The Tribune

THE NATIONAL Health Insurance (NHI) Bahamas has enrolled 56,000 beneficiaries to-date according to Health Minister Dr Duane Sands revealed In Parliament yesterday, while nothing that universal heath care and national health insurance remains “unfinished business”.

During his contribution to the 2019/2020 budget communication Dr Sands stated: “To date, there are 56,000 beneficiaries enrolled with the plan and covered by a package of good quality primary health care services. This represents a 122 percent in growth year over year. The Bahamas has been on the journey to fully implement Universal Health Care (UHC) for its residents for over 30 years; and we are still on that journey.” NHI enrolment began in 2017.

“I would be the first to say that UHC and NHI remains unfinished business. The core principles of UHC/NHI, affordable and accessible quality care are unwavering –– and are not being debated. We can all agree, everyone will benefit! What is debated is the formula for sustainably funding UHC/NHI,” said Dr Sands.

He noted the current proposal is for employers to share the cost with employees in ensuring that all beneficiaries receive standard health benefits.

“All employees no matter the salary will pay a percentage of their income as a contribution to the plan and employers will pay the remainder. The focus here is to ensure that all Bahamians who cannot afford private insurance including many children, indigent, unemployed, elderly are covered through a funding mechanism that will create a balance for all to receive the standard health care coverage. A basic premium rate will be the consistent rate charged for the Standard Health benefit regardless of personal health status, pre-existing conditions, age or other demographic risk factors,” said Dr Sands.

Among the key policy suggestions put into place are premium sharing, with the premium no longer to be shared 50/50. “The employer will be able to collect up to 1.5 percent of monthly income, lowered from two percent, up to the standard premium rate with employers paying the remaining balance. This allows for a more equal distribution on average for employers, supports low-income employees and causes high-income earners to contribute more.”

“The mandate would apply for all employers, regardless of company size on July 1, 2020, providing for a consistent start across the board. The policy change addresses concerns made by business groups about artificial distinctions between small and large employers,” Dr Sands added.

According to Dr Sands, NHI proposes a National Fee Schedule which both the organisation and private insurers would reimburse providers under the agreement for services rendered. “This allows for the standard premium rate to be more easily adopted by private insurers and would simplify the risk equalisation process. Ninety-five percent of current beneficiaries reported being were either very satisfied or satisfied with the health care experience they received from their NHI doctor. In a public opinion poll 87 percent of respondents supported the expansion of NHI Bahamas to provide affordable coverage for high cost medical care. In addition, 57 percent of respondents said a combination of government, employees and employers should pay for universal healthcare,” said Dr Sands.