The Tribune

By KHRISNA VIRGIL

Deputy Chief Reporter

kvirgil@tribunemedia.net

NATIONAL Health Insurance Project Manager Dr Delon Brennen yesterday rejected criticism that the government’s $24m catastrophic fund is insufficient to cover those who fall under the specialised care category, as he stressed that the fund will be used in addition to the provisions already in use in the country’s public health system.

However, he admitted that the government is still in the process of designing the best way to execute the catastrophic fund.

Asked if it were possible that the catastrophic fund could be expanded once officials decide how it will be put in place, Dr Brennen said this is a policy decision that the government will have to make.

Dr Brennen was responding to Senator Dr Duane Sands’ comments last week when he told The Tribune that while the Christie administration has earmarked $24m for the special medical fund, it is not nearly enough and will only assist a maximum of 30 people.

He spoke to reporters at the NHI Secretariat building at East Street during a press conference to announce the government officially issuing a Request For Proposals (RFP) for services relating to the public insurer under the NHI plan. Officials insist that a public insurer will drive the most cost effective and fair NHI model.

“We know that our healthcare needs as a country do lay out that there are people who are unable to access those services,” Dr Brennen explained, “so the government has said that we’ll have this $24m fund available to be able to start implementing those things that we know are affecting those people in the population.

“We are currently, much like we are with some other parts of the system, designing how that is going to happen in consultation with healthcare providers in country and administrators of healthcare plans and our healthcare facilities. So we have brought together levels of healthcare expertise within country to figure out what’s the best way to do this. In addition we are using models from other jurisdictions to be able to do this as well.”

He added: “As you can imagine there are many jurisdictions out there that know that what they are putting into the healthcare system right now whether it is primary care or other specialised services does not address every health need.

“So they have funds that are often set aside to do something very similar and so they have administrative practices where they either have algorithms or logic models to deliver that care or they have committees of healthcare experts that are put in that reviews each of those cases and then says this meets a certain threshold. In doing so we get to use that fund for this delivery. It does not ignore for those who may not meet that threshold. It is designed to make sure they get into the system whether that’s in the public sector or private sector using the current resources that we have in those because we haven’t removed that.

“We haven’t taken away the Public Hospitals Authority (PHA) and the tertiary care institutions. We haven’t taken away the private sector. Those are still there. What we are saying is this is additional funds that we haven’t had available to us before that we’ll be able to use for others who weren’t able to get care. But now we are going to figure out a system of how do we get people into that funds system, but also making sure we integrate all care across the system so that beneficiaries will still be able to get care whether at the PMH, the Rand or at other healthcare institutions in the country using funds we already have in the system.”

On August 14, Dr Sands told The Tribune that when NHI’s primary care phase launches, “thousands of Bahamians will continue to die.”

He said it is “disappointing” that 30 years after the discussion on universal healthcare began that “this is as far as we have come.”

“The government has not even defined how much money Duane Sands will get if I need surgery,” he said at the time. “Is there a limit? Does everyone get 10, 15, 50, 100 thousand?”

“And when you do it like that, it opens up a huge opportunity for allegations of abuse. Who decides who gets help and how much money the person will get? What is the difficulty of defining this before the legislation is passed? So when Susie Smith needs heart surgery or expensive chemotherapy she is expecting NHI will help her. Let’s be honest and say ‘No, ma’am, not for another 10 or 20 years.’ So a number of Bahamians who believed NHI would have saved them or their loved ones will find out otherwise. While this plan will put us on the road to improved patient care, it will be a generation before we see the real benefit and thousands of Bahamians will continue to die,” he said.

Dr Sands said the government currently spends $800m on healthcare so $24m is “nowhere near” what is needed to help those with catastrophic illnesses.