By YOURI KEMP

Tribune Business Reporter

ykemp@tribunemedia.net

The National Health Insurance Authority’s (NHIA) chairman yesterday said he is “puzzled” by the insurance industry’s call for the scheme to set out a “long-term framework” and strategic plan.

Dr Robin Roberts told Tribune Business this had already been “outlined”, and was something the insurance industry is well aware of. “We have gone public. We have had stakeholder engagement and we told them the next level was the introduction of the high-cost care plan,” he said.

“We talked about having our employer and employee mandate. We talked about having our risk adjustments. We talked about affordable and sustainable care. We are being very public on what our plans are. The whole programme for National Health Insurance (NHI) has always been set at us having private care, we have high cost care. and then we move towards a more comprehensive package in the end. This is going to be phased.”

Responding to concerns that the NHI lost direction after Hurricane Dorian, and there were concerns its funding will be cut back, Dr Roberts replied: “We have not only said we are doing the electronic health records (EHR) but, in the interim, we will expand our primary care programme.

“So instead of saying we are introducing primary care 1.0 and going to high-cost care 2.0, we are going to go to primary care 1.1. So we are going to expand our primary care services, and a part of this expansion is the introduction of the EHR. So I am kind of puzzled when they say they don’t know our strategic plan. Not only that, they have representation on the board of the NHI Authority.”

Dr Roberts added: “We had our timelines for all of this set up. So if you want to go on our web page it would clearly define what was going to be the next phase of our development, and you would see that the shared responsibility and looking at high-cost care was the next phase for the NHI plan.

“The final stage would have been once that is implemented, somewhere down the road we will look at increasing the number of benefits for the third phase of a more comprehensive benefits plan.”

Explaining the current status of NHI’s employer mandate, Dr Roberts said: “We said that the employer mandate, where we are looking at high cost care, would have been introduced this year, but the government said no new taxes.

“So they decided to hold back on the next step. Now we have to wait on the government to do that - whether or not the government sees that it is economically feasible to move forward on this endeavour, because it will involve a greater budget in order to invest the people’s money.”

Arguing that NHI has been “very explicit” on the scheme’s intentions and progress, Dr Roberts said: “We went and had a stakeholder period of some 55 days. We had some 13 or so town hall meetings, we visited some ten islands and were on numerous radio and talk shows and in the newspapers.

“So we were very clear. We talked about the shared responsibility, and we talked about producing a package of benefits where we were looking at the introduction initially of the four common cancers and cardiac conditions, end stage renal disease and childhood cancers.

“We said what that package of benefits was, we projected what the costs would have been, and we have projected how we are going to pay for that. So we were very clear on what our next stage was going to be.”