Although there is no set timeline for the National Health Insurance (NHI) to come on stream, Health Minister Dr. Perry Gomez said the government is continuing work towards the programme.
“In preparation for NHI we are presently looking at the service delivery in our clinics, trying to boost the quality of care and staffing in our clinics,” Dr. Gomez said.
“And to do this, we are looking at physicians. The public clinics do the vast majority of work in our county. People tend to be hospital centered, but when you look at the work being done in our community clinics and all the Family Islands, they are done by practitioners many times alone. And so we are trying to upgrade the quality of care throughout the archipelago. And to that extent we have started some negotiations with the Public Hospitals Authority with doctors of the same level as those who are working in public health clinics.”
NHI was originally crafted by the first Christie administration.
When the NHI scheme comes on stream it will require the full participation of all employers and their employees who will have to pay to enjoy the government-introduced benefit.
NHI is a form of social health insurance, which uses the principles of fund pooling and risk sharing to provide equity in access to care.
Government officials say individuals will pay an “affordable” amount on a consistent basis and in return will be able to have their healthcare needs provided for, regardless of cost.
It is envisioned that this ‘cradle to the grave’ national healthcare coverage will cover persons who are currently excluded from private insurance plans such as individuals with pre-existing illnesses, newborn babies and those over 65.
Dr. Gomez stressed that the level of care in clinics must match what is being offered in hospitals.
“There is a disparity between the two at the present time. And so you find many physicians tend to be in the hospital because they are better paid. Even though they are at the same level as compared to the doctors who work in clinics and it is a major issue that we are trying to address because it could mean a tremendous difference in what we do in our clinics in our Family Islands,” he said.
“They only have visiting doctors and the same is true from many segments of the country like South Andros, North Andros or Acklins – there’s always a question of coverage. So when NHI comes in place, these issues have to be behind us.”
When asked if the government has determined the price tag of NHI, the minister said it will get external assistance to determine the cost.
Recently, former Health Minister Dr. Marcus Bethel urged the government to pump the brakes in introducing NHI.
“The Bahamas cannot afford exacerbation of the national debt, nor burden the working population and employers with more taxes during this recession state,” Dr. Bethel said in a press statement.
“Hence the government is advised to exercise extreme caution and delay the implementation of the proposed comprehensive national health insurance plan until the macro-economy and fiscal conditions markedly improve.”
Dr. Gomez said he agrees.
“There’s no delay, but we have to do it when the time is right. That’s what Dr. Bethel was saying in his letter,” he said.
“NHI is a participatory programme and the level of unemployment is critical in making that decision because the higher the unemployment the less people will pay and when we design NHI, the unemployment rate was eight per cent.”
The current unemployment rate hovers around 15.9 per cent.
