The Tribune

ACCORDING to the government its much touted National Health Insurance scheme will be released to the public by the end of this month, its draft legislation having just been approved by Cabinet. This draft, which is currently undergoing “final revisions together with stakeholders” has yet to go through all the legislative process — and don’t let’s forget this time that it also has to be Gazetted before it becomes law.

Although Bahamians, the recipients of government’s take-over of their health care, still don’t know what they are getting themselves into will be asked to start registering from January 18 — a mere 12 days from now. The National Insurance Board is to be used as its vehicle. Without registration with the National Insurance Board they will not be considered a part of government’s so-called free medical programme.

Never before have we seen a democratic government presume to corral its citizens like a herd of animals into a programme without informing them of what is expected of them and of what they should expect of their government.

If registration for the universal health care programme is to start in 12 days time, this suggests that it will start without the required legislation to make registration enforceable.

We can inform them right now that The Tribune will sign up for nothing until we are given all the information about this programme — even down to the fine print. In addition to National Insurance, our staff has private health insurance, and we do not agree that after all these years they should step down to accept anything less — or even to have to pay any more for what they are now receiving — just to accommodate government’s election plans.

As it now stands, the indigent are not turned away from the Princess Margaret’s Out Patients department, nor denied service at its free clinics. And if those who cannot afford private medical insurance, think that they will receive any better treatment than they now receive from government services, they will be sadly disappointed. We predict that the service will be even worse, with more disgruntled patients than they now have. Why? Because the Princess Margaret is even now not equipped to efficiently take care of its present patient turn-over. Yet when Government Health Insurance kicks in, the out patients lines will grow even longer with Bahamians having great expectations of superior medical service. The hospital will not be able to meet their expectations. When this happens, howls of angry protest will be heard as far up the street as The Tribune’s news room.

Trade Union Congress president Obie Ferguson has every right to back the Prime Minister’s National Health Insurance scheme, but he does his government a great disservice to tell Bahamians that their “cookout days are over”.

This is simply not true, because the insurance being offered does not take care of catastrophic cases requiring specialist care. It is for these cases that cookouts are held, usually to raise enough funds for families to send their loved ones to hospitals in the US. These are the promises that will create problems for the government when the people realise that once again they have been fooled.

Even Sanigest Internacional, advisers to government on this programme, has warned government of impending problems because some 114,517 Bahamians — or more than a third of the population – already have private insurance. This indeed presents a major problem when these people realise that their programmes are either to be tweaked or will have to be dropped altogether, thus forcing them to join the Princess Margaret Hospital queue.

In its report Sanigest, according to Tribune Business, said “The Bahamas has one of the highest private insurance penetration rates among countries seeking to implement a socialised healthcare scheme, and effectively warned the Government that the move to NHI would create private sector job losses.”

Said Sanigest: “This has important implications for NHI policy-making decisions, as it shows that over one-third of all Bahamians already have some form of private health insurance coverage. This is unique amongst most of the countries moving towards an NHI or other universal health care system, where the majority would have very low penetration of private health insurance.”

In The Tribune’s last interview with the private insurers, there was still much uncertainty as to how they will fit into government’s programme. Or, if not, would they have to reduce their own staff to adjust to the shrinking market?

If government were wise, it would concentrate on raising the standards of its present medical services before it talks of rolling out a programme that it is not capable of delivering.

Surely it is not going to rush into introducing another programme, which if properly planned could be of benefit to the less fortunate, only to have it join it’s growing list of failures — rising crime, the Bahamas Agriculture and Marine Science Institute (BAMSI), Bank of the Bahamas, failure to create 10,000 immediate jobs if elected, and the list goes on. With the failure of Baha Mar and the lay-off of more than 2,000 Bahamian staff the job promise quickly evaporated.

Will National Health Insurance join this list of failures because it was rushed into existence without the proper planning and consultation with the various partners whose full co-operation is necessary to its success?