profit organisation? What are the fees to be paid to the organisation and by whom? When and where was the organisation incorporated?

“Is it a wholly Bahamian owned/operated organisation or does it have non-Bahaman interests? That is, are we again going down the road of unproven foreign consultants? If there are foreign consultants, what is the remuneration scheme? Does the organisation have a track record of success or is this some hastily put together organisation to hijack the Bahamian healthcare sector? Does the BIPA have a client list proving a track record of success?”

Dr Pierre said the MAB – as the largest and officially recognised physicians association – refused to sign onto a BIPA agreement because it was not in the best interests of the Bahamian people, and could “potentially marginalise Bahamian physicians”.

‘Partnership’

Last week, the TUC and BIPA announced a partnership between the two factions seeking to make NHI a reality.

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

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.

However, despite this notion, Dr Pierre noted that MAB, the country’s largest and officially recognised physicians association, has no intention of signing any agreement that could potentially marginalise Bahamian physicians and act against the best interest of the citizens and legal residents of the Bahamas.

Dr Pierre raised several observations surrounding the BIPA’s service definitions, questioning the organisation’s marginalisation plan, its proposed electronic record system, potential bankruptcy issues, contractual negotiations, services models, the way it defines its IPA and a host of its outlays.

He said for these reasons and more, the Medical Association of the Bahamas is totally against any IPA being the primary instrument through which NHI is funnelled to provide universal healthcare.

Dr Pierre said while there has been a lot of confusion in the past as to whether most Bahamian healthcare providers were against NHI, nothing could be further from the truth.

He noted that MAB has lobbied for a proper universal healthcare plan for more than 30 years.

He said the group has long advocated for a scheme that would give a properly managed NHI plan to the Bahamas without any “upheaval” to the current system.

Dr Pierre stated that the system would have to fully use the present infrastructure, limit government expenditure, and provide a mechanism whereby benefits can be easily added if fiscally sustainable.

Additionally, Dr Pierre said the system would not only have to keep providers, but offer a system that future Bahamian providers would be proud of and want to fully take part in.

Parliament is expected to conclude its debate over the NHI Bill today.