By NICO SCAVELLA
Tribune Staff Reporter
nscavella@tribunemedia.net
GOVERNMENT officials are debating whether to impose a penalty for individuals who choose not to enrol for National Health Insurance, an NHI Secretariat representative said yesterday.
Damara Dillett, NHI Secretariat legal consultant, said while officials are currently of the view that a penalty “ought not be imposed directly,” they realise that there must be “some consequential effect” if the scheme is “to have the teeth that we need it to have.”
She said officials are now tasked with coming up with “some happy medium” to ensure that the plan is not jeopardised if many individuals do not enrol.
Ms Dillett also said that the NHI draft legislation, which was due for public release on Monday, has been revisited by officials due to concerns raised by stakeholders. She said the legislation would be released for wider stakeholder community once the concerns have been addressed.
A draft version of the NHI Bill 2016, which was leaked to the media last week, contains a clause that suggests that enrolling in NHI will be mandatory.
Section 17(1) of the draft bill states: “Every person who is eligible for the plan must enrol in accordance with prescribed regulations and at the time of enrolment shall be required to: select a primary care provider from the approved list of providers published by the authority by notice in the gazette; and select an administrator from the approved list of administrators published by the authority by notice in the Gazette.”
If enshrined into law, it would mean that Bahamians would essentially have no choice but to enrol in NHI.
“That has been the basis of a very heated debate over the last five to six days, whether or not we’re going to impose a penalty for individuals who chose not to enrol,” Ms Dillett said yesterday at a monthly meeting for the Bahamas Society of Engineers. “What we have done is prepared – and I believe that that policy paper is going to be issued for the decision makers to review and come down on a final decision.
“The current feeling is that the penalty ought not to be imposed directly, so for example a fine, imprisonment, that sort of thing. But we do realise in order for the provision to have the teeth that we need it to have, there must be some consequential effect.”
She added: “Here, we have to look at all the shades of grey and come up with some happy medium as to how we’re able to ensure that the plan is not jeopardised if individuals do not enrol.”
Regarding the draft legislation, Ms Dillett explained that NHI officials held a workshop with the medical community over the weekend, during which “one or two concerns were raised and caused us to go back to the drawing table to see how best we can incorporate or accommodate some of the concerns that were addressed over the weekend.”
“We do hope that in short order, hopefully within the coming days that we’re in the position to release this particular bill for individuals in both the stakeholder community as well as the wider public, to take a look at, review, comment, provide us with their comments and concerns and allow us to incorporate where necessary certain provisions that we may have overlooked,” Ms Dillett added.
The NHI legislation will provide the legal foundation for NHI. NHI registration began on January 18 through National Insurance Board outlets.
Comments
TruePeople 8 years, 9 months ago
submit or suffer = PLP
DillyTree 8 years, 9 months ago
This is complete extortion! If the NHI system is so wonderful, then why isn't everyone signing up in droves? There's a clue!
No way am I signing up for this absolute farce of "health coverage". I like my private insurance just fine, thank you! I pay a lot for it (and it's a choice I make by eating out less or taking less vacation, driving an older car, etc.), but I know what I'm getting, and I also am not stupid enough to think you get something for nothing, as NHI would like us to believe.
jackbnimble 8 years, 9 months ago
Of course you won't. NO insurance ever gives you back what you put in. Most of us will never recover more than 10% of what we put in. Like NHI, it will be a slush fund with only a few persons really benefitting and the well taking care of the sick.
killemwitdakno 8 years, 9 months ago
It's to cover all the people that never pay which is cost to the hospital.
sealice 8 years, 9 months ago
i am not to worried about any consequence - they can't arrest all the criminals here but they are going to start locking people up for not signing up? We're all gonna have to pay the bloody tax regardless = this is a good step towards communism which daily it appears the PLP is leaning more and more towards under the guise of socialists (sounds like nazi's and hitler really)
GrassRoot 8 years, 9 months ago
it is a socialist approach. If you are rich and get caught with a gun, you pay 15,000 BSD fine. If you are poor and get caught with a gun, they book you and let you go and if you are lucky you get your day in court. This is how this country is run. See they will go after the honest people and will let the crooks of the hook. Look at the BOB loans, look at the big accounts at BEC, look at the selective property tax enforcement
TruePeople 8 years, 9 months ago
They let people 'good son' go is what....
sheeprunner12 8 years, 9 months ago
Is NHI going to be like union dues??????? Even if you don't join the union, you still have to pay 90% of the dues as "agency shop"????????? ............ do we hear that in this statement??????
asiseeit 8 years, 9 months ago
Keep pushing, sooner or later the people will push back. Haiti, here we come!
themessenger 8 years, 9 months ago
How can you penalize anyone for refusing to sign on to something that has not even be properly legislated, debated and passed in both houses and Gazetted? Oh, I forgot that the law of the land don't apply to yinna.
Rontom 8 years, 9 months ago
In all healthcare systems that are nationalized enrollment is mandatory with the possibility of disincentive not to do otherwise. This is similar but not the same as NIB.
