The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Minister of Health yesterday said “tremendous progress” has already been made in designing a catastrophic health insurance scheme, with the Government focusing on a private-public partnership (PPP) delivery model.

Dr Duane Sands told Tribune Business that while such a plan would be “unsustainable” if it sought to provide unlimited amounts of funding for every patient, it was still possible to “add phenomenal value” to care quality.

He added that there was significant “capacity and expertise” in the Bahamian healthcare industry when it came to dealing with catastrophic illnesses, indicating that the Government would seek to draw upon the sector in designing and delivering such a scheme.

Dr Sands said if implemented correctly, this would increase Bahamian healthcare investment and move the country away from a model where persons were collectively spending $200-$300 million annually for care in Florida.

While acknowledging that catastrophic healthcare can quickly become very expensive, he explained: “It depends on your definition of a catastrophic care plan.

“If you say there’s an infinite amount of money for every patient, it’s not sustainable, but depending on how you define the benefits of the programme, it can add phenomenal value to any given patient.”

Dr Sands further explained: “If you introduce any new programme, it’s effectiveness and reach depends on how one qualifies for that programme. It has to be fair and equitable. Will it be all things to all people? I don’t think so.

“We have already made tremendous headway in our approach that has buy-in from a number of stakeholders. PPPs at discounted rates that take advantage of existing local capacity and expertise on the catastrophic healthcare side.”

Pointing out that he had provided cardiac surgical services for some 20 years, Dr Sands added: “We have learned a few lessons about our providing very expensive healthcare services at a fraction of the cost.”

Dr Sands told Tribune Business that unlike the former Christie administration, the new government would seek the participation of all medical industry stakeholders in the design and implementation of a catastrophic health insurance programme, thereby ensuring private sector buy-in from the start.

He added that this was especially important given that the scheme would likely work through a PPP, and be the opposite of what many felt was “an almost hostile takeover of the healthcare industry” by the former government.

“I believe a number of stakeholders across all sectors of healthcare recognise the intent and spirit of NHI,” Dr Sands said. “Many have been insulted and called all sorts of names under the previous administration.

“I think that limited buy-in, and the challenge is to get all their participation in advancing access to, and the quality of care, for as many Bahamians as possible, but at the same time making a durable contribution to capacity building in the Bahamas.

“What we ultimately hope to do is while we improve the quality of care for Bahamians, the investment in the sector increases opportunity in the healthcare system,” he continued. “You make a significant strengthening of the local healthcare system.

“It’s all well and good to say we spend $200 million to $300 million in Florida annually. We need to move away from that model and improve access, quality of services and quality of outcomes in the local healthcare system, whether public or private.”

Dr Sands added that senior Public Hospitals Authority (PHA) executives “understand and agree that there has to be significant improvement in the quality of care at that institution [Princess Margaret Hospital], and are committed to making that happen.

“We have to identify a mechanism of funding and come up with a timetable and plan to make that happen.”

Having worked in the public sector himself, Dr Sands said he and his colleagues had suffered “many frustrations”, and an inability to do what was required through either “limitations of political will, funding and inertia”.

“Let’s see if we can make some of the headway we have spoken about today,” he told Tribune Business.