The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

Medical insurance will become “pro-poor” once the Government launches National Health Insurance’s (NHI) $100 million primary care phase, the scheme’s consultants have forecast.

The KPMG accounting firm said the switch to NHI would result in reduced insurance costs for all participating Bahamians and legal residents, implying that existing premium rates were too high and unaffordable for many middle class and low income persons.

Explaining how payments would work, its 20-page study of NHI’s economic benefits said: “NHI benefits will be administered by competing private insurers and the introduction of a public insurer, to be called BahamaCare.

“BahamaCare will be publicly owned, but the operations will be outsourced to a private manager with the requisite expertise. The combination of public and private insurers will make the payer environment in the country significantly more competitive and pro-poor.”

Emmanuel Komolafe, the Bahamas Insurance Association’s (BIA) chairman, yesterday said he and other industry representatives were still studying the KPMG report, but would ultimately provide a response. Dr Sy Pierre, the Medical Association of the Bahamas (MAB) president, said the same thing.

The Government’s political opponents, and those in the healthcare industry, yesterday predictably queued up to attack the KPMG report and its estimates, one doctor arguing that the study was “biased” because of the accounting firm’s role as an NHI adviser.

Speaking on condition of anonymity, they said the report itself admitted to lacking much of the necessary data upon which to base its assumptions and estimates, a point that was also conceded by KPMG (Bahamas) partner, Simon Townend, at Monday’s Bahamas Business Outlook conference.

“Because of the limited data available to forecast all the different effects [of NHI], a simpler ‘pragmatic’ framework was developed to calculate the main effects of the primary care phase of NHI,” KPMG said.

“This reduces the number of economic levers from 15 to around seven where we were able to find reliable current and projected data for the Bahamas.”

However, the accounting firm said this likely resulted in its model and estimates being more “conservative” than was necessary, adding: “It is likely that this pragmatic model underestimates the potential benefits of NHI.”

The KPMG report also confirmed the Government’s control over NHI, stating: “There will be no contributions or co-payments required to receive primary health care during the initial rollout of services under NHI Bahamas.

“For the primary care stage of NHI Bahamas, the Government will manage finances so as to compensate providers through a National Health Insurance Fund (NHI Fund) financed by the Government’s consolidated fund.”

Explaining where the money will come from, the study added: “No new taxation is envisioned to fund this initial phase, and as a result funding will consist of a combination of new government expenditure (approximately $60 million) and a re-allocation of the existing national health budget from various sources, including the Ministry of Health and the National Prescription Drug Plan (approximately $40 million).

“The current sources receiving this B$40 million are not expected to lose out as part of this reallocation; rather the money is likely to be paid through a different mechanism and potentially exceed the current levels for some.”