MAB chief: Top doctors are not signing to NHI

As of Friday, March 24, 2017

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Medical Association of the Bahamas (MAB) president yesterday said this nation’s best doctors are not signing up for the National Health Insurance (NHI) scheme, with the Government’s efforts to woo and pressure them seemingly failing.

Dr Sy Pierre told Tribune Business that while he had no ‘hard’ numbers, his conversations with high-level physicians and MAB members indicated that few, if any, were registering to provide services for the $100 million primary care phase.

“I’ve spoken to the consultant-level physicians, those who have specialist licenses,” Dr Pierre said, describing these as the likes of paediatricians, obstetricians, gynaecologists, and family medicine specialists.

“I don’t have any official numbers, but my feeling is that the top-level consultants are not signing up. The guys who are signing up are the GPs (general practitioners).

“They’re the ones who are out in the community, but don’t have specialist training. They are general practitioners. They are a dying breed, but there are a number of them. These guys are the ones signing up,” the MAB president added.

“The lower tier physicians will take this; it will be an economic boon for them. But the primary care specialists, the experts, they’re telling me they’re not signing up because they can’t run a practice on what the NHI primary care phase is paying.”

The Christie administration’s NHI Secretariat this week appears to have intensified its efforts to both encourage, and pressure, private doctors to sign up for the primary care phase prior to the March 31 deadline.

A full-page newspaper advertisement, taken out in both dailies, shows a doctor sitting with a patient, under the headline,’Have you had the talk’.

It implies that doctors will lose out, and could suffer a reduction in patient volumes, if they do not sign up for NHI, citing a ‘poll’ that found 64 per cent of Bahamians surveyed would switch physician if they were not registered for the scheme.

No statistical or scientific data was available to back up this finding, with the advertisement effectively urging the Bahamian public to pressure private doctors to sign-up for NHI.

It also called on Bahamian doctors to “be part of history” and register, and added: “Have your patients talked to you about NHI?”

It appears, though, that the Government’s tactics to encourage private doctor sign-up are not working. Tribune Business last night spoke to two senior private doctors who, speaking on condition of anonymity, said not one patient had requested them to sign on for NHI.

“I’ve had no pressure from any patient,” one told Tribune Business. “They’re saying: ‘We don’t want you to sign up; don’t be part of this madness’. I’ve certainly not seen any negativity from my patient population.

“My patient population are very concerned that NHI is just another scheme for the Government to misuse public funds.”

The other doctor added: “I talk to my patients all the time. They think it’s a pile of nonsense, can’t be sustained and feel that they’re being forced to sign-up through the NIB smart card.”

Adamant that neither of them would sign on to provide services under the NHI scheme as currently proposed, they added that the Secretariat’s campaign was “a sign of desperation”, and that there was “no question” that not enough physicians were signing up.

“They’re pulling at straws,” one of the doctors said. “They’re trying to get the junior doctors to sign up. None of the obstetricians and gynaecologists, none of the paediatricians, and none of the family doctors have signed up.

“I’m not surprised at the tack they’re [the Secretariat] taking, and turning the patients on. They won’t be able to get the quality of care; the quality of care will be compromised.”

They added that the NHI Secretariat and the Government were “ignoring the time and resources I’ve put in over the years to get my practice to where it needs to be, and what it costs to operate a proper medical practice in this country”.

Tribune Business was told that each specialist group of doctors is coming together, with none signing on for NHI. This newspaper understands that the prevailing mood among specialist physicians is to ‘wait it out’ and see what happens with the general election outcome, hoping for a change of government.

One doctor spoken to by Tribune Business last night questioned whether those doctors signing up to provide NHI primary care services had the necessary capacity at their facilities to deal with the likely patient volume.

They also questioned whether they would have the links to radiologists and x-ray imagers, laboratories, pharmacists and care managers, that are required for holistic care.

Dr Pierre agreed that “the quality of care is always a question”, but argued that these issues would always arise with a system of “socialised medicine” such as ObamaCare or NHI.

With the NHI scheme likely to increase patient volumes and populations, Dr Pierre said questions would arise over how much time doctors will be able to spend with individuals. Waiting times and queues for treatment, he added, were another concern.

With some 200,000 Bahamians said to lack private health insurance, the MAB chief reiterated that NHI’s $100 million primary care budget equated to $500 per person, per year.

This equates to less than $50 per person, per month, and Dr Pierre said: “You cannot get a good health insurance plan for a family for $300-$500 per month.”

He added that the main way to improve healthcare was through an expanding Bahamian economy, where jobs and rising incomes enabled people to better afford health insurance.

Without enough private doctors registering to provide services, a major goal of NHI - to take the pressure off the public healthcare system by sending patients to them - could be in jeopardy.

birdiestrachan 7 years, 1 month ago

The best doctors? who made them best."Money it is all about the money

ThisIsOurs 7 years, 1 month ago

Various international certification Boards. Extensive post graduate training, etc etc.

