The Tribune

By KHRISNA VIRGIL

Deputy Chief Reporter

kvirgil@tribunemedia.net

AS the Christie administration faces a time crunch to implement the primary care phase of National Health Insurance before Bahamians head to the polls this year, the government is challenged by “immense” logistical problems because public facilities are not structurally sound, a high level NHI insider has told The Tribune.

According to the source, who is intimately involved with planning intricate details of the healthcare scheme, the committee appointed to decide how the $24m catastrophic fund will be spent has also reached a stalemate because the plans in this regard are “horribly ambitious”.

These issues among others, have put the success of NHI in question and the government’s intentions under great speculation, the insider said yesterday.

“So if we take specifically the Abaco mini hospital,” the source said, “the floor in that facility is not usable and so they have had to contract somebody to replace the vinyl flooring. That contract was just done and it has a minimum eight-week time frame.

“They are actively in the process of trying to get people to sign up or to consider signing up. They have certainly not even told the people what it is they are signing up for and what they are going to get. And so it is a real challenge now.

“The catastrophic care committee, which is tasked with determining what and how to spend the $24m set aside for catastrophic illnesses, has not even finalised how it is going to spend that money and what it is going to spend the money on. And the last time they met was Wednesday.”

Asked to explain this delay, the insider continued: “Because it’s a horribly ambitious programme. You speak in general terms about catastrophic care, but they only have $24m to spend on it. So what is it that you are going to do with that money?

“When you could exhaust that money with 100 patients or 50 patients. So do you define that benefit for John Brown that says if he has a stroke or a heart attack, does he get $50,000 or $75,000 or $100,000 from the government or do they say first come first served and say they are going to spend $500,000 on John and dog eat your lunch if you come after him?

“These are issues that have to be resolved because once you start this programme then everyone is going to say their relatives have a catastrophic illness and needs the money.”

Last year, NHI Project Manager Dr Delon Brennen rejected criticism that the government’s $24m catastrophic fund is insufficient to cover those who fall under the specialised care category, as he stressed that the fund will be used in addition to the provisions already in use in the country’s public health system.

However, he admitted that the government was still in the process of designing the best way to execute the catastrophic fund.

Asked if it were possible that the catastrophic fund could be expanded once officials decide how it will be put in place, Dr Brennen said this is a policy decision that the government will have to make.

Earlier this month Tribune Business reported that NHI’s $100 million primary care phase has been pushed back to May 2017.

However, Dr Brennen has said the launch would now take place during the first quarter of 2017.