The Tribune

By RASHAD ROLLE

Tribune Staff Reporter

rrolle@tribunemedia.net

SOME Bahamians with comprehensive employer-sponsored group health insurance plans fear businesses will drop these and provide only the minimum benefits required by the Minnis administration’s proposed National Health Insurance scheme.

Explaining the problem, one industry insider told The Tribune yesterday: “Health insurance premiums are high because healthcare costs are high. The healthcare costs that are high are not related to primary healthcare services but big ticket items like cancer or operations related to cardiovascular diseases. If employers look at this and conclude they only have to pay the annual maximum of $500 for each employee whereas right now they might be paying $5,000 or $6,000, what do you think will they do?”

The insider continued: “What they are then selling to people is you can get supplementary health insurance but those don’t exist right now and when you strip it out and all the supplementary coverage you provide is over this expensive care, it becomes more difficult to price and if you price it the premiums could be very high. It almost becomes a luxury product to fly away, to go to New York or Miami for treatment and the pool will be smaller which makes it more expensive. For persons who say, ‘if my employer downgrades all of us to this standard health benefit they could go get me supplemental coverage,’ the employer may find they cannot afford it.”

Health Minister Dr Duane Sands, nonetheless, warned yesterday against predicting how the market will respond to the proposed regulations.

“We can raise the spectre of a lot of boogeymen,” he told The Tribune. “We don’t know what the response is going to be. People make a choice to provide certain benefits because they have a particular belief about their approach to their employees. Some people try and they can’t sustain it. Some people don’t have it and they add it. We haven’t the foggiest idea what the market’s response will be to the introduction to a new plan with just the standard health benefit package relative to the comprehensive plans that currently exists in our market. Certainly there are a huge number of people who have no insurance and they are looking to get a little something.

“There are trade unions that have plans and those plans are struggling to stay afloat. They’re looking to standardise the plans they provide to their memberships and this makes it a lot easier to get into this market and stay in those markets. We can speculate as to what’s going to happen and say all the people that currently have major medical plans are going to drop down to this, but I don’t think that is going to happen and certainly it is not the plan of the government to reduce the major medical plans of the existing civil servants like the police, defence force, nurses, teachers, etc, to the NHI plan. “

Under the government’s proposed scheme, existing private insurance plans will be restructured upon their first renewal after January 1, 2021 to ensure the provision of the standard health benefit package. That standard health benefit package covers primary care services, diagnostic and imaging services and select high cost care services such as treatment for some cancers.

Dr Sands said analysis indicates both public and private facilities in the Bahamas should be open to serving people who have the standard minimum package, rebuffing concern that such people will only be able to get services at Princess Margaret Hospital and other public facilities. He said it is unlikely oversees care costs will be covered under the standard package.

As for concerns about the cost of supplemental plans, NHIA chairman Dr Robin Roberts conceded they could be expensive.

“It could (be expensive) but it could also mean that in a free market system those supplemental packages would be more competitive,” he said. “The standard price is one package regulated across the board so how do you increase your number of insurers? You give them packages which are more affordable and attractive to them than your competitors.”