The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

A well-known physician yesterday warned that political expediency still threatens to undermine efforts to create a properly-functioning Bahamian universal healthcare (UHC) scheme, which could be devised within six months.

Dr Duane Sands warned that the Government could undo all the progress created by its recently-revised approach to healthcare reform if it decided to rush a scheme into being simply to boost its re-election chances.

Speaking as the National Health Insurance (NHI) Advisory Council held its first meeting yesterday, Dr Sands said acknowledged that its formation represented an effort by the Christie administration to develop a more ‘inclusive’ approach to healthcare reform.

Suggesting that this could “reap huge benefits”, and lead to more affordable, better quality healthcare for the Bahamian people, he suggested that a workable UHC scheme all parties can live with could be developed with six months’ “hard work”.

However, Dr Sands said all this good work would be compromised if the Christie administration, seeking something to bolster its election prospects, sought to introduce a UHC scheme regardless of whether it was the right model and/or ready.

“It seems as if there has been a considerable readjustment to the schematic approach to NHI in general,” Dr Sands, the FNM candidate for Elizabeth in the upcoming election, said.

“What is happening is that they are now doing what they should have done two years ago. I think they are finding that is reaping huge benefits in terms of the successful planning and implementation of NHI.

“I think they’re also realising that many of the stakeholders are not devils or anti-NHI, or opposed to UHC, as they may have thought. They were fighting windmills that don’t need to be fought.”

NHI is merely one option for financing a UHC scheme. The UHC Stakeholders Advisory Council, which met yesterday with the NHI Secretariat, has been billed as a major overhaul of the scheme’s governance, and an attempt to involve all healthcare industry professions in its design.

Dr Sands argued that a working UHC scheme could be designed within six months, provided all healthcare industry stakeholders were “on board” and actively participated in the necessary work.

“I think Dr Perry Gomez, the minister of health, wasn’t too far off when he said about six months,” he told Tribune Business. “But I’m not sure the main stakeholders have been adequately engaged yet, certainly not as a group.

“The challenge is six months of hard work. If we can get everybody on board, and they make the appropriate contributions, it could definitely take six months start to finish. I don’t see any reason why it couldn’t be done.”

Despite castigating the Government for wasting two years by not adopting the Advisory Council approach earlier, Dr Sands added: “Some things are happening, and I believe that if they continue, the benefits will be significant. They’re definitely on the right path.”

In truth, the Government was forced to alter its healthcare reform approach after running into opposition and push back from virtually all players in the industry.

Without their support, and especially that of the private primary care doctors, the implementation of the NHI structure being pushed then was simply impossible.

However, Dr Sands expressed concern that the Christie administration may again succumb to political pressures in the run-up to the general election, which is likely to be called by May 2017.

“My concern is the overarching political imperative,” he told Tribune Business. “There is a finite clock. Ultimately, the decision will be made to go with something, whether it is the right approach or not. The political imperative to do something looms, and looms large.”

Dr Sands said the Government’s desire for a social programme that it could promote as a major accomplishment to the Bahamian people was “the underlying driving force for the introduction of NHI”.

He said the KPMG accounting firm, the latest health reform consultants, had managed - for the moment - “to steer them in a more reasonable direction” on UHC/NHI than previous advisers.

“They [the Government] arrived at this conclusion at the 11th hour,” Dr Sands told Tribune Business. “It’s no fault of the participants that the Government finds itself running out of time. It’s their fault they’re running out of time.

“The challenge will be that they want to do something, and do enough for people to touch and feel and say they’ve experienced NHI.

“This is not going to be something that does it right, does it properly and leads to the best outcome for people paying for it, the Bahamian public.”

Dr Sands continued: “The Prime Minister said some will reap, and some will sow. This is an example where, if he follows his own advice, he will be interested in creating something in which he will repose tremendous pride.

“I am not certain he is going to resist the temptation to roll this out before it’s ready for prime time. We’ll have to see. The challenge is they have very little of which to be proud as it relates to programmes impacting the life of the average Bahamian.”

Dr Sands said this was why the Government had elected to revive its Mortgage Relief Plan, and announce numerous other social initiatives, such as programmes to tackle youth unemployment, in its 2016-2017 Budget.

Turning back to UHC, he added: “Everybody is on board. I don’t think you have a single individual opposed to UHC, or even NHI.

“But now that they have been engaged, let it be a real engagement as opposed to window dressing or a footnote.”