The Tribune

By RICARDO WELLS

Tribune Staff Reporter

rwells@tribunemedia.net

NEARLY a week after he admitted the National Health Insurance scheme’s “non-existent checks and balances” have left taxpayers totally exposed to fraud, Health Minister Dr Duane Sands yesterday insisted the Minnis administration was in the process of taking several corrective steps in its attempt to correct the scheme.

In an interview in which he chastised the former administration for its “ill-conceived approach” to NHI, Dr Sands lamented the challenges that have arisen as a result of the “premature roll out” of the plan during the Christie administration.

“I think [this] government has made it very clear to the Bahamian people that NHI will be approved, but we acknowledge the challenges, we acknowledge the premature roll-out of NHI,” Dr Sands said.

“What we are watching play out are manifestations of an ill-conceived approach to National Health Insurance. That said, we have made a commitment to the Bahamian people to make it right. To make it work. That requires a series of steps. Those steps will be taken, the problems will be corrected and in short order.”

Dr Sands said the lack of a clear legal framework for NHI has severely limited the impact of the service since its introduction, noting the lack of certain provisions have left the decision makers attached to the plan unable to rule one way or the other on major issues.

The Elizabeth MP said the government is well on its way to announcing and implementing all the necessary legal framework needed to make the scheme work properly.

Dr Sands stated: “...And so, while I am aware of legal opinions on either side, we have to make a decision.”

“That decision is, we are going to constitute the board to ensure that the National Health Insurance Authority is legally and properly constituted; that we have the right governing structure, the right corporate structure, that all of the contracts that have been issued have a sound legal footing, but most importantly that the Bahamian people get benefit for the millions of dollars that they have spent and they continue to spend on this programme,” he said.

Late last month, Dr Sands confirmed the Minnis administration had rejected the Christie administration’s model in which the publicly owned BahamaCare would have administered all care and benefits packages to the “exclusion” of the private health insurance sector.

The former Christie administration launched NHI without key components of its management and governance structure being in place, with the insurance sector among these missing elements.

The original model envisaged BahamaCare and the private health insurance underwriters operating as regulated health administrators (RHAs), offering the same benefits packages at the same price to the Bahamian public.

However, the scheme was launched without either. Key details had not been agreed with the private insurance industry, while BahamaCare had not been created despite Aetna and its Bahamian partner, Family Guardian’s BahamaHealth business, being selected as its operators.

Dr Sands yesterday also revealed that shortly after coming to office, he was presented with a contract drafted between the government of the Bahamas and Aetna; however, he didn’t sign it because of the new administration’s view that no foreign provider should be awarded a contract for local service.

“Having reviewed that decision, I don’t think we are minded to go with the approach of using a foreign provider for local services,” Dr Sands said.

He later added: “There was no contract signed. The decision had been made [by the former administration], the contract was drafted, it was gazetted, it was presented for signature; I did not sign it.”

Dr Sands also maintained the FNM government had not abandoned the “public insurer” idea, again pledging to re-work the scheme and re-introduce it in a more viable format.