The Tribune

By RASHAD ROLLE

Tribune Staff Reporter

rrolle@tribunemedia.net

THE “inconclusive” information the government has provided on National Health Insurance will make it difficult for insured people to make decisions about their healthcare, Bahamas Insurance Association Chairman Emmanuel Komolafe told The Tribune yesterday.

Mr Komolafe said the government has provided the BIA with excerpts of its NHI road map, however the body is still unclear on how the state-funded health scheme will function.

Though the NHI Roadmap is about 15 pages long, the BIA was only provided with about three pages of excerpts, he said.

With 12 days to go before NHI registration begins, much about the government’s primary healthcare scheme remains unknown.

Mr Komolafe said the BIA lacks details about how many doctors and healthcare providers will choose to participate in the programme.

“It follows therefore that the identities or names of the medical professionals and facilities that will be a part of the scheme cannot be determined at this time,” he said.

“This is an important point because the physician-patient relationship is a unique one; individuals often have doctors with whom they have built relationships for several years. The question also arises as to whether the PHC coverage under NHI and the PHC coverage under private health insurance policies will be identical and have the same quality; only time will tell. We expect additional information and details in the coming weeks as the government’s education and public relations campaign intensifies. However, it seems fair to state that the uncertainty and inconclusive information at the moment may inhibit the ability of insured groups and individuals to make informed crucial decisions particularly as it relates to their healthcare in a post-NHI environment.”

But the NHI roadmap, Mr Komolafe said, contains some key details about the role the NHI Authority and Insurance Commission of the Bahamas will play under the new regime.

“An extract from portions of the NHI Roadmap made available to the BIA suggests that the NHI Authority or Commission will have extensive powers and responsibilities,” he said yesterday. “The document indicates that this body will be assigned responsibility for the stewardship of funds presumably coming from the government’s consolidated fund and/or other sources. We also understand that the NHI Authority will be responsible for entering into agreements with payers, administering any risk adjustment mechanism as well as certifying and decertifying providers.

“It is proposed that the responsibility for establishing certification standards, setting rates for providers and quality functions will also be assigned to this body. We are advised that the role of the current insurance regulator - the Insurance Commission of The Bahamas (ICB) - will be expanded to cover regulated health administrators and the ICB will retain oversight for prudential matters such as licensing, solvency and capital adequacy.”

Nonetheless, Mr Komolafe said that in the absence of legislation on NHI, it is difficult to know for sure how the new regime will function.

“It is anticipated that the draft NHI Bill and accompanying regulations will provide much needed details and clarity on the registration process, governance structure, benefits package, administration, adjudication and responsibilities of the various government agencies and stakeholders in relation to NHI,” he said.

“More importantly, we are hopeful that the general public and currently insured persons will be able to get the information they need vis-à-vis the proposed scheme.”

The legislation, according to government officials, will be released to the public by the end of the month.

Registration for NHI is expected to begin on January 18 through the National Insurance Board. Officials have said NHI’s primary healthcare (PHC) package will be introduced in April.