The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

Private Bahamian underwriters are involved in all three bids for the management of the National Health Insurance (NHI) public insurer, the scheme’s advisers suggesting this showed the industry had “bought in” to the scheme.

Simon Townend, a KPMG (Bahamas) partner and head of the accounting firm’s Caribbean advisory practice, confirmed to Tribune Business that a ‘recommendation’ had been made as to the ‘preferred bidder’.

Declining to reveal its identity, or those of the Bahamian insurance companies involved in the process, Mr Townend implied that the winner’s selection now awaited the Government’s approval.

Disclosing that the three offers to manage BahamaCare “all had local insurance elements to their bids”, Mr Townend said: “All of these bids included private insurers from the Bahamas, suggesting they buy into the model.

“The bids have been shortlisted, and a decision has been made to move forward. That recommendation [winning bidder selection] has been made in terms of the next steps.”

Mr Townend said the recommendations had been made by a committee of public and private sector representatives, which included representatives from KPMG and the NHI Secretariat, although he did not identify anyone by name.

Among the likely candidates as the ‘Bahamian elements’ in the public insurer bidding process are Colina Insurance Company, Family Guardian, BAF Financial and Generali.

It is unclear, though, whether the Bahamian participation shows local insurance industry ‘buy in’ and a willingness to participate in NHI, as the various players may see the BahamaCare management contract purely as an opportunity to ensure their continued involvement in the sector.

Dr Kevin Bowe, the NHI Secretariat’s deputy project manager, confirmed to Tribune Business that the $100 million primary care phase, which the Government hopes to launch prior to the upcoming general election, did not require participation from the private health insurance underwriters.

He indicated that primary care could start with BahamaCare as the sole insurance underwriting vehicle, should the health insurers elect not to participate as regulated health administrators (RHAs) - selling the same NHI products at the same prices, under the control of a central NHI Authority.

Also casting doubt on insurance industry ‘buy in’ are previous comments by Emmanuel Komolafe, the Bahamas Insurance Association’s (BIA) chairman, who criticised the public insurer tender as “skewed” in favour of foreign companies.

He argued that “restrictions” were placed on the successful bidder’s ability to offer health insurance policies outside NHI, meaning they would be unable to offer complementary or top-up policies to Bahamians wanting them.

Mr Komolafe had also suggested that the evolving NHI scheme was akin to ‘death by a thousand cuts’ for the private Bahamian health insurance sector in the long-run.

The NHI consultants and Secretariat representatives interviewed by Tribune Business this week did not provide much in the way of specifics, in terms of launch/milestone dates, costs and the fine details involved in the wide-ranging healthcare reform.

Acknowledging this, Dr Bowe said: “We sound like we’re singing a chorus here, but we can assure you that you will hear from us.” He and the KPMG executives present implied that many of the key decisions now had to be taken by the Christie cabinet.

Still, Dr Bowe said the Board for the NHI Authority, which will oversee the scheme from a governance perspective, is due to be unveiled shortly.

“This is something that in very short order is going to be announced,” he told Tribune Business. “We’re at critical points.

“A number of things will flow from that Board announcement, but in terms of readiness around the framework of governance, that’s in place. It’s a matter of pulling the trigger and getting it moving.”

Mr Townend said designing and implementing NHI was an extremely complex undertaking, given the numerous ‘moving parts’ to the scheme that had to be put in place simultaneously.

Apart from the governance structure with the NHI Authority, he explained that the Secretariat and KPMG had been working simultaneously on numerous other fronts, developing an IT platform, addressing physical and other infrastructure issues, and negotiating with the various professions that make up the Bahamian healthcare industry.

Adrian Hamilton, a management consulting director with KPMG (Bahamas), said development of the NHI Authority’s structure had been “underway for quite some time”, with advertisements for the first jobs released at the end of November.

“As soon as the Board’s in place, the Authority will be established and offers made,” Mr Hamilton said. “We’re doing all the groundwork to enable the Board to be put in place.”