Leslyn Smith, a local schoolteacher, said yesterday that she is tired of having cookouts to raise money for her son who was born with facial deformities. For her, the idea of a national health insurance sounds good, but she wonders how it would be funded.
The cost dilemma is something that the Blue Ribbon Commission on National Health Insurance recognizes.
Commission Chairman Dr. Perry Gomez said yesterday that one option involves salary deductions, but he recognized that attempting to collect from all workers – particularly those in the so-called informal sector, like straw vendors and fishermen – would be a real challenge.
It would be similar to the challenges of collections that the National Insurance Board now faces, Dr. Gomez told the Bahama Journal.
But he said one consultant to the Commission pointed to the Israeli scheme, which makes one member of each working group responsible for collections. It’s a sort of peer pressure that has apparently had some degree of success, he pointed out.
While Ms. Smith wonders how the government would deal with collecting from immigrants, she feels the authorities should move quickly to find a solution to the cost dilemma.
“I think we need something like [a national health insurance plan] because when I went away with [my son], everybody had insurance except me,” Ms. Smith said. “Medical treatment is very expensive, so the government should implement something…but what are they going to do with all the expatriates who are using up our services?”
Elridge McKenzie, 75, said even though he now has private health insurance, he would welcome the introduction of a national plan.
But exactly how the government would collect from the elderly is another matter authorities will have to look into.
“The poor man, who doesn’t have money, wouldn’t have to worry,” Mr. McKenzie said.
On Wednesday, he was sitting on the pavement in front of the Central Police Station on East Street North. He appeared strong and healthy and remarked, “I’ve never really been sick a day in my life.”
PLP Chairman Raynard Rigby, who spoke with the Bahama Journal around the corner in Parliament Square, added, “It’s always been a major concern of the party that when we look at the social and medical safety net in the country, too many Bahamians are falling through the cracks in the sense that they have not had the option of being provided with comprehensive medical coverage.”
But there are others who now have private health insurance who question whether a national scheme would be mandatory.
One woman thought it would be unfair for some people to be made to pay more because they earn more.
But Dr. Gomez said salary deductions are only one way that such a scheme could be funded, but he did not expand on other methods.
He said the actual costing mechanism would be for the government to decide and there are other things that would need to be looked at, like what medical conditions may not be covered.
With such plans running into trouble in many countries, authorities say they want to carefully devise a scheme that would be best for The Bahamas.
“We can appreciate what Bermuda went through, their problems and successes, but they are quite different from The Bahamas,” Dr. Gomez said.
Local insurance executives, meanwhile, have their own ideas on how the plan should be funded.
“Whoever gets the service should pay for it as a form of tax, or the plan can perhaps make provisions for certain services,” said Gerald Strachan, a former executive. “For instance, there could be a limit on what services would be provided for retirees.”
Others have pointed out that there might not be a way to get around the funding issue, with the plan covering such a wide population.
“With the aging of the population and the increased call for technology and services, expectations for healthcare are skyrocketing, and both the government and the private sector have to be prepared to acknowledge what those costs are going to be,” said Alan Mytty, chief executive officer of Bahama Health Insurance.
For now, many people, like Ms. Smith, continue to resort to fundraisers, hoping that they will soon get the medical insurance coverage they desire.
“He needs more operations, but he’s not having anymore if I have anything to do with it,” she said of her son, Pat, whose jaw needs to be reset. “It’s just too much stress.”
By Candia Dames, The Bahama Journal
