The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Government’s fiscal crisis dictates that it re-examine the creation of new agencies to oversee the proposed National Health Insurance (NHI) scheme, the Bahamas Insurance Association’s (BIA) chairman says.

Emmanuel Komolafe, speaking after the sector met the Minister of Health last week, said the $429 million in taxpayer subsidies granted to public agencies in the 2017-2018 Budget highlighted why healthcare reform needed to be balanced with fiscal prudence.

The Minnis administration has allocated $40 million for the NHI Authority’s creation in the upcoming fiscal year, and Mr Komolafe said both the insurance industry and government had agreed “sacrifices will have to be made by all” if NHI is to succeed.

“We find ourselves in a Catch 22 situation,” the BIA chairman told Tribune Business. “It is imperative that we skillfully navigate through the NHI conundrum while managing the expectations of the populace in relation to NHI.

“In an environment that calls for fiscal prudence, financial discipline and the curbing of government spending, the implementation of social programmes (such as NHI) will have to be done in a pragmatic manner.”

He added: “In the same vein, we have to re-examine the necessity of establishing additional government agencies and the creation of multiple layers of bureaucracy within the healthcare sector in order to implement NHI.

“As an example, the NHI Authority will be an addition to the Public Hospitals Authority (with a staff complement of over 4,000), Department of Public Health, Ministry of Health, the Rand Memorial Hospital, Sandilands Rehabilitation Centre, National Medical Services and the Supply Management Agency, at further costs to taxpayers.

“Following reports of wastage (including some $100 million as stated by the chief medical officer) and inefficiencies across the existing agencies in an economy plagued by negative or zero growth and high unemployment, any new government agency will be subject to much scrutiny with a need to justify its existence.”

Mr Komolafe suggested that tough decisions would be needed on NHI and other social programmes, given a strained financial position that requires the new government to obtain approval to borrow up to $722 million as one of its first acts since taking office.

Recalling the BIA’s meeting with Dr Sands, he told Tribune Business: “The conversation was honest and frank in relation to the inherent challenges within the NHI scheme.

“We reaffirmed our commitment to being an active partner with the Government in the expansion of universal healthcare in the Bahamas. There was a general consensus that sacrifices will have to be made by all stakeholders if the NHI program is to succeed”.

He added: “The Minister asked for patience from stakeholders as the new administration presses the proverbial reset button and commences the process of redefining the NHI product, instituting a proper governance framework for the NHI scheme and building relationships with stakeholders.

“We believe that it is apparent that there is much work to be done to put in place a much-needed structure, and defining the future path of a National Health Insurance programme that is sustainable.

“We had a productive meeting with the Minister. Dr Sands opined that while all stakeholders will probably not agree on all matters relating to NHI, our deliberations and exchanges will be honest, respectful and constructive.”