Islandgirl 7 years, 1 month ago

Are you paid enough for the garbage you spew on a daily basis? Let's take into consideration the attempted wholesale hijacking of these individuals' hard earned career; the hundreds of thousands of dollars that went in to their education, training and practice to now be absconded by this lousy government who wants to shove peanuts on them in return for their participating in an ill thought out scheme that actually puts people's lives on the line, and this is what you have to say? Are you the minister of labour, who referred to them as greedy doctors? The new wealthy man? I can't wait for the public disclosure of candidates' assets. Luckily I kept a copy of the 2012 version. I want to see how they line up, with public servants (and that is exactly what these MPs and cabinet ministers are) becoming incredibly wealthy in the span of five years and with the country in a deep depression. Special interest for the MP from West End and Bimini whose sole declared source of income was a $28,000.00 MP's salary prior to his party taking control of the government in 2012. getting back to your ill thought out comment, these are the best doctors. They have the training and experience and licensure to declare them so. Try this is with the accountants, lawyers, and numbers men. You are sickening.

DDK 7 years, 1 month ago

Finally something I can agree with you on!

Sickened 7 years, 1 month ago

Another PLP failure. If only they were successful in one thing they promised us. What a shame. We not only wasted the last five years of our lives waiting for something good to happen, but the damage created by this current administration has made it so difficult to recover in the future. To simply get back to our debt levels of 2012 may take us 5 to 10 years. It is not looking good people. Thankfully though I know one person who is very happy with where our country is now... Birdiestrachan. I can only assume that you have been on your death bed for 4 and half years and are just grateful to be alive each and every day. Good for you. Stay positive buddy! Life can't get much worse I guess.

The_Oracle 7 years, 1 month ago

I sure as hell don't want the Government involved in my health care, it is bad enough they're getting involved in every other aspect! Nor can I see subjecting myself to a board of political appointees who will have the power to approve or deny my treatment, or the level of treatment. There is no service or tangible good the Government supplies in a timely manner, or even have available half the time! (think license plates, document processing, court dates, current Medical care, prescriptions, Pig feed, livestock feeds, hell even payments for goods and services from the treasury!) Zero competence. Zero credibility. Zero effort to improve.

sheeprunner12 7 years, 1 month ago

Just fix up the clinics with resident GP doctor, dentist & internet accessiblity in the Family Islands ............. have three regional hospitals at GB, NP and Exuma ........... with national air emergency and catastrophic coverage for defined ailments with special buy-in incentives for those who drink, smoke, do drugs and are obese ........... and you have NHI-Bahamian style ........... Add 2% to NIB contribution as well and stop giving free healthcare to all these Unions ..............................The government cannot be all things to all people

ohdrap4 7 years, 1 month ago

that newspaper ad is risible. they want me to blackmail my doctor into joining.

if he joins, fine, i will continue to go there. if he does not, i will go both to him and to a nhi doctor for minor ailments. i can alos go to the private doctor for a second opinion.

health insurance, well i dropped it over ten years ago. had i not dropped, i would be paying 45% of my earnings to it and would be able to pay for living expenses, transportation expenses or food.

OMG 7 years, 1 month ago

You have to cry about the logic of the powers that be when a huge area of land in central Eleuthera was purchased reportedly from an ex Minister and cleared at great expense yet main local clinic cannot get regular supplies of basic medications or equipment such as arm slings. Many people here actually believe that a hospital will be built but never consider what services a proper hospital should offer, such as x ray equipment, operating theatre, and the required qualified staff. Given that the MOH got rid of our resident doctor and cannot find a permanent replacement willing to come ,one wonders how hard it will be to staff a mini-hospital ?

thomas 7 years, 1 month ago

Exactly....They have taken out the biggest line of credit against our country, pocketed the money and left us to repay the loan.

Well_mudda_take_sic 7 years, 1 month ago

What physician in their right mind would want to effectively become nothing more than a mistreated employee of Crooked Christie's corrupt PLP government or for that matter any government headed by the likes of the Dimwitted Doc Minnis ?!

sheeprunner12 7 years, 1 month ago

Well who is your choice for PM????? ......... Hint: the person has to be an MP

Well_mudda_take_sic 7 years, 1 month ago

What's the matter, or, should I say, does it really matter? It's a simple fact that neither Christie nor Minnis will provide you with safe green pasture where you can run your sheep.

sheeprunner12 7 years, 1 month ago

Long Island is FNM country ......... We are supporting Minnis for PM ....... If you have no practical option for PM in 2017 ....... Be Quiet!!!!!!!

It is either Perry or Minnis ............ and Perry is GONE!!!!!!!!!!!!

DDK 7 years, 1 month ago

Quit knocking the Doc unless you can do better. He does not appear dim-witted to me.

Porcupine 7 years, 1 month ago

The travesty is that good health care is so expensive for the average person. The insurance companies make out like bandits, for providing...............what? The hospitals are businesses. The doctors must recoup their huge personal investment in education and training. The whole system is pretty messed up, especially when any decent person can understand that good health care should be a right, not a privilege. NHI will solve nothing except another layer of money for the kleptocrat politicians to skim from. Our out island clinics are a disgrace. Period.

DDK 7 years, 1 month ago

Not to mention the extortionate cost of Big Pharma's drugs.

ohdrap4 7 years, 1 month ago

well the efforts to reduce the costs of health care are concentrated in the patients and doctors.

no one touches the insurance companies, hospitals and the drug companies.

this type of compensation is meant to attract the newbie doctors who will move on when they get established, this govt cannot possibly be serious to think they will attract all the specialists in town. there are so few of them that they can afford to say no.

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