The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamas Insurance Association’s (BIA) chairman says the industry is “challenged” to provide comprehensive feedback on the National Health Insurance (NHI) Bill because the Government has yet to release the accompanying regulations.

Emmanuel Komolafe said the regulations, which typically contain “the meat and teeth” to support any Bahamian laws, were “very important” in relation to NHI because the draft Bill frequently refers to them.

Without the regulations, he explained it was extremely difficult for the BIA and its members to conduct a thorough review of the Bill, and provide informed recommendations to the Government, because so much remained unknown.

While confirming that the BIA was assessing the NHI Bill, Mr Komolafe told Tribune Business: “In the absence of the regulations, it’s kind of difficult.

“The regulations have the details, and that’s where the meat and teeth are documented. There are a lot of references to the regulations in the Bill, and if we don’t have the regulations, we cannot make informed decisions and provide comments that are useful.

“They’re extremely important, especially in this case, as so much is supposed to be included in the regulations,” the BIA chairman added.

“The BIA is currently conducting a thorough review of the draft legislation. However, the absence of the accompanying regulations which is expected to contain important details on the proposed scheme makes it quite challenging to conduct a comprehensive review.

““The BIA formally wrote to the NHI Secretariat on Monday, February 29, 2016, expressing our concerns about the inadequate consultation period, the constraints created by the absence of the regulations, and advising them that we will be providing our formal (documented) feedback on or before April 15, 2016.”

On the positive side, Mr Komolafe said the Government’s NHI Secretariat had advised the BIA that they wanted to involve it - and the insurance industry - in the drafting of the scheme’s regulations.

He added that the BIA was now awaiting a formal communication from the NHI Secretariat on this issue, as no date had been given for when this exercise would begin.

“What the challenge will be, and has been, is that there isn’t enough detail,” Mr Komolafe reiterated on the NHI Bill, explaining that the publication of the regulations might force the industry to revise its comments and recommendations.

The NHI Secretariat initially gave insurers and other medical stakeholders just nine working days to provide feedback on the draft NHI Bill, but appears willing to extend the consultation period for longer.

Mr Komolafe and the BIA previously said a three-month consultation period was typically the international norm for such a wide-ranging and fundamental reform as NHI.

They also contrasted the NHI Bill feedback period with the time granted to the private sector to provide recommendations on Value-Added Tax (VAT), and the three months allowed by the Central Bank of the Bahamas on the Credit Reporting Bill.

Mr Komolafe told Tribune Business that the NHI Secretariat has asked the BIA to provide “initial comments” earlier, and had suggested it would allow more time for a fuller analysis by the sector.

He added, though, that this had not been communicated formally, and given the sector’s numerous stakeholders, collating their various views and positions, and condensing them into one document that presented a common position satisfactory to all took time.

Mr Komolafe, meanwhile, confirmed that members of the BIA’s NHI Committee had met with the Government’s newly appointed consultants, the KPMG accounting firm, on March 1.

“We had an extensive discussion on key components of our NHI alternative proposal with them, and answered their questions,” he said.

“It was more of an introductory meeting and an avenue for sharing our thoughts on the proposed NHI scheme. They indicated that they are familiar with some of the issues raised by the BIA.”

Mr Komolafe added: “We were advised that as part of the initial phase of their work, they are expected to provide feedback and recommendations to the Government on the proposed NHI model, as well as the draft NHI Bill, within the next few weeks.

“Additionally, we were informed that KPMG is assisting the Government in putting together a comprehensive healthcare reform plan”.

Other Tribune Business sources, speaking on condition of anonymity, told this newspaper that KPMG has been given an end-March deadline to provide its recommendations to the Christie administration - a timescale intended to coincide with the proposed April 1 roll-out of NHI’s primary care phase.

KPMG was given eight weeks, or just over two months, from its initial appointment to complete a vital exercise - a timeline that many observers felt was unrealistic, and showed the Christie administration’s haste.

It is also unclear whether the Government will implement KPMG’s recommendations, given that it effectively appeared to ‘shelve’ the report by former consultants, PricewaterhouseCoopers (PwC), when it did not accord with its NHI plans.

With the NHI Bill yet to make it to the House of Assembly, consultations still ongoing, and many vital details surrounding the scheme either unknown or yet to be resolved, the primary care launch date appears almost certain to be pushed back from April 1.