The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

Bahamian insurers yesterday hit back at the rosy National Health Insurance (NHI) picture being painted by the Government’s chief consultants, arguing that their comments should be “taken with a pinch of salt”.

The Bahamas Insurance Association (BIA), in a riposte to comments by Dr Mark Britnell, head of KPMG’s 4,000-strong global healthcare practice, denied his suggestion that the industry had met with the accounting firm on NHI last week.

The Association, in a hard-hitting statement, also directly contradicted Dr Britnell’s glowing assessment of the Government’s NHI Policy Paper, describing it as “lacking in substance”.

Reiterating its belief that NHI’s public insurer, Bahama Care, has “no economic justification” and is a political tool, the BIA also called on the Government and KPMG to release studies showing that $100 million is enough to finance the scheme’s first primary care phase.

The insurance industry queried how KPMG could have concluded that $100 million is sufficient when the fees that NHI will pay to doctors and healthcare providers have yet to be determined, along with payment mechanisms.

While again backing the universal healthcare (UHC)scheme that NHI promises to create, the BIA again argued that “there continues to be a carefully orchestrated plan to silence the voices of reason and dismiss genuine concerns about the proposed scheme”.

And, while Dr Britnell described the Government’s NHI Policy Paper as being among “one of the finest” he has seen, the insurance industry begs to differ.

“The recently released NHI Policy Paper, when compared with similar documents on an important national issue such as UHC/NHI from other jurisdictions, is lacking in substance,” the BIA argued.

“The Policy Paper is akin to marketing material or a brochure rather than a document that provides a detailed road map for UHC and NHI in the Bahamas. It falls short of our expectations, is quite disappointing and fails to meet the higher levels of transparency and disclosure alluded to by Dr Britnell.”

While acknowledging the KPMG chief’s qualifications. and high regard in which he is held, the BIA suggested his hiring was designed to give the Christie administration’s NHI scheme a much-needed credibility boost.

It added that KPMG had been tasked with making NHI a reality, and was a paid Government consultant. “This constrains us to take some of their comments with a pinch of salt when compared with the observations of their predecessors and other experts in the field,” the Association added.

“The BIA’s position on the establishment of a public insurer is clear and has been articulated on numerous occasions. Based on feedback received from government consultants and officials involved in NHI, it is clear that the establishment of a public insurer is political in nature and has no economic justification.”

The BIA also denied Dr Britnell’s suggestion that the industry body had met with KPMG over NHI last week. It added that inquiries with its major health insurance members “leave us in the dark” as to whom KPMG met with.

Calling for greater transparency and “true consultation”, the BIA demanded “the immediate release” of KPMG’s report on how much NHI’s primary healthcare phase, which is supposed to launch in January, will cost.

“This is extremely important to ensure full disclosure on the assumptions supporting their conclusions on the cost, including but not limited to fees to be paid to healthcare providers, administration costs and utilisation rates built into their costing model,” the BIA said.

“We are advised that negotiations on capitation and administration fees are at preliminary stages and, in some cases, have not yet commenced.

“Hence, it is unclear how the overall cost was verified or validated unless the Government plans to present its terms to stakeholders on a ‘take it or leave it’ basis, leaving no room for negotiation.”

The BIA also demanded that the Government release all reports and documents related to NHI, the public healthcare system and Princess Margaret Hospital (PMH).

“We note that despite numerous requests, the Beck Group report, which was heralded as the ‘master plan’ for the overhauling of PMH, has not been released to date,” the BIA said.

“In fact, none of the consultant reports relating to NHI (paid for by taxpayers) have been voluntarily released to date. Rather, they have been leaked to the public through the media. This unfortunate lack of transparency must be improved upon if we are to work together to build a healthcare system that we can all be proud of.”

Calling for NHI to be both affordable and sustainable, the Association added: “The promotion of this programme should not be carried out with deliberate economising of the truth and use of political rhetoric to paint a false picture.”