Although its members did not come up with a price tag for the programme.
But after 20 months of awaiting the report, the government is still in the dark regarding funding issues related to the scheme. Several insurance executives who spoke to the Journal are worried about the possible adverse effects on their businesses when a national health insurance scheme is brought on line given that the scheme would be compulsory.
Health Minister Dr Marcus Bethel will officially present a report on the feasibility of a National Health Insurance scheme to Cabinet today.
The Blue Ribbon Commission report, represents the fulfillment of an election promise made by Prime Minister Perry Christie to examine the feasibility of such a scheme.
At the report presentation ceremony at the British Colonial Hilton yesterday, Mr. Christie said that Cabinet will move assiduously in its examination of the commission’s finding.
“We shall ask our colleagues to familiarize themselves with its contents as quickly [as possible] and then we would be able to say to the Bahamian public that we are now moving to the next phase because we are aware of the importance of the recommendations,” he said.
If the report receives approval, the process of implementing the National Health Insurance (NHI) system would begin immediately.
According to Commission Chairman Dr Perry Gomez, there are three phases in the process: planning, pre-implementation, and launching and implementation phase. Once, kicked off, he expects the combined phases to take about 18 months.
The national health insurance would cover all Bahamians, including newborns, senior citizens and persons with pre-existing illnesses.
Dr. Gomez said the report does not outline any figure needed to finance such a scheme, nor does it address specific sources of funding.
“That is a part of the next phase,” he said. “The costing of the National Health Insurance system will require the acquisition of actuaries to do that kind of study.
“It’s not just costing for now, you have to take into consideration what is happening to the population over a period of time.”
The government must consider the fact that persons over 65 are now currently less than six percent of the population, but in the next 50 years it’s being projected that senior citizens will comprise approximately 20 percent of the population, according to the report’s summary.
Current health care expenditures in The Bahamas total around $340 million annually, of which the government shoulders 48 percent.
Said Dr. Gomez: “National Health Insurance is a form of social health insurance which uses the principles of fund pooling and risk sharing to provide equity in access to care.
“Individuals pay an affordable amount on a consistent basis and – in return – are able to have their health care needs provided for, regardless of cost.”
He added that social health insurance is similar to a nationwide Asue, where everybody pays up front and collects when utilizing the health care system. Coverage is lifelong.
The Blue Ribbon Commission made eight recommendations for Cabinet’s consideration.
It suggests that NHI be universal with legislation enacted to govern the scheme and the National Insurance Board should administer it.
It also recommended that NHI offer a comprehensive benefits package, with contributions at a set rate, that is not only affordable for the majority of the population, but also offers private and public healthcare providers the opportunity to join the National Health Insurance system.
Lastly, the report indicates that all provider payment mechanisms should be considered and that a percentage of revenue be set aside for purposes that ensure the stability and sustainability of NHI.
Putting the commission’s recommendations aside, Dr. Bethel advised that there is still much more work to be done and more public discourse on the matter is required, he said.
Tosheena Blair, The Bahama Journal