The thing is everyone can agree that the healthcare system has to change for the following reasons: inadequate medication supplies, long waits at ER, limited access to operating rooms, long waits to see specialists... What is immoral about this is that it's your money that is being used and you don't have equitable access to medical care that you paid for. So since there are only twenty ICU beds and all are filled and your mother has aneurysm that is bleeding and there is no bed available because all other patients are also critical and you cannot afford private care; you cannot afford a flight to Miami, what is left is she receives sub-standard care in a less than favorable ward where the nurses are not ICU trained and the outcome is not good most of the time. That is why NHI is needed. Access. Availability. Affordable. Timely.
GrassRoot 8 years, 9 months ago
Agree. concept of adverse selection. the people that can not afford insurance will sign up for NHI, and these are the people that did not invest in their health in the past, hence are not only the biggest risk, but also the biggest cost factor in the whole system. NHI needs healthy, wealthy people to balance this out. Now the problem is as you pointed out, that the mandatory systems work only in environment where also the healthy wealthy people get something out of the health care model (short or long term) and the money is properly accounted for, else it will be seen as another tax. The current situation is such, that I would think most people that are part of the groups carrying the burden of financing this government through VAT, NHI, Duty, etc. are against the system. The government better do everything to win these people over else this NHI will be a DOA: A second class medicare system, run by corrupt doctors and administrators, overseen by corrupt government officials, that has no incentive to provide decent services to the ones of our society that need it. In other words, we will be worse off after implementation altogether.
Rontom 8 years, 9 months ago
Ahhh, GrassRoot you pretty much nailed it. My one caveat is this: you are correct--NHI scheme presumes sufficient healthy, paying people to carry the load for those who are mostly ill who cannot afford to pay: socialized medicine. But, sometimes, Healthy people have babies with complications that require medical/surgical intervention that can cost as much as $750,000. (Believe me I know first hand). And then that same family can have a member that develops cancer and that along with your outstanding will send you to the poor house. And thus NHI can benefit you. Also, eventually, we will ALL need medical intervention as we get older and every year the cost of healthcare goes up and up and up. So with the meagre pension and gratuity money (because the private insurance WILL drop you after 65yrs or premiums will be on the scale of $1200- $1500 per month--assuming you ARE healthy at that age, which is unlikely) you are not able to afford the care you need at that time and so NHI is needed.
But you are soooo correct. Corrupt doctors and administrators and insurers left to manage $850 million a year is asking for trouble without PROPER and I mean HONEST oversight... and on that note, I just don't know if we could do that in this climate without serious uprooting reform in how we do things.
killemwitdakno 8 years, 9 months ago
Yes, they needed to fix everything first.
killemwitdakno 8 years, 9 months ago
Stupid idiots. No because that's communism, imposing on civil liberties.
Emac 8 years, 9 months ago
Dey mean dey gon charge dey Mar ay? Talkin' fool is a very serious ting, hear Ms. Dillet???!!!
killemwitdakno 8 years, 9 months ago
Of course in order for everyone to be covered, everyone has to afford it. This fundamental needed to be planned out before, or it means NHI is not ready. It's either fake or an obligation we don't know about. Figured they could slip this part in last minute to force it.
1 If you don't get it, be billed at an increased cost. 2 Deduct from VAT return (for businesses who choose private employee coverage). 3 Benefits to enrolling within a timeframe and at an early age. 4 Force insurance companies to include affordable government packages. 5 No deductible for those who enroll this first year, if needed before a minimal amount was contributed, just continue paying like an early Asue win. 6. A fee for switching to private. 7. Web shop gaming privilege revoked for missed payments , any illegal winnings will be confiscated from the supplier before being paid out.
Freedom Secured
Now what the hell is going to cover the cost of more foreign practitioners required?
stislez 8 years, 9 months ago
this wouldnt even be a big conversation if people wasnt relying on insurance an doctors for their health. Health is a FOOD CONCERN! not a insurance or doctor concern. I understand a doctor has his/her role to play when it come to health, but we as individuals have a greater role than the doctor for ourselves. If your food is your medicine, the need for a doctor is very limited therefore giving you less chances of having a health related issue. We need to stop DEPENDING on doctors to take care of us, lets acknowledge the power god give us and learn about our bodies, learn about the foods designed for our bodies so that we can help each other. Our bodies is a balance of Alkaline and Acid, Alkaline being the healthy side, so eat Alkaline food to keep your potential hydrogen 7.0 an above, drink natural spring water or alkaline water, stay away from meat, starch, fat, unnatural sugar, dairy products. Smoke weed or vaporize it, juice it, cook with it. Learn about our african foods cuz das where we from. When these things happen, we will create a whole different conversation which in my opinion is a wayyyyyyyyyyyyyyyyyyyyyyyyyy better one than this.
DisgustedBahamian 8 years, 9 months ago
Where is Mrs. Pindling's fine for not paying her taxes for 14 years, & Leslie Miller's fines for not paying BEC $250,000.00 ??? They never turned his power off much less fined him. Politicians need to obey the same law that the citizens have to, even more so because they should lead by EXAMPLE... What a poor job they are doing.
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