The Tribune

By DENISE MAYCOCK

Tribune Freeport Reporter

dmaycock@tribunemedia.net

THE first of a series of National Health Insurance town meetings in Grand Bahama was held in Freeport on Wednesday evening, however the lack of sufficient public notice resulted in a small turnout of residents at the Bahamas Union of Teachers Hall.

Dr Delon Brennen, NHI project manager, and Damara Dillet, NHI legal advisor, made a short, detailed presentation about NHI and took questions from the audience.

The first phase of NHI will provide access to primary care services, which is expected to come on stream by April –May. These services will be provided free at cost, Dr Brennen said.

He noted that undocumented migrants will be able to access public health care facilities, but are not eligible for NHI. Only Bahamians and legal residents will be able to register and enrol for NHI.

“You must have your NIB smart card with the microchip embedded in order to register and enrol,” he said. “When primary care services begin, all legal residents of Bahamas will have access to getting those services provided free of cost; you have to get your card to get your care.”

Dr Brennen said the advantage of access to primary care services under NHI is that persons enrolled will not have to pay a co-pay; meet a deductible; pay for medication or diagnostic tests, such as lab work, mammogram, x-ray, and ultra sounds, which will be free.

However, persons with access only to public health care facilities will have to pay a registration fee, pay for their medication, and for all their diagnostic tests, he explained.

“Around the country, we are improving health care infrastructure and you have seen these improvements already to all primary care centres. At the EMR clinic persons have access after hours so you don’t have to go into Freeport to get care,” he said.

Dr Brennen said that emergency services would need to be improved at the Rand Memorial Hospital in Freeport so that wait time is reduced.

“We want to make sure that as you pay for care it meets a certain quality standard,” he said. “We want to make sure you will get the best quality of care.”

Dr Brennen said the government decided to start first with primary care services because everyone requires it at least once a year, and a third of the population are not accessing right now because they cannot afford it.

Concerns were expressed by persons who asked why they should have to pay for NHI when undocumented migrants would have access to public health care.

Dr Brennen said that it is important that public health care is provided to those migrants to protect from the spread of communicable diseases that could impact the country’s healthy population.

There was also concern about whether it makes sense for persons with private health insurance to register for NHI.

Dr Brennen explained that while persons with private insurance will have to pay a co-pay, premium, and meet a deductible – none of that is associated with NHI.

“You can go to your insurance company and alter your plan when you register with NHI,” he said.

“Services covered in the first phase, there is no co-pay for it. So you can choose to keep private health insurance for whatever you want to keep it for, but you can use the same provider that you are using to access primary care services, and if you do there is no co pay and medications are free, diagnostic tests are free – all those with no co-pay. So NHI has added to your benefit without taking anything away.”

He said another option is that persons can make a proposition to their private insurance provider, explaining that they are currently accessing primary care services with NHI and no longer want to pay for those services.

He suggested that those with health insurance coverage could ask their respective companies to modify their plans to only pay for services that are not covered under NHI.

In the second phase, he said persons registered for NHI will be able to see who the primary care providers are and which insurance companies will be the administrators.

“They now will be able to select who they want to be their primary care provider and what private insurance company they want as their administrator,” he said.

When the provision of specialist care comes on stream in the next phase there will be the start of contribution payments to NHI.

After the meeting, Dr Brennen told The Tribune that the main concern most people had were whether they would have to give up their private health insurance.

“I think there are some very personal situations where people feel as though I would need to keep it, but the greater majority of the population feel they may not need to keep private health insurance because they can get those benefit through NHI.”

“So it really depends on people’s individual situations but (most) realise it is a benefit to them that they weren’t necessarily getting out of having their private health insurance.”

For those Bahamians who do not register for NHI he said they would not reap the benefits of the plan.

“Yes, you can be seen in the public sector, but registration fees that come along with it, payment for medication, payment for ultra sound, x rays - all of that would still apply because you are not signed on to NHI and so you have to find a way to pay for that, even in the public sector today you have to pay for that.

“NHI allows you to have a payment mechanism that where you don’t have to worry about that, but you can access it both from public sector and private sector.”

Dr Brennen said officials are still negotiating with primary care providers and private insurance companies.

“Once we finalise the negotiations, enrolment will commence,” he said.

Another town meeting is scheduled for Friday in McLean’s Town, East Grand Bahama.