By YOURI KEMP

Tribune Business Reporter

ykemp@tribunemedia.net

The government yesterday said it was targeting $62m in savings over a five-year period by permitting the National Health Insurance (NHI) scheme to lead the primary healthcare system's transformation.

K Peter Turnquest, deputy prime minister, in unveiling the 2020-2021 budget said the government is seeking to prevent a $44.4m annual increase in the public healthcare system's primary care costs by reforming how this is delivered via NHI.

With these costs, and the burden they impose on taxpayers, threatening to rise from the present $83.3m to $127.7m per year by 2025, Mr Turnquest said primary care's "integration and streamlining" with NHI was critical to both improving patient care quality and generating greater efficiency savings.

Dr Robin Roberts, the National Health Insurance Authority's (NHIA) chairman, yesterday told Tribune Business the plan is for all primary care patients to be registered with NHI. "NHI has been very reformative in our healthcare system, and we continue to be very progressive in this. We are extremely pleased that the government has agreed to the proposal we have put forward with regard to primary healthcare," he said.

Acknowledging that NHI's catastrophic care proposal is not moving forward because of concerns over potential costs, Dr Roberts added: "The government has seen fit that this year we will proceed with us advancing our primary care package, and that will be very transformative.

"For one, we are looking toward the full benefits of primary care that everyone in this country will have a primary care physician such that we are looking at the benefits of detecting diseases early so that we can prevent it from being more progressive and more costly."

Dr Roberts continued: "We are also looking at very stringent prevention methods, and advancing health promotion and well-being so, in the long run, we are looking at people living longer and healthier lives. In addition, we have just advanced our electronic health records, which in addition to just the primary care services we will be able to now monitor and manage and be accountable for the care doctors deliver.

"Thirdly, we have made a request to the government that the public clinic systems, whereby in our public primary care clinics, those physicians and the management of those clinics come under the auspices of the NHI Secretariat."

Mr Turnquest, unveiling the plan yesterday, said: "The government is increasing its allocation to National Health Insurance (or NHI) by $18m. When the Prime Minister discusses his health portfolio during the upcoming budget debate he will speak in detail of the successes that NHI has had to-date, and how its expansion will both improve the delivery of healthcare and rationalise the operations and efficiencies in the health care sector.

"Primary care delivery is estimated to cost the government $83.3m each year. Without significant change to the delivery model, this would escalate to $127.7m by 2025 - an increase of $44.4m. The integration and streamlining of these separate healthcare delivery systems are essential to ensure better quality care of patients.

"Therefore, the government is proposing for the National Health Insurance Authority (NHIA) to lead a series of reforms, which would effectively and efficiently address these ongoing challenges. This refocused NHI initiative will require no additional taxation or employer mandate," he continued.

"Most importantly, it will ensure that every Bahamian and resident has consistent access to a family doctor with minimal co-pay requirements or deductibles. As the changes crystalise, this new streamlined approach is estimated to save the Government of The Bahamas approximately $62m over the next five years. "

The government is providing $235.455m in subsidies to the Public Hospitals Authority (PHA) this fiscal year, with a modest reduction to $223.456m projected for the 2020-2021 fiscal year. "The enhanced NHI would help us to move to a more efficient and accountable approach and, more importantly, expand primary health care coverage to every Bahamian.

"Given that allocations to the Public Health Authority represents our largest subvention to state-owned enterprises (SOEs), the government cannot give effect to reform in the SOE sector without determining how it will make delivery of basic health care more efficient and effective."