The Tribune

By KHRISNA RUSSELL

Deputy Chief Reporter

krussell@tribunemedia.net

THE government is preparing for push back more than 500 potential fee increases at the Princess Margaret Hospital to be implemented before year’s end, Health Minister Dr Duane Sands said yesterday, as he suggested civil servants may also be affected by the changes.

He stressed that these fees will be “progressive,” meaning people with better financial means will pay more than the poor and most vulnerable.

Speaking to reporters yesterday, Dr Sands noted the “missteps” regarding the implementation of new fees at the morgue earlier this year, which were rescinded, adding it is clear now this issue comes down to a change in culture.

“We need to ensure that we get it right so when we implement it, you know there would be some push back,” he told reporters yesterday before heading into a Cabinet meeting. “We’d like that push back to be not on the basis of something that was done inappropriately.”

Asked if Bahamians would see the fees implemented by the end of the year, he said: “I believe you will.”

He continued: “Bear in mind our goal is to make the changes in the fee schedule fairly progressive and so its anticipated that people with more will pay more and so if you have insurance and that insurance is paid for by the people of the Bahamas, there is no reason why that insurance can’t be used to the benefit of the public health care system.

“I mean Bahamians spend almost $80m dollars a year buying insurance for people like me, for teachers, for nurses, for doctors, for defence force officers, etc.

“And we also have rules that say civil servants don’t pay. Now if I were a civil servant, I would not want a change in policy to mean that I now have to reach into my pocket. But if the people of the Bahamas are paying for a health plan why shouldn’t that plan benefit the primary healthcare institutions in the country as opposed to Cleveland Clinic (or) Jackson Memorial, etc? That don’t make no sense.

“So when you look at the Road Act, the number of people mashing up cars and hurting people on the road is just out of control, but when those people come into the hospital, the public has to pay for them as opposed to the insurances.

“But when we start talking about revising the fee schedule we are specifically looking to make sure that we are taking advantage of existing financial arrangements, insurance plans, etc, which is not to say that we’re not going to be changing the fee schedule for the average person coming into the facility, but the goal is to have it weighted such that those with the ability to pay will pay more and we remain committed to the view that the least among us, the most vulnerable, the poor will not be denied health care services.”

Last week, the heath minister told Tribune Business that implementing the 500 fees was not as simple as it may seem. He said the government would not accomplish its revenue targets if the fees fail to capture more than the 13 percent of persons currently paying for services at PMH.

“I have said repeatedly that 87 percent of people who use services in our healthcare system don’t pay anything,” Dr Sands said at the time.

“It’s all well and good to change the fee schedule, but if you’re still only getting 13 percent of persons paying the fees it’s not going to accomplish what you want. We are going to have to, in some cases, legislatively modify the approach and in other cases change some of the contractual agreements, some of the union agreements and so on. That process is not as simple as it may seem,” he said